The Quirónsalud Hospital in Barcelona applies focal therapy (HIFU) in the treatment of prostate cancer. It is indicated in patients from 70 years of age with low or moderate risk prostate cancer who wish to be treated or whose high surgical risk or patient comorbidities make more aggressive treatments not recommended.
High Intensity Focal Ultrasound Therapy (HIFU)
It allows to destroy the center of the tumor by the concentration of heat, thus preserving the prostate. Through the rectum and, guided by ultrasound, it is possible to reach very small therapeutic targets (up to 3 mm in diameter); greater precision than other focal therapies such as cryotherapy. In addition, preserving the prostate ensures that the functions of the gland – ejaculatory, urinary incontinence and erectile function – are not affected. The intervention lasts two hours and within 24 hours the patient can return home, which improves recovery after the postoperative period.
With the Focal One kit, supplied by Coupler Medical, MRI is used for diagnosis and ultrasound is used to guide biopsies; then the team merges this information during the treatment and at the end the result is validated by ultrasound contrast. The application procedure is done via a robotic system with real-time ultrasonic control and incisions are not necessary.
It is a minimally invasive therapeutic alternative
For patients with prostate cancer where the high surgical risk, advanced age or co-morbidities of the patient do not recommend more aggressive treatments. HIFU is also considered an option for patients with low grade prostate cancer who wish to maintain continence and erectile function.
Dr Miguel Ángel López Costea, specialist in urology and robotic urological surgery at Quirónsalud Hospital in Barcelona, assures us that “the removal of prostate tumors by Focal One ultrasound is an undeniable advance in the treatment of cancer prostate cancer at low risk in age groups who are not candidates for robotic surgery or who have a specific contraindication to it.Likewise, it is a valid alternative for patients included in surveillance programs or who reject surgery as a therapeutic option. “.
This ablative technique, developed 20 years ago, was already used in other diseases such as uterine fibrosis, or to relieve metastatic bone pain, and it has also been applied in breast, brain and breast cancer. pancreas. This is the first time that this technique (Focal One) has been applied for the treatment of prostate cancer in Catalonia and the third time in the rest of Spain.
A technique with a long history in the United States and Europe
In the United States, there were approximately 50,000 cases and in Europe approximately 40,000. The results which were carried out on this technique show that, 5 years after the treatment, between 61% and 95% of the patients are free of disease. ; and 7 to 8 years after treatment, the percentage is between 69 and 84% of patients. The functions of the prostate remain at a good level. For this reason, it is a technique which is proposed as an option to be taken into account in the treatment of prostate cancer in patients in whom the functional preservation of the organ is a priority.
The gradual increase in the expectation of the population makes us consider an increasing number of patients who, not so long ago, were excluded from any type of therapy as taxpayers for cancer treatment.
The growing demand for minimally invasive therapies, as well as the good results obtained on long series of patients treated with HIFU, suggest a good position of the technique in the treatment of prostate cancer in the years to come. For 10 years, the unit led by Dr López Costea has carried out treatments in selected cases using this technique, although the Focal One technology represents an undisputed advance in terms of precision and associated side effects.
First private center to use robotic surgery for prostate cancer
Quirónsalud Barcelona Hospital was the first private center to use robotic surgery in the treatment of prostate cancer in 2011. Currently, the center has the latest model of the Da Vinci Surgical System, the SI HD, a robot that combines the advantages of 3D and augmented vision of the surgical field with others such as the possibility of operating through a single and minimal incision (surgery of single port), or the possibility of carrying out a multispecialty robotic surgery, with different medical teams operating at the same time.
The removal of the prostate is the main application of the Da Vinci Surgical System, but this latest generation model is also used in other urological pathologies (bladder and kidney), abdominal, cardiac, thoracic, pediatric and gynecological surgery, otorhinolaryngology and, when the case, with an entire multidisciplinary medical team.
The Quirónsalud Barcelona Hospital has the Minimally Invasive and Robotic Urology Center (CUMIR), formed by Drs. Oscar Bielsa Galí and José Antonio Lorente Garín who focus on the diagnosis and treatment of prostate cancer and other pathologies; and by Dr. Miguel Ángel López Costea, surgeon specialized in Da Vinci robotic surgery. Quirónsalud Barcelona’s urology service is made up of a team with extensive experience in minimally invasive surgery, including endoscopic, laparoscopic and robotic surgery.
Hospital Quirónsalud Barcelona.