High intensity focused ultrasound (HIFU)

High intensity focused ultrasound (HIFU) is a cancer treatment. It aims to kill cancer cells with high frequency sound waves. HIFU doesn't pass through solid bone or air, so it's not suitable for every cancer.

You might have HIFU as part of a clinical trial for prostate cancer. Researchers are also looking at HIFU for some other types of cancer. 

Doctors also use HIFU to treat some non cancerous (benign) conditions such as benign growths (fibroids) in the womb.

What is high intensity focused ultrasound (HIFU)?

HIFU is a cancer treatment that uses high-frequency sound waves. You have HIFU from a machine. The machine gives off the sound waves which deliver a strong beam to a specific part of a cancer. This heats and destroys the cancer cells. 

Who can have HIFU?

HIFU can treat a single tumour or part of a large tumour.

Researchers are looking at HIFU as a treatment for different cancer types. Most of the research so far has been for prostate cancer. But you might also have it as part of a clinical trial for:

• rectal cancer
• cervical cancer
• vaginal cancer
• womb cancer
• soft tissue sarcoma
• pancreatic cancer
• breast cancer

Researchers around the world have also looked at HIFU as a treatment for other cancers including kidney cancer and liver cancer.

Researchers also want to know if HIFU helps people with advanced cancer. They want to find out if it helps with symptoms such as pain. 

You might have HIFU if you cannot have some treatments for your cancer or if your cancer has come back in one place. You might also have HIFU together with another treatment for your cancer. 

You can have have HIFU again if your cancer grows back. Or your doctor might suggest another treatment.

HIFU for prostate cancer

Research has shown that HIFU for prostate cancer is safe. But we still need more research about whether it is as good as other treatments in the longer term.

The National Institute for Health and Care Excellence (NICE) has issued guidelines for the treatment of prostate cancer. These guidelines say that men should have HIFU for prostate cancer as part of a clinical trial or in a specialist centre. 

You might be offered HIFU instead of surgery or radiotherapy for localised prostate cancer.

Doctors have used it for cancer that has just been diagnosed, or for cancer that has come back in the prostate after earlier treatment. This is known as salvage treatment.  

HIFU for non cancerous conditions

Doctors can also use HIFU to treat:

• non cancerous growths in the womb (uterine fibroids)
• non cancerous growths on the breast (fibroadenomas)
• glaucoma

How you have HIFU

The doctor uses a small device called an ultrasound probe. This probe gives out high intensity ultrasound that can destroy the cancer cells. The doctor places the ultrasound probe close to the cancer. 

There are different ways to have HIFU. How you have it depends on where the cancer is in your body.

You might have HIFU through your:

• back passage (rectum) to treat cancers in your pelvis
• skin to treat cancers in your tummy (abdomen)

Your doctor or specialist nurse will talk to you beforehand. They will tell you how you will have treatment and exactly what it involves.

Before you have HIFU

You have treatment at the hospital. You might be able to go home on the same day, although some people stay in hospital overnight.  

For prostate cancer, you have HIFU in the operating theatre. For other types of cancer, you usually have the treatment in the radiology department. 

You might have an MRI scan before treatment. This is to find the exact position of the cancer.

You usually have general anaesthetic which means you are asleep during the treatment. Or for some cancers or conditions you might have a spinal anaesthetic (epidural) or sedation which makes you sleepy. 

Having HIFU through your back passage (rectum)

You have HIFU through your back passage (rectum) to treat cancers in your pelvis. These include prostate cancer, rectal cancer, vaginal cancer, cervical cancer or womb cancer.

The doctor puts the ultrasound probe into your rectum. This probe gives out high intensity ultrasound that can destroy the cancer cells. The high intensity ultrasound travels through the back passage to the cancer. 

The doctor usually puts a catheter through the tube which carries urine from your bladder to the outside of your body (urethra). This is to drain your urine into a bag. You might need to keep the catheter for up to a week.

Having HIFU through your skin (extracorporeal HIFU)

You might have HIFU through your skin. Doctors also call this extracorporeal HIFU. The doctor doesn’t need to cut your skin.  The HIFU machine remains outside your body and the high intensity ultrasound travels through your skin to the cancer.

You have this type of HIFU to treat cancers in your tummy (abdomen). These include kidney cancers, liver cancers, pancreatic cancers or sarcomas.  You can also have this to treat non cancerous growths (fibroids) in your womb.

You have treatment on a special HIFU table. There is usually a water bath within the table. There is a disc at the bottom of the water bath. This disc sends out the focused ultrasound waves. Ultrasound waves don't travel well through air so doctors use water. This also helps reduce damage to the skin.

You lie on the table. The position you lie in depends on which part of your body is being treated.  You might lie on your back, your front or your side. The body part being treated goes into the water in the bath. So for example, to treat fibroids in your womb, you lie on your front. Your  pelvis and lower abdomen go into the water bath.

The disc sends out the focused ultrasound waves. These travel through the water and go through your skin to treat the cancer or fibroids.

Side effects of HIFU

The possible side effects depend on the area of your body that you're having treatment to.  

Before you agree to treatment your doctor will talk to you about the possible risks. 

If you are having HIFU as part of a clinical trial, the doctors might not know about all the side effects.

Side effects of HIFU treatment through your back passage (rectum)

The most serious side effect might be a hole in your rectum. This is because the HIFU treatment could damage the wall of your rectum.

Side effects of HIFU for prostate cancer include:

• bleeding
• pain
• infection

You might also have flu symptoms.

Side effects of HIFU through your skin

HIFU through the skin can cause a burn to the skin in the treatment area. You might also have some mild pain or discomfort in the treatment area. There is a very small risk of damaging normal tissues, such as the bowel or bladder if they are in the treatment area.