Non-Invasive Prostate Cancer Treatment

HIFU offers a cutting-edge treatment with low risk of side effects

SPONSORED CONTENT: New Non-Invasive Treatment Option for Prostate Cancer

Prostate cancer is very prevalent in the U.S. and approximately 1 in 8 men will be diagnosed with prostate cancer in their lifetime. The U.S. prostate cancer cases are expected to surpass the incidence of breast cancer in 2022. It is the most common, non-skin cancer, found in men and the American Cancer Society estimates 268,490 cases will be diagnosed in the U.S. this year alone.  Furthermore, African American men are nearly twice as likely to be diagnosed and die from prostate cancer compared to Caucasian men. Prostate cancer is highly curable when caught in the early stages before it has spread to other organs.

Prostate cancer is being diagnosed at much earlier stages due to a simple blood test called the PSA which is provided annually by a primary care physician. The key to successful treatment is early detection. When caught early, there are many treatment options for prostate cancer with high cure rates, but most of them, such as surgery and radiation, have high rates of erectile dysfunction and urinary incontinence.  An FDA-approved technique called High Intensity Focused Ultrasound, or HIFU, offers men the same cure rate as surgery and radiation with far fewer complications such as erectile dysfunction and urinary incontinence.

As one of the most advanced treatments for prostate cancer, HIFU is being offered at Associated Urologists of NC (AUNC) in Raleigh by six experienced physicians: Frank Tortora MD, Daniel Khera-McRackan MD, Mark Jalkut MD, William Kizer MD, Emil Kheterpal MD and Joseph Neighbors MD.  HIFU was approved for use in the U.S. in late 2015 by the FDA, but several of the AUNC physicians started treating their patients over 10 years ago outside of the U.S.  Fortunately, they have been providing this exceptional treatment in several locations in the Raleigh market since 2016.  “HIFU provides an effective prostate cancer treatment, which is comparable to surgery and radiation without the complications such as erectile dysfunction and incontinence commonly seen with other treatments,” commented Dr. Tortora. 

The outpatient HIFU treatment is bloodless and uses focused ultrasound to heat the prostate, similar to light being focused through a magnifying glass.  The two-to three-hour HIFU treatment is very appealing to many men as it allows them to return to their normal lifestyles within a couple days.  “HIFU is the only treatment that I can tailor to the patient’s individual needs, and I can appropriately contour the gland as well as detect and avoid the neurovascular bundles which control sexual function. This gives my patients a greater chance of preserved erectile function and prevention of urinary incontinence,” commented Dr. Jalkut.  “In addition to a higher quality of life, the downtime is minimal, and my patients enjoy returning to their active lifestyles and even golfing within a week,” continued Dr. Jalkut.

What is HIFU for Prostate Cancer?

HIFU is a one-time, non-invasive, outpatient procedure that uses ultrasound energy to heat and destroy cancerous tissue in the prostate. It is radiation-free and bloodless, and studies show that the risk of side effects, such as erectile dysfunction and urinary incontinence, are significantly lower with HIFU than with surgery (radical prostatectomy) or radiation.  “Although HIFU is relatively new in the U.S., the technology has been approved for use in Europe and Canada for nearly 20 years and is currently used in 50 countries worldwide for prostate cancer,” remarked Dr. Kheterpal.  

HIFU is delivered using a medical device called the Sonablate. The Sonablate probe contains transducers that emit ultrasound energy that provides an image of the prostate; it can also be focused to a central point, where the temperature is raised rapidly, causing cell destruction. This works in the same way that sunlight can be focused to burn a hole in a leaf. This does not cause any discomfort to the patient. 

The Sonablate system allows doctors to obtain a real-time image of the prostate and plan exactly where they want to deliver the HIFU energy, thus destroying the targeted tissue. The physician also receives immediate feedback to confirm the targeted prostatic tissue has been eliminated. The precision of HIFU system allows the physician to see the nerve bundles that control sexual function and to avoid harming these critical structures.

Unlike surgery, which requires the physician to remove the entire prostate, HIFU enables the patient to receive whole gland treatment, hemi-ablation, or a focal treatment.  If there is only cancer on one side of the prostate the physician and patient can determine if only the cancerous portion of the prostate is treated.  As breast cancer moved from mastectomy to lumpectomy, the same is occurring in prostate cancer as we have more advanced MRI imaging and diagnostic tools to evaluate the stage of the prostate cancer.  HIFU is often referred to as the lumpectomy for men. “I expect HIFU to become the treatment of choice for patients diagnosed with early-stage prostate cancer due to its low impact and high cure rates,” commented Dr. McRackan.

“After the HIFU treatment is completed, my patients recover from the anesthesia, get dressed and walk out of the surgery center, return home and are back to work in a few days.  It’s truly remarkable how short the recovery time is from HIFU.” 

—Dr. William Kizer

Recovery After HIFU

HIFU is an outpatient procedure that typically lasts 2 to 3 hours, depending on the size of the prostate. After a brief recovery from general anesthesia at the surgery center, patients return home to recover more comfortably and often return to their normal lifestyle after a few days.  Patients are routinely back to work in a couple days.  “After the HIFU treatment is completed, my patients recover from the anesthesia, get dressed and walk out of the surgery center, return home and are back to work in a few days.  It’s truly remarkable how short the recovery time is from HIFU,” Dr. Kizer explained.

Additionally, unlike with radiation and surgery, if for some reason there is a recurrence of prostate cancer, HIFU does not exclude patients from having any other treatments. This also means that, while not common, HIFU may be repeated if necessary. If a man chooses to have HIFU, he is not limiting himself to pursuing other treatment options down the road.

Who Qualifies for HIFU?

While only a physician can determine whether you qualify for HIFU, typically men with a prostate gland of less than 40 grams with localized prostate cancer (meaning the tumor has not spread outside of the prostate gland) may be candidates for HIFU. The other information that physicians usually look at to determine if you qualify for HIFU is a PSA of 20 or less and a Gleason score of 7 or less. 

Anyone interested in HIFU for localized prostate cancer should speak with a doctor about his specific diagnosis and whether it would be a good treatment option in his case.

Associated Urologists of NC

In addition to being one of the early adopters of the HIFU treatment, AUNC is home to some of the most progressive and experienced urologists in the country. They utilize revolutionary technology and techniques to provide incredible outcomes, providing compassionate and personalized care to maximize quality of life and minimize side effects. To set-up an office visit, find our locations, or to learn more, please visit us at


3821 Ed Dr.

Wake Forest
1904 South Main Street 

160 MacGregor Pines Dr.

110 Kildaire Park Dr.

95 Springbrook Avenue

Holly Springs
781 Avent Ferry Rd.

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About the Author

Angela Brown
Angela Brown is the author of our Business & Economy section.