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Urology is Ablatherm, which is a roboti- cally controlled system developed by the French company EDA P TMS. ADVANTAGES OF HIFU "The great advantage of HIFU is that you can do this very accurately," Dr. Gluck explains. "You can create a lesion which we know is exactly 1.7 millimeters in w idt h a nd 20 t o 2 4 m i l l i met ers i n length. We can then adjust as necessary and very carefully ablate the prostate tissue using that energ y. By ablating the tissue, we destroy the protein, and that a llows hea ling to occur." HIFU o•ers several advantages over surgica l treatment options, according to Ja mes Lin, MD, a boa rd-cer tified urologist and colleag ue of Dr. Gluck 's at Greater Boston Urolog y. " With surgery, we are changing the anatomy by taking the prostate out," he says. "It 's an invasive procedure and, therefore, has a higher risk of causing erectile dysfunction or incontinence. HIFU is a minimally invasive outpatient procedure. Instead of remov ing the prostate, we are using high-intensity foca l ultra sound to elevate the tem- perature to over 100 degrees Celsius to ablate the prostate. It kills the cancer cells and the prostate cells. We have an excellent chance of creating very small margins between treatment areas — hot and cold, so to speak — which translates into an excellent chance of preserving ner ves a nd the str uctures that con- trol urination." S i m i l a r l y, H I F U o f f e r s s u p e - r i o r o u t c o m e s t o t h e r a d i a t i o n therapies that have traditiona lly been the primary treatment a lternative for prostate cancer. "HIFU causes the tissue damage up front, and hea ling occurs afterwards," Dr. Gluck explains. " With radiation, the tissue damage occurs and continues for the rest of the patient's life, whether that is radiation cystisis, radiation proctisis, or fistula, or some other ma lady. "Another significant advantage with HIFU is that it can be repeated. And if a patient has a cancer that is loca lized to one side of the prostate or another, which is actua lly quite common, we c a n t r e a t on ly t he c a nc er ou s side a nd spa re the hea lthy side, therefore spa ring the patient 's continence a nd erectile function." IDEAL CANDIDATES According to Dr. Lin, a lmost a ll pros- tate ca ncer patients ca n be treated using HIFU. "There isn't an age limit on HIFU," he says, "but there is a prostate size limit. If a patient has a prostate that is larger than 40 grams, we can first reduce the size with a conventional transurethral resection of the prostate, or TURP. That helps to downsize prostate and open up the urethra to minimize issues with urination afterwards." Example of medical professionals treating a patient during a typical HIFU procedure M D N E W S . C O M /// M D N E W S S O U T H O F B O S T O N / R H O D E I S L A N D ■ 2 016 0 7