Dr. Sachin Arakere Nataraj is a uro-oncologist, robotic surgeon and focal HIFU therapist. He has performed about 2,000 robotic surgeries since 2014. He sees patients in Noida, Delhi NCR and Bangalore.
This page explains focal HIFU (high-intensity focused ultrasound), a treatment for some men with prostate cancer that has not spread outside the prostate. It covers who may be suitable, what the procedure involves and how it compares with robotic surgery.
What is focal HIFU?
HIFU focuses ultrasound energy on a small area of the prostate. The energy heats that area and destroys the cancer tissue there. The ultrasound is delivered through a probe placed in the back passage, so no cut is made on the skin.
"Focal" means only the part of the prostate that contains significant cancer is treated, not the whole gland. The aim is to treat the cancer while leaving the nerves, urinary sphincter and healthy prostate tissue alone, because these control erections and bladder control.
Treatment is planned with an MRI scan of the prostate and targeted (fusion) biopsy results. These are combined with live ultrasound images during the procedure.
Who may be a candidate for focal HIFU?
Focal HIFU is not suitable for every man with prostate cancer. It may be considered when:
- The cancer is confined to the prostate (localised).
- The cancer is low or intermediate risk, usually Gleason 3+4 or selected 4+3 (Grade Group 2–3).
- The significant cancer is seen in one area on MRI and confirmed by targeted biopsy.
- The PSA level and prostate size are within suitable limits.
- The man wants to lower the risk of effects on urinary control and sexual function, and accepts regular follow-up.
Focal HIFU may also be considered for some men whose cancer comes back in one area after radiotherapy. This is called salvage HIFU.
To find out whether it suits you, Dr. Sachin reviews your PSA history, MRI, biopsy slides and general health. He then discusses all your options with you, including active surveillance, robotic prostatectomy and radiotherapy.
The procedure: what to expect
- Anaesthesia: usually spinal anaesthesia, so you are numb from the waist down. Sedation can be added if needed.
- Duration: usually 1–3 hours, depending on the size of the area treated.
- How it works: you lie on your side or back, and a probe is placed in the back passage. Your MRI and biopsy findings guide which zone is treated, and the treatment is monitored on ultrasound in real time.
- Catheter: a urinary catheter is usually placed for about a day.
- Hospital stay: often the same day or overnight.
Recovery after focal HIFU
- Most men return to light daily activities within a few days.
- For a few weeks you may notice burning when passing urine, needing to pass urine more often, or blood or debris in the urine.
- Avoid heavy lifting, cycling and straining for about 2–3 weeks.
- Follow-up: PSA tests every 3 months at first, an MRI at about 6–12 months, and a biopsy if your doctor advises one.
- If cancer remains or appears in another area later, the treatment can often be repeated, or surgery or radiotherapy can be used.
Focal HIFU compared with robotic prostatectomy
| Focal HIFU | Robotic radical prostatectomy | |
|---|---|---|
| What is treated | Only the cancer-bearing area | The whole prostate is removed |
| Incisions | None | Small keyhole incisions |
| Anaesthesia | Spinal (usually) | General |
| Hospital stay | Day care or overnight | Usually 1–3 days |
| Catheter | About 1 day | 5 days |
| Effect on urinary control and erections | Lower risk for most men | Higher risk; recovery varies |
| Full pathology report of whole gland | No | Yes |
| Follow-up | Regular PSA and MRI; may need re-treatment | PSA monitoring |
| Suitable for | Selected localised, one-area cancers | Wider range, incl. higher-risk and multi-area disease |
Dr. Sachin performs both focal HIFU and robotic prostatectomy. He can explain how each option fits your scan and biopsy results.
Frequently asked questions
Is focal HIFU a surgery? It is a procedure without incisions. Ultrasound energy is delivered through a probe in the back passage, usually under spinal anaesthesia.
Who is suitable for focal HIFU? Men with localised prostate cancer, usually Grade Group 2–3, where MRI and targeted biopsy show the significant cancer in one area. A specialist needs to review your reports in detail.
How long does the procedure take? Usually 1–3 hours. Many men go home the same day or the next day.
Will I need a catheter? Usually yes, for about a day.
What follow-up is needed after HIFU? PSA tests every 3 months at first, then an MRI and sometimes a biopsy. Regular follow-up is an essential part of focal therapy.
Can HIFU be repeated, or can I have surgery later? Yes. Focal HIFU can often be repeated, and robotic prostatectomy or radiotherapy remain options if they are needed later.
Can HIFU be used if cancer returns after radiotherapy? In selected cases, yes. Salvage HIFU may be considered when the recurrence is confined to one area of the prostate.
Where can I consult Dr. Sachin for focal HIFU? In Noida, Delhi NCR and Bangalore. Call +91 7676273920 for an appointment. Please bring your PSA reports, MRI and biopsy reports.
Book a consultation
Call +91 7676273920 to arrange a consultation in Noida, Delhi NCR and Bangalore. Please bring your PSA reports, MRI films or CD, and biopsy reports and slides.
Watch and read more about focal HIFU
YouTube
- An MDT case: deciding whether focal therapy suits a man with Grade Group 2 prostate cancer
- Focal salvage HIFU for prostate cancer that returns after radiotherapy