Focal One HIFU machine used by Dr. Wei Phin Tan at NYU Langone, dual-screen workstation with ultrasound probe for prostate focal therapy Focal Therapy · NYC

HIFU Focal Therapy for Prostate Cancer

HIFU (high-intensity focused ultrasound) is a focal, organ-sparing therapy that uses focused ultrasound heat to ablate the cancerous region of the prostate, along with a safety margin, while preserving the rest of the gland when appropriate. It is an incisionless procedure performed under general anesthesia, delivered through a transrectal probe using real-time ultrasound, often with MRI/ultrasound fusion planning.

For appropriately selected patients, focal HIFU may reduce the risk of urinary, sexual, and bowel side effects compared with whole-gland treatment, although outcomes depend on tumor location, treatment extent, baseline function, and follow-up findings. Dr. Tan performs HIFU using the Focal One machine as an outpatient procedure in Manhattan, and discusses HIFU prostate cancer NYC, HIFU vs prostatectomy, HIFU vs radiation, and focal therapy candidacy in detail with each patient.

HIFU · Focal One Machine Outpatient · Same-day discharge Incisionless · Organ-sparing
“For the right patient, focal therapy can treat the cancer precisely while protecting the structures that matter most.”
- Dr. Wei Phin Tan, MD, MHS, FACS

Who Is a Candidate?

  • Low-risk or carefully selected intermediate-risk prostate cancer
  • A dominant MRI-visible lesion or region of disease that can be accurately targeted
  • Cancer biology that fits a targeted approach (confirmed by MRI and biopsy mapping)
  • Men prioritizing urinary and sexual function preservation

Key Benefits

  • Outpatient, same-day, home the day of the procedure
  • Organ-sparing, the prostate is preserved, not removed
  • Lower risk of urinary leakage and erectile dysfunction compared with many whole-gland treatments in appropriately selected patients
  • Future options remain open, repeat focal therapy, surgery, or radiation may remain available if additional treatment is needed

HIFU vs. Surgery vs. Radiation

HIFU FocalRobotic SurgeryRadiation
OutpatientYesSame-day typicalMultiple visits
Prostate preservedYesNoYes (anatomically)
Urinary side effectsLeakage uncommon; temporary urgency or weak stream possibleStress leakage early after surgery, usually improvesUrgency, frequency, and irritative symptoms during treatment; delayed urge symptoms possible
RepeatableOften, depending on anatomy and prior treatmentNoLimited
Same-day dischargeYesOftenN/A

Frequently Asked Questions

How long does HIFU focal therapy take?
Most procedures take 60–90 minutes. HIFU is typically performed as outpatient with same-day discharge.
What is recovery like?
Most men return to light activity within a few days. A urinary catheter is typically in place for 5 to 7 days. Compared with whole-gland treatments, HIFU is associated with a lower risk of urinary leakage and erectile dysfunction in appropriately selected patients.
Is HIFU covered by insurance?
HIFU is FDA-cleared for ablation of prostate tissue. Coverage varies by insurer and clinical scenario. Medicare and some commercial plans may cover HIFU for appropriate candidates, but benefits should be verified before scheduling.
What is the success rate?
Published series report favorable medium-term cancer control in carefully selected patients, but outcomes depend on risk group, tumor location, treatment extent, and whether repeat focal treatment is included. Because the prostate remains in place, ongoing PSA monitoring, MRI, and sometimes repeat biopsy are still needed.
Can I have HIFU after radiation?
Salvage focal therapy after radiation can be considered in carefully selected patients with biopsy-proven local recurrence, though it carries higher risk than primary focal therapy. Dr. Tan also offers salvage cryoablation, which he often prefers for radio-recurrent disease.

Selected Evidence (Dr. Tan's Published Work)

Dr. Tan is a contributing author on Focal Therapy Society best-practice guidance for primary whole-gland ablation, which covers HIFU and cryotherapy:

  • Deivasigamani S, Kotamarti S, Rastinehad AR, et al. (incl. Tan WP). Primary whole-gland ablation for localized prostate cancer: Focal Therapy Society best practice. European Urology. 2023. PMID 37419773
  • Tan WP. Re: Microwave focal therapy of prostate cancer. Current Urology. 2023. PMID 37448613
  • Tan WP, Rastinehad AR, Klotz L, et al. Focal therapy for patients discontinuing active surveillance, Delphi consensus. Urologic Oncology. 2021. PMID 33676851

Full publication list pulled live from PubMed on the Publications page.

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