Less than two weeks ago, I witnessed my first HIFU prostate ablation case. Having only learned about this technology for nearly a month leading up to the event, I had few assumptions of what the procedure would consist of. I understood that the focused ultrasound device would “ablate” or destroy targeted tissue within the prostate gland. I could also quote that “the procedure was considered minimally-invasive and only required an incision if a catheter were to be placed within the patient.” What I did not know, however, was the effect HIFU can have on a patient’s life, and my own.
Around 11:30 AM on the procedure date, I left my workplace desk to change into gray scrubs embroidered with the “SonaCare Medical” logo that my boss had allowed me to borrow. In the past, I had always tucked the shirt of the scrubs into the pants. This time though, I was forced to roll the pants at the waist and leave my shirt untucked since my boss is quite taller than me. With a laugh, I rolled my eyes at my lifelong desire to be taller than six feet and returned to the office to leave with the team.
We arrived to the urologist’s office at noon, forty-five minutes before the procedure was set to begin. As I awaited the physician’s arrival, I spoke with one of our Case Support Managers, an individual who would instruct proper use of the Sonablate, and a Service Engineer who was undergoing on-site training. At one point, the patient’s spouse passed through the office to find refuge in the waiting room. Her face told the story of a woman who had experienced months of anxiety, worrying about her husband’s prostate diagnosis. I could not understand what she and her husband were going through, but I sympathized with the fear they must have faced. I was excited to finally see the device in action, to understand what we were doing for patients and their families.
At 12:50 PM, I walked into the operating room. My eyes were locked on the patient, a gentleman seemingly only sixty-years of age. He was younger than I had imagined, clearly much of his adult life left ahead of him. By this time, he had been placed under anesthesia, which is a requirement for HIFU ablation procedures. The physician, located at the foot of the patient’s bed, swiftly placed a catheter as the anesthesiologist monitored vitals by the head of the bed.
A nurse assisted the physician with positioning the device, then proceeded to dim the lights in the room. The physician turned on a computer located on the console, which powers the device itself. The screen showed a live ultrasound, allowing for the physician to quickly find the patient’s prostate gland and draw a figure around the associated lesions. The figure drawn would act as a guide for the ablation zone. In several minutes, a plan had been created for which prostate tissue would be destroyed, and which would be preserved.
With the click of several buttons, the Sonablate device began automatically ablating the targeted lesions. The physician, while seemingly relaxed, was also actively involved with monitoring the computer screen to confirm that every HIFU shot was thoughtful and deliberate. The procedure was truly customized to the patient. After the first of the three targeted zones was completed, utilizing ultrasound guidance, the doctor smoothly transitioned to the next ablation region.
During the second of the three ablation zones, the physician and I bonded over the university where he completed his residency, which is my soon-to-be alma mater. By the time we reached the third zone, the physician swiftly wrapped up the procedure. At 2:00 PM, the physician left to handle his next case and I returned to continue my day at my own worksite. The patient was wheeled into a recovery room to wake up from the anesthesia.
In one hour and ten minutes, I witnessed a man shed the diagnosis that had caused he and his wife pain that could be seen simply by reading the expressions on their faces. During my thirty-minute drive back to the office, the patient had likely woken up and received the news of his successful procedure. I do not know what he did that afternoon, but I am sure the he walked out of the office under his own power and celebrated in one form or another. The patient would likely have his catheter removed in less than two weeks, and be able to visit the restroom without having to change an adult diaper, a side-effect almost guaranteed when undergoing prostate radiation or a prostatectomy. The use of pills might be necessary for a short duration, but he will be able to avoid the embarrassment and frustration associated with erectile dysfunction. By choosing HIFU, this patient has the opportunity to continue experiencing all of life’s pleasures with the people he loves.
When I first began working for SonaCare Medical, I would tell others that I was simply interested in assisting in the advancement of patient care. I thought I knew exactly what I was doing, what lives I was serving to improve. Now, I work every day to spread the message of my experience in that operating room. I work to advocate for HIFU, what I see as the future of medical technologies. I devote my efforts to informing others that a reliable alternative prostate procedure exists, and that the use of archaic treatments with horrific side effects are no longer the only option for men worldwide. HIFU will continue to positively impact lives for decades, I just did not expect it to change mine so quickly.