Let’s call this “new technology” what it is; it’s a form of HIFU


According to information in the Boston Herald earlier today, researchers at Brigham & Women’s Hospital in Boston (one of the main teaching hospitals associated with Harvard University) are testing a new form of technology to treat localized prostate cancer.

To be precise, according to the article in the Herald,

Researchers at Brigham and Women’s Hospital are testing a tumor-destroying technology they say could spare prostate cancer patients the sometimes devastating and life-altering consequences of standard treatments.

“We have patients who need to be treated, and the current treatment modalities have side effects,” said Dr. Adam Kibel, chief of urology at the hospital. “This could provide an avenue to cure patients, and at the same time maintain quality of life.”

The technique uses MRI imaging and ultrasound technology to guide a probe that focuses on cancerous material within the chestnut-size gland, killing the tumor with high heat, Kibel said.

If this sounds like high-intensity focused ultrasound (HIFU) to you, that’s what it sounds like to us too. And in fact, back in 2013, in an article in Oncology Advances, that’s exactly what the Dana-Farber Cancer Center and Brigham & Women’s Hospital said they would be testing! It seems to have taken them nearly 3 years to start to do it, however, and now they don’t want to seem to be quite so straightforward about what they are testing, which bears every indication of being a form of multiparametric MRI-guided, focal HIFU.

So what is going on here? We already know that multiparametric MRI-guided focal HIFU can be used to treat low-risk (and perhaps also some patients with favorable intermediate-risk) prostate cancer. Of course whether those are “patients who need to be treated” is debatable. They may wish to be treated, which is fine, but that’s not quite the same. We know that many such patients can just be monitored — for decades. This study actually appears to be part of a Phase I trial of the InSightec ExAblate HIFU technology which has now been available for years (but not for the treatment of localized prostate cancer). Indeed this particular trial was first started back in 2012 and is supposed to enroll just 40 patients at six of the nation’s major prostate cancer centers, so one wonders what the problem is.

For institutions like Harvard University and Brigham & Women’s Hospital to be implying that what they are doing is something excitingly new and innovative after hundreds of men have already been receiving treatments like this using other forms of HIFU in many places around the world seems rather sad to us. We know that high-quality HIFU (focal and whole-gland) can be used very effectively in some patients. We also know that it comes with risk for side effects, for disease recurrence, and for repeat treatments in some patients too.

According to the article in the Herald, this “trial” of the new technology will be open for another year. That’s fine. Let’s just call it what it is … an initial trial of multiparametric MRI-guided, focal HIFU using the InSightec ExAblate HIFU technology.  We still think people can’t have been trying very hard to enroll patients if it’s taken this long to enroll 40 of them at six centers like Brigham & Women’s and Memorial Sloan-Kettering Cancer Center and similar! Another comparable Phase I trial is being done outside the US and is supposed to be enrolling 80 patients by 2016.

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