I have just taken my Sonablate HIFU treatment on March 29, 2008. When I researched that various types of prostate procedures, my biggest concern was incontinence. The problem with radiation treatment was that it could damage so much of the surrounding tissue including the bladder and urinary sphincters and rectal wall and rectal sphincter as well. With Brachytherm one source stated that the patient should not be near children or pregnant women. If the radiation coming off the patient could create a problem for those persons than what could it also do to other organs within the man's body. I was talking to a member of a prostate cancer support group who has not had his treatment and his urologist after discussing various options commented that the beads in Brachytherm can move by getting into the blood stream. The urologist stated that he had a patient who had a couple of beads move through the blood stream from the prostate to the lung.
I had initially chose the Albatherm for my treatment but my prostate was too large, 72 cc, so I had to reduce it using hormone treatment, Androgen deprivation therapy using a Zoladex implant and Casodex pills and later Avadart. Needless to say the prostate did not get below the 40cc size needed for the Albatherm. I had stated to look at the Sonablate system which can treat prostates that are 50 cc, mine was at this time 43.5cc. I wasn't too sure about the Sonablate system as the write up gave me the impression that the doctor was moving the machine for each treatment and I could not see how a doctor could move the probe one to two millimeters. After a more detailed examination of the system I realized that the doctor only positioned the probe in the rectum then locked it down. The transducer, the component that emits the ultrasound, moved within a cylinder in the probe. The Albatherm had the probe move back and forth in the rectum for each plane of treatment.
Differences and similarities
Both machines include a motion detector and a rectal temperature monitor. Because the machine is taking such as small strip of tissue and heating it to 80 to 90 degrees Celius you cannot have any movement as that would cause the machine to hit the wrong target. The motion detector causes the machine to shut off thus protecting the wrong tissue from being destroyed.
Both machines have the probe covered by a condom that has degassed water pumped in to swell the condom to make a tight fit to the rectal wall. The water is cooled to keep the transducer and rectal wall cool. This avoids any heat damage that may occur to the rectal wall.
The Sonoblate machine has its transducer ( the sound emitting device) in a cylinder attached to the end of the probe. The transducer consists of two transducers one for deeper treatment and one for shallower treatment. The transducer moves within a cylinder at the end of the probe so the probe does not move once it is positioned. Both probes can be used to for treatment or imaging. The Sonablate machine takes images after each treatment shot so the doctor has a continuous upto date image of the prostate and any changes that occur during treatment. The prostate will swell with the first shot to increase in size about 10% at least that is what happened with my prostate. As pointed out the Sonablate has a doppler imaging system to give good color and identification of the nerve and vascular (blood vessel) bundles.
The Albatherm has one transducer at the end of the probe and it is fixed. The whole probe moves back and forth in the rectum during the treatment phase. The Albatherm can take only one picture at the beginning of the procedure as it requires a different transducer to take the image. That transducer must slide out into position while the treatment transducer is retracted. The imaging system can identify the nerve and vascular bundles.
The Sonablate procedure has the man lying on his back with his legs up in stirrups. You are under a spinal but can also be under a sedation to make you sleep. However, in the Sonablate procedure a patient can in fact not take the sedation and so be awake through the whole process. I was awake during my procedure.
The Albatherm procedure has the man lying on his right side on the Albatherm table and he has both the spinal and the sedation for the procedure. No option to be awake.
Both have good result with incontinence and erectile dysfunction. The Sonablate procedure has stats of 0.6% incontinence. The Albatherm stats shows a 5 to 6% with most of that type I or II incontinence which means the man will get a drop or two when he exerts himself in activities like lift a weight or swinging a golf club. Their stats show that a very small number may show a more serious type of incontinence but this is very rare. Remember that Albatherm has better stats data that Sonablate as the Albatherm has been monitoring for a long time and Sonablate systems have not. Erectile dysfunction is stated at 20% but I think this is too high as the updated technology has improved the systems and the use of Cialis after the catheter is out will help regain the erectile function. I know that Sonablate treatment includes Cialis but the Albatherm as far as I have seen does not.
The Albatherm frequently will have the patient undergo a TURP (transurethral resection of the Prostate) in order to reduce the size of the prostate and apparently this also eliminates the pain after the treatment. The Sonablate system does not use the TURP. The TURP can cause its own problems and there is a risk of damaging the sphincters that control urine flow even though this maybe a low risk.
The Sonablate machine takes a treatment strip that is 1 to 2 mm by 10 to 15 mm long while the Albatherm machine takes a strip that is 1 to 2 mm by 18 to 24mm long. The Sonablate system divides the prostate into 3 zones with each zone consisting of two blocks. The Albatherm does not appear to have zones but only blocks across the entire prostate. The Sonablate with its smaller strip length can get into tighter corners of the prostate.
I hope this will help you. If you check www.yanonow.net site you can see various people stories on all the treatments. Mine is there too under TV.