Prostate cancer treatment by high intensity focussed ultrasound (HIFU) at The Montefiore Hospital

If you’ve been diagnosed with prostate cancer your first concern will probably be about the treatment you should have.

High intensity focused ultrasound (HIFU) is a relatively non-invasive treatment for prostate cancer that is directed only at the cancerous cells and aims to leave healthy tissue unaffected. The risk of side effects from HIFU is usually lower than other treatments according to the NHS and it usually takes two to four hours.

The treatment can be carried out under general anaesthetic (which means you’ll be asleep) or a local one (you’ll be awake but not in pain). Often you can go home on the same day, although that may depend partly on which anaesthetic you have.

Your expert surgeon will insert a lubricated ultrasound probe into your rectum so they can see your prostate on a video screen. The surgeon will use then focus a high-intensity beam of ultrasound onto the cancerous tissue. The heat will destroy the cells.

If you decide to have your treatment with us, you will be looked after by an experienced multi-disciplinary care team.

Our patients are at the heart of what we do and we want you to be in control of your care. To us, that means you can choose the consultant you want to see, and when you want. They'll be with you every step of the way.

All of our consultants are of the highest calibre and benefit from working in our modern, well-equipped hospitals.

Our consultants have high standards to meet, often holding specialist NHS posts and delivering expertise in complex sub-specialty surgeries. Many of our consultants have international reputations for their research in their specialised field.

You will have a formal consultation with a healthcare professional. During this time you will be able to explain your medical history, symptoms and raise any concerns that you might have.

We will also discuss with you whether any further diagnostic tests, such as scans or blood tests, are needed. Any additional costs will be discussed before further tests are carried out.

We've tried to make your experience with us as easy and relaxed as possible.

For more information on visiting hours, our food, what to pack if you're staying with us, parking and all those other important practicalities, please visit our patient information pages.

Our dedicated team will also give you tailored advice to follow in the run up to your visit.

We understand that having any test or surgery can cause anxiety. Our experienced and caring medical staff will be there to reassure you throughout.

You and your consultant will discuss in your initial consultation whether a general or local anaesthetic is best for you.

Your surgeon will examine your prostate and bladder with a narrow telescope and if necessary enlarge the channel in the prostate to allow urine to flow more easily after HIFU prostate cancer treatment.

Once the anaesthetic has taken affect, you will be placed (or helped) onto your right side on the table and your surgeon will carefully pass a lubricated ultrasound probe into your rectum. The probe will feel uncomfortable, but should not be painful. An image of your prostate will be displayed on a video screen.

Your surgeon will use the probe to focus a high-intensity beam of ultrasound on to the prostate tissue with cancer, so that it heats and destroys it. The procedure usually takes about two to four hours to complete.

You will usually be able to go home once you have made a full recovery from the anaesthesia. However, you will need to arrange for someone to drive you home and then stay with you for the first 24 hours.

Pain relief and recovery time

After the treatment, your rectal area may feel tender but this should ease quickly. Please continue to take painkillers as directed by the hospital if you need them. You may also be given a course of antibiotics to take home.

You are likely to have scrotal swelling and this can affect your ability to pass urine. You may have a urethral catheter in place for three to 14 days to help drain urine from your bladder. You may also notice some blood in your urine for up to eight weeks. After the catheter is removed, you may feel the need to pass urine more frequently and urgently for up to six weeks. You may also feel a burning sensation on passing urine for up to eight weeks.

How your loved ones can help

At home it’s sensible to take it easy for the first few weeks. If you live alone you should ask a friend or relative to help with shopping and other chores.

Looking after you

Before you go home, your nurse will give you advice about caring for the catheter, hygiene and bathing. You will also be given a contact telephone number for the hospital, in case you need to ask for further advice. Your nurse will give you a date for your follow-up appointment. You will usually return three to ten days later to have your catheter removed.

As with all treatments for prostate cancer, you will unfortunately be infertile after treatment and will have little or no ejaculatory fluid.

As with all medical treatments complications can occur. The main complications specific to HIFU prostate treatment include the ones listed below.

• Urinary tract infection. The risk of infection is higher for the first few weeks. It’s important you complete your course of antibiotics to reduce the risk of infection.
• Stress incontinence (when urine leaks because you coughed, sneezed or made a sudden movement).
• Very rarely, the ureter or bladder can be damaged by the catheter. This can create scar tissue and you may need surgery to repair this.
• Erectile dysfunction (impotence). It's possible you may not be able to get or maintain an erection after treatment.
• A repeat treatment may be necessary if the cancer tissue is not completely destroyed or you have a recurrence.

You should contact the hospital immediately if you:

• feel unwell or have constant pain
• develop a high temperature or fever
• get an increase in the blood in your urine or your urine becomes smelly.

If you have any questions or concerns, we’re ready to help.

We are committed to delivering excellent individual care and customer service across our network of hospitals, clinics and specialist care centres around the UK. Our dedicated and highly trained team aim to achieve consistently excellent results. For us it's more than just treating patients, it's about looking after people.

Important to note

The treatment described on this page may be adapted to meet your individual needs, so it's important to follow your healthcare professional's advice and raise any questions that you may have with them.