Thomas Vicars was 60-years-old when he was diagnosed with prostate cancer. His prostate-specific antigen (PSA), which had been monitored throughout his 50s, had been rising for several years. After it went up to a little over 16, a biopsy confirmed prostate cancer. Thomas began looking into treatment options and wanted to go with brachytherapy, but was turned down due to his diabetes. This left surgery as the only alternative; however, he felt this procedure would be too invasive because of his diabetes. Instead, he decided on treatment with high-intensity focused ultrasound (HIFU).
High-intensity focused ultrasound (HIFU) is a medical procedure that applies high-intensity focused ultrasound energy to locally heat and destroy diseased or damaged tissue through ablation. Thomas sought out further information and resources on the treatment from cancer groups in both the US and Canada.
The first HIFU treatment facility opened in Toronto in 2008, but the facility had no track record. The procedure was already available outside of the country, including Japan, Israel and Australia. Thomas had family connections in Japan, so he opted for treatment there. Priced at $10,000 US, it was far cheaper than the $22,000 price tag attached to the procedure in Toronto. Thomas did not encounter any difficulties in Japan with the language barrier – his doctor spoke fluent English, and Thomas also understood some basic Japanese, which was helpful.
During his first treatment in Japan, Thomas went to a clinic facility outside Tokyo near Mount Fuji on a Wednesday, underwent medical tests on Thursday and had the procedure performed on Friday morning. He went to dinner with the head of the clinic later that same day and was discharged the next day. He went from the facility to the airport and flew back to North America with a catheter inserted. Thomas had the catheter in for four weeks, and a few months later, he was back to normal. There were no complications after the first treatment, which left approximately six centimeters of the prostate in place.
After two years of stability, Thomas’s PSA began to rise again, and in 2012, he returned for a second treatment of HIFU. The Japan centre had now completed approximately 1,200 HIFU procedures, up from the 800 completed around the time of his first visit. At this point, very little of Thomas’ prostate remained, so neither surgery nor radiation was an option. He had been informed that some patients have to repeat the HIFU procedure, so he was prepared for this.
The second treatment was much more complex than the first, and his family was no longer with him in Japan. He entered hospital on a Sunday and was there for one week while they conducted medical tests and scans. The HIFU machine now had more elaborate imaging capabilities and, this time, his prostate was completely removed.
However, after returning to Canada, Thomas developed a urinary tract infection (UTI). It took him ten months to recover from the UTI, during which time he was on and off catheters. He was also in and out of emergency wards and clinics about 18 times before going into hospital for 5 days and being placed on an antibiotic IV drip to kill off the UTI.
Thomas now has a checkup with his urologist every six months to monitor his PSA and possible side effects. Living with Type 1 diabetes, he has always been careful with his diet.
HIFU is now available in several centres in Canada and around the world, but is not yet approved for use in the US. However, a number of American doctors will travel outside the US to centres that provide the HIFU procedure to US-based patients seeking this treatment option.
Vancouver, British Columbia