Campaigning for Informed Choice

HIFU (High-Intensity Focused Ultrasound), also known as focal therapy, is available within the NHS, but it is not routinely discussed or offered to men as part of the standard prostate cancer treatment conversation.

As a result, many men are never made aware that HIFU may be a suitable option for them (including myself, if it was not for my son's alternative research), based on their PSA levels, MRI findings, biopsy results, Gleason score, and overall diagnosis. Too often, HIFU is only considered if a patient already knows to ask about it.

Our campaign aims to change that.

Who HIFU Can Help

HIFU is suitable for some men with early-stage, localised prostate cancer, based on factors such as:

• PSA level and rate of change

• MRI scan results

• Biopsy findings

• Gleason score

• Overall diagnosis and cancer staging

At present, HIFU is not routinely offered on the NHS. In many cases, it is only discussed if a patient specifically asks about it—and only if they already know it exists.

Private clinics do offer HIFU, but at a cost of around £15,000, putting it beyond the reach of most men. That needs to change.

The Reality Men Face After Diagnosis

Following a prostate cancer diagnosis, men are typically presented with a set of standard treatment options:

• Surgery

• Radiotherapy

• Hormone therapy

• Brachytherapy (seed radiation)

• Active surveillance

Patients are often told to "go away and read about them," attend multiple consultations across different departments, absorb complex medical information, and then make a life-altering decision.

That is an enormous burden—especially when other potentially suitable treatments are not discussed.

Making an informed choice is difficult enough. Making one without full awareness of all options is unacceptable.

The Standard Treatment Pathway (In Brief)

Surgery (Radical Prostatectomy)
Radical prostatectomy involves removing the prostate and reconnecting the bladder to the urethra. Nerve-sparing techniques can be used to try to preserve erectile function.Common side effects: urinary incontinence and erectile dysfunction.

Source: NHS – Prostate cancer: Surgery

Radiotherapy (External Beam)
External beam radiotherapy targets the prostate but nearby tissues (bladder, rectum) can receive some radiation.Possible side effects include urinary issues (frequency, urgency), bowel problems (diarrhoea, bleeding), and sexual dysfunction.

Source: NHS – Prostate cancer: Radiotherapy

Hormone Therapy (ADT)
ADT reduces testosterone to slow prostate cancer growth. Side effects: hot flashes, reduced libido, fatigue, mood changes, reduced bone density, and metabolic changes. Frequently combined with radiotherapy for higher-risk cancers.

Source: NHS – Prostate cancer: Hormone therapy

Brachytherapy (Seed Radiation)
Low-dose-rate (LDR) brachytherapy involves implanting radioactive seeds in the prostate. High-dose-rate (HDR) brachytherapy is less common and done temporarily. Side effects: urinary irritation, frequency, bowel issues, erectile dysfunction. Radiation precautions: for LDR seeds, there may be slight radiation exposure to others initially; guidance varies depending on type of seeds and local protocols. Generally, patients are advised on safety with children and pregnant women for a short period.

Source: NHS – Prostate cancer: Brachytherapy

Active Surveillance
Active surveillance is used for low-risk, slow-growing cancers. Monitoring includes PSA tests, sometimes MRI, and periodic biopsies. Treatment is initiated only if there are signs of progression.

Source: NHS – Active surveillance for prostate cancer

The Human Impact

For many men, the greatest fears at this stage are not just cancer itself, but the life-changing side effects:

• Erectile dysfunction

• Urinary incontinence

• Bowel problems

• Loss of dignity

• Reduced self-esteem

• Loneliness and isolation

Many men withdraw from daily life, staying indoors for months, struggling in silence with issues that deeply affect identity, confidence, and relationships.

These realities must be part of the treatment conversation.

Why HIFU and Focal Therapy Matter

HIFU (High-Intensity Focused Ultrasound), also known as focal therapy, is an emerging treatment for early-stage, localized prostate cancer. Here's what makes it different:

1. Targets only the cancerous area

HIFU targets only the cancerous area of the prostate, leaving healthy tissue untouched wherever possible.
Focal therapy is designed to treat only the cancerous portion of the prostate rather than removing or irradiating the whole gland.
Goal: Minimize damage to surrounding healthy tissue and reduce side effects.
Source: NHS – Focal therapy for prostate cancer & Prostate Cancer UK

2. Fewer side effects

For eligible men with localised, early-stage disease, HIFU can offer significantly fewer side effects.
Studies show that HIFU has lower rates of urinary incontinence and erectile dysfunction compared to radical prostatectomy or whole-gland radiotherapy, particularly when the cancer is small and localized. Side effects still exist but are generally less severe.
Source: NHS Evidence – Focal therapy

3. Better preservation of continence and sexual function

Because HIFU treats only part of the prostate, the bladder and erectile nerves are often preserved, leading to better continence and sexual function outcomes than whole-gland treatments.
Source: Prostate Cancer UK – Focal therapy

4. Shorter recovery times

Focal therapy is minimally invasive, often done under spinal or general anesthesia, and patients are usually discharged the same day or within 24 hours.
Recovery time is typically much shorter than surgery or radiotherapy, with fewer lifestyle restrictions.
Source: Prostate Cancer UK – Focal therapy

5. Maintained dignity and quality of life

By minimizing side effects like incontinence and erectile dysfunction, HIFU helps men maintain a higher quality of life post-treatment compared to standard options.
Source: NICE guidance and multiple clinical studies comparing HIFU to radical prostatectomy or radiotherapy

Our Commitment

We are working to:

• Raise awareness of HIFU and focal therapy

• Ensure men are informed of all appropriate treatment options

• Advocate for fair NHS access based on clinical criteria, not financial means

Every man deserves the right to make a fully informed decision about his treatment—one that considers not only survival, but quality of life, dignity, and long-term wellbeing.