Issue 4: The Location of High-Intensity Focused Ultrasound Facilities in Canada for the Treatment of Prostate Cancer and Access to Treatment

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Context

High-intensity focused ultrasound (HIFU) is a non-invasive technology that destroys localized cancerous prostate tissue.1

HIFU is an alternative treatment to radical prostatectomy (surgical removal of part of or the entire prostate) and radiation in men with well, or moderately differentiated, tumours and a life expectancy of more than five years. Advantages include low complication rates, and the ability to repeat treatment or use additional interventions in the future. Used for either primary or salvage (recurrence) therapy, HIFU may be an option for those who are ineligible for prostatectomy.2

Objective

The purpose of this report is to provide information regarding the access to and location of HIFU facilities in Canada for the treatment of prostate cancer. The following questions will specifically be addressed:

  1. Where are HIFU centres located in Canada?
  2. Is HIFU, for the treatment of prostate cancer, publicly funded?

The information in this report that is not referenced is based on personal communications with HIFU manufacturers.

Findings

There are currently two commercially available technologies to perform HIFU for prostate cancer treatment approved by Health Canada: Ablatherm (EDAP TMS S.A., Vaulx-en-Velin, France) approved in April 2003, and Sonablate 500 (Focus Surgery Inc., Indianapolis, IN) approved in June 2005.2

HIFU for prostate cancer is not a publicly funded procedure. There are six private clinics offering this service in three Canadian provinces. Table 1 provides additional information on the location of these facilities and the system used.

Table 1: Location of Privately Funded HIFU Systems for the Treatment of Prostate Cancer (2009)

Canadian City, Province Sonablate 500 System Ablatherm System
Toronto, Ontario (two clinics) yes yes
Brampton, Ontario yes no
Niagara, Ontario yes no
Winnipeg, Manitoba yes no
Montreal, Quebec yes no

The procedure costs approximately C$22,000. 2

Knowledge Gaps

Results of this report are based on a limited literature search and communications with health care officials. As such, the comprehensiveness of this report cannot be guaranteed. This report is based on information gathered as of November 5, 2009 and may not reflect more current information.

Conclusion

There are six private clinics offering HIFU for the treatment of prostate cancer in three Canadian provinces: three in Ontario, one in Manitoba, and one in Quebec. This is not a publicly funded procedure in Canada.

References

  1. Rewcastle J. High intensity focused ultrasound for prostate cancer: A review of the Scientific Foundation, technology and clinical outcomes. Technol Cancer Res Treat. 2006;5(6). Available from: http://www.urotoday.com/images/pdf_files/hifu/7-rewcastle%20tcrt_dec_2006.pdf
  2. High-intensity focused ultrasound  for prostate caner. Health Tech Update. 2006;(4). Available from: http://www.cadth.ca/index.php/en/hta/reports-publications/health-technology-update/issue4/high-intensity