HIFU: Wave of the Future?

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Dr. George Suarez, a Miami urologist, is unabashed in his enthusiasm for high-intensity focused ultrasound (HIFU), the use of ultrasound waves energy to destroy cancerous prostate cells.

But not all urologists share in his excitement, and many express skepticism whether the benefits outweigh the risks. Dr. Peter Scardino, a urologist and chair of the Department of Surgery at Memorial Sloan Kettering Cancer Center, is one of them. “When I look at the results of HIFU for prostate cancer—which has been used in Europe for the last 15 years—what I see is cancer control rates that are no better than radiation therapy of the past, and that’s not very good. And complication rates that are comparable to surgery,” he says. “It seems to me that it’s the worst of both worlds.”

The FDA partially agrees with Dr. Scardino’s assessment. In October 2015, after a decade of clinical trials and investigations, it approved the use of HIFU as part of a treatment regimen for prostate cancer—with a major caveat. The FDA panel noted that there was insufficient evidence to suggest that HIFU could serve as a cancer treatment; instead, they said it was capable of safely destroying prostate tissue. It’s a subtle but significant distinction, one that suggested the FDA was not confident in answering whether HIFU can effectively treat cancer.

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