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Prostate Cancer

New Wave Therapy

Tuesday, April 19, 2005; Page HE03

A nonsurgical ultrasound treatment for prostate cancer has debuted north of the U.S. border. The approach, known as high-intensity focused ultrasound or HIFU, delivers ultrasound waves from a probe inserted into the rectum, heating and killing prostate tissue, according to urologic oncologist John Warner, medical director of Maple Leaf HIFU Co. (www.hifu.com), a Canadian medical-device importer and operator. The treatment, in use in Europe and Asia, is not approved in the United States.

Each year, nearly a quarter of a million American men discover they have prostate cancer, the most commonly diagnosed male malignancy, according to the American Cancer Society; about 30,000 die. For tumors that haven't yet spread, options include surgery and radiation therapy. Both have high rates of side effects such as erectile dysfunction and urinary incontinence. If either treatment fails, a man's prospects for secondary therapy aren't good.

No promises Warner said studies in Europe and Asia suggest HIFU is as effective as surgery and radiation therapy, and causes fewer side effects, particularly in patients who've had cancer recur after radiation. At New York's Memorial Sloan-Kettering Cancer Center, urologist Peter Scardino said the approach had promise. But, he said, one U.S. study of the method was called short several years ago, and it's "very much uncertain" how successful the therapy is using the current generation of devices. Guidelines issued last month by British medical experts describe HIFU as reasonably safe and effective, but state that it's uncertain whether the technique saves lives.

Dollars and cents The Toronto clinic offering the procedure will consider treating U.S. patients with cancer confined to the prostate gland -- if they pay about $23,000 plus travel expenses (hotel is included). Some U.S. doctors are also performing HIFU at similar cost in Mexico and the Dominican Republic.

-- Ben Harder

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