Friday, October 27, 2006

Trip to Lyon, France, HIFU for Prostate Cancer

This thursday I took a plane to Lyon, to visit Dr. Murat and Dr. Gelet, both world experts in the treatment of localised prostate cancer with HIFU (High Intensity Focused Ultrasound). I went to theatre to witness two HIFU cases, one for a primary prostate cancer (recently diagnosed), and the second one was a patient who was treated with radiotherapy and this treatment failed, and recurred to HIFU as a salvage treatment.
Next tuesday we will perform our first case in Madrid, we will have the first permanent HIFU device installed in Spain and we will offer this treatment option to our patients, and the possibility of getting trained to those urologists who want to learn. It is an impressive technology, that allows prostate cancer to be treated with minimal discomfort and with a lower risk of complications or secuelae.

This video shows how the technique is performed.


antani said...

Hi Dr Gomez Sancha.
I'm writing from Italy and I found your webpage after googling for "HIFU treatment".
I'm interested in that treatment for my father. He's almost 80 years old and about ten years ago his prostate was removed due a cancer.
In this 10 years he has been fine checking regularly his PSA level. Last year due a growing level of PSA (if i'm not wrong) he was treated with radiotherapy like the second patient you wrote about.
I googled a bit and I found this treatment in them seems that Dr Murat and Dr Gelet are leaders.
Can you tell me how is going with your 2md patient?
Can I contact you through email for some other answers?
Sorry for the bothering but, as you can understand, is really important to us.
I appreciate,

Dr. Fernando Gómez Sancha said...


I am not sure your father can benefit from HIFU after radiotherapy several years after a radical prostatectomy. He will probably be a better candidate to use hormonal treatment due to his age. I would need more details about his case. What is his current PSA?


antani said...

Many thanks for the answer.
So the whole story is as follows: 1994 the PSA value was 13,1 and a biopsy (I don't know how to spell that) highlighted a cancer. They did a radical

prostatectomy. After one month the PSA was 0,50; one month after, 0,20. The value was stable for 3 years. In Juny 95 an ecography showed an "area ipoecogina"

(in italian, hope that in spanish could be similar) sized 10-15mm.
In 1998 the PSA decreased to 0,10 and after that began to increase reaching in 2005 4,44.
For 4 months (April September 2006) my father has been submitted to hormonal treatment with Casodex 50mg; between July and September 2006 he has been

sbimitted also to a radiotherapy with 37 applications "ov 66,6 GY" (no idea what does it mean) and on 10.03.07 the PSA was 0,01.
On 31.05.07 PSA was 0,03 and 27.11.07 was 0,15.

Dr. Fernando Gómez Sancha said...

Dear Francesco,

Your father has already been subjected to surgery and radiotherapy. Although he has three consecutive rises of PSA after radiotherapy, he stil has a good prognosis.
I do not think HIFU would add anything to his situation, unless a residual prostatic mass was palpable transrectally and a biopsy confirmed that this is actually prostate cancer.
He might benefit more from hormonal treatment. Please discuss this with your urologist and do not hesitate to contact me if I can be of help.


Fernando Gómez Sancha

antani said...

Dr. Gomez Sancha,
there is a part that I omitted to write you because I'm not able to translate it.
But you write about "unless a residual prostatic mass was palpable transrectally and a biopsy confirmed that this is actually prostate cancer", so maybe this part can play a role.
In italian is "l'ecografia transrettale del 07 giugno 2007 evidenzia (highlights) un zona disomogenea (non omogenea) di echi addensati, fibrotica con esiti ("something like results") cicatriziali di terapia attinica con scarsissima (very low) vascolarizzazione (there is very log flow of blood in this part) all'osservazione doppler. Non si rilevano altre tumefazioni pelviche ecograficamente evidenti (There is no other tumefazioni in pelvis area viewable with an ecography).
Do you think that this last part can be somehow useful to your judgement? Is your last suggestion still valid?
Thank you and I'd hope that every doctor I know could be so available to questions (oh God, even by internet! :) .

Dr. Fernando Gómez Sancha said...

If there is something visible with ultrasound, that can be palpated it could be biopsied... I think it is unlikely that this would be amenable to treatment with HIFU...

Best of lucks,


antani said...

Thank you for all the answers you just gave me.
I appreciate.
I wish you and your family a merry christmas (and hope a warmer christmas than here in italy these days :)