Prostate cancer patients offer their thoughts on the innovative HIFU treatment

When I was researching my new article on high-intensity focused ultrasound, or HIFU, one patient complaint kept propping up: there’s not enough information out there on this prostate cancer treatment or its side effects. A couple of patients I spoke to from the United States -- where the treatment is still unavailable (it's approved in Canada and Europe) -- struck out on their own in search of info and decided to go for the treatment, with mixed results. Here are their stories:

A prostatectomy? That's barbaric!
Chicago businessman Peter Wenz got diagnosed with prostate cancer a year ago. “Someone from an online support group suggested I get a colour flow Doppler test done and in the process, the urologist found a second tumour at the apex of my prostate,” he says.

The tricky location of the second tumour limited Mr Wenz’s treatment options to radiation and androgen deprivation -- which, according to new research, actually makes the cancer spread -- until he brought up HIFU. His urologist encouraged him to pursue the option, and shortly afterwards Mr Wenz jetted to Germany for the treatment.

The procedure was a success and a test showed that his PSA levels were undetectable -- the cancer was zapped. Although he did develop urethral strictures, he chalks those up to the transurethral resection of the prostate (a procedure that was done along with the HIFU in order to speed up the recovery). Three months and a few dilation treatments later, Mr Wenz is doing well -- erectile function is normal and urinary function is getting there. He is on his way to a complete recovery and has become a big HIFU advocate.

“Compared to all other modalities, only HIFU and cryotherapy specifically target the cancer cells, you just go in and only destroy that area,” he says. In fact, he believes those minimally invasive procedures will change the way prostate cancer is treated in the future. “The day will come when radical prostatectomies will be looked at the way we look at lobotomies. It’s barbaric -- it completely destroys the quality of life!”

Not sold on it
Sixty-nine-year-old Fred Gillick was diagnosed with prostate cancer nearly 12 years ago. He was initially treated with external beam radiation and seed implants, but four years later, cancer reared its ugly head again. His doctor told him there was nothing more to be done, but Mr Gillick had heard about HIFU through a cancer support site. So he went for it. Unfortunately, the previous radiation treatment had left its mark on him and the salvage procedure just made matters worse. He is now impotent, in constant pain and wearing a permanent catheter. And his cancer is still there. “There’s very little hope,” Mr Gillick told me in a phone interview.

Strictures of hope
Firefighter and paramedic Eric Sondeen is one of those patients who chose HIFU. The Boulder, Colorado resident got the call a year ago, on Christmas Eve. His PSA levels were through the roof — he had prostate cancer. His urologist suggested HIFU, so Mr Sondeen did what most patients do these days: he went online.

"I did a lot of research and it looked like the best option," he recalls.

Since the treatment is not yet approved in the US, though clinical trials are underway, Mr Sondeen joined the ranks of medical tourists and headed to the Dominican Republic — with his urologist. All was well in the beginning, the cancer was flushed out and everything was in working order.

But at month four, trouble struck. Mr Sondeen developed urethral strictures — scar tissue was clogging up his urethra, making urinating difficult and downright painful. It's got to the point that he now has to self-catheterize on a regular basis to empty his bladder.

He now says he wishes he'd weighed his options a little more carefully — and not believed the hype. "The incidence of urethral strictures is actually closer to 20% according to one study," he says, "rather than the 2% presented to me and my doctor."

Mr Sondeen is now looking into repair treatments. But, despite his difficulties, he remains optimistic about the future of HIFU. "I think I was among the percentage of people to take a bullet for this so we could all learn about it," he says. "I wouldn't want to throw the technology out with the bathwater."

JUST THE FACTS
For more information on HIFU, visit Dr Ian Brown’s Niagara HIFU clinic website and Dr William Oravan’s Maple Leaf HIFU clinic. Both offer detailed information on the procedure and who is most likely to benefit from it.

Another great site is Australian Terry Herbert’s prostate cancer support site. It offers sufferers a forum to discuss their experiences with various treatments on an ongoing basis. Patients exploring their options can look up the treatments and see the longterm prospects of each. It’s all there: the good, the bad and the ugly.


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