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Ultrasound is a treatment option for some people diagnosed with prostate cancer. Ultrasound is a minimally invasive and precise procedure that involves aiming ultrasound waves directly at the prostate tumor, heating the tumor cells to a very high temperature in order to ablate (destroy) them. Ultrasound is most often a treatment option for patients whose prostate cancer is considered low- to intermediate-risk and is confined to the prostate. Two forms of ultrasound are described below.

High Intensity Focused Ultrasound

What is HIFU?

High Intensity Focused Ultrasound, or HIFU, is a treatment that obtained FDA approval in the United States in 2015. In HIFU, the normally harmless ultrasound waves are produced at a higher intensity and in a highly focused form.

How does HIFU work?

HIFU works by destroying tissue with rapid heat pulses that focus on the cancer that has not yet spread to other parts of the body. The procedure involves using a transrectal ultrasound probe to aim sound waves on the prostate tumor. The cancer cells are then heated to a very high temperature so they will die. The entire procedure takes about two hours and the patient needs to have a urinary catheter in place for about two weeks following the procedure.

Where can I learn more about HIFU?

Studies on this treatment’s effectiveness are limited. However, preliminary research shows survival rates are 90 percent at five years and 83 percent at eight years. You can watch two videos of patients who have undergone HIFU at this link. These two patients are not affiliated with ZERO – The End of Prostate Cancer, and their videos are not meant as an endorsement of this treatment. To search for a clinical trial using HIFU, visit the National Cancer Institute’s Clinical Trials section or the clinical trials database at www.clinicaltrials.gov.

TULSA Procedure

What is the TULSA Procedure?

The word TULSA stands for Transurethral Ultrasound Ablation. It is a minimally invasive procedure that uses directional ultrasound to produce very high temperatures to ablate (destroy or kill) targeted prostate tissue. The procedure is performed in a Magnetic Resonance Imaging (MRI) suite and uses the TULSA-PRO® system to ablate prostate tissue. The procedure combines real-time MRI with robotically-driven directional thermal ultrasound to deliver predictable, physician-prescribed ablation of whole-gland or partial prostate tissue.

How does the TULSA Procedure work?

A device is inserted into the urethra (transurethral), which delivers the ultrasound energy towards the prostate. This transurethral device also cools the urethra, protecting it from the thermal ultrasound energy. Likewise, a cooling device is inserted into the rectum, which protects the rectal tissue, helping to preserve the patient’s natural functions.

During treatment planning, the physician uses high-precision MR imaging to determine the areas of the prostate that will be ablated and draw out these boundary lines, while avoiding important nerve bundles and critical structures around the prostate.

During the procedure, the TULSA-PRO system automatically carries out the ablation instructions outlined by the physician, ablating only within the prescribed boundary lines using real-time thermal images. The transurethral device rotates within the urethra, creating a sweeping heating pattern that is directional. The prostate tissue is ablated using an ‘inside-out’ approach because the directional ultrasound energy comes from the urethra, which is located inside the prostate and travels outwards towards the edge of the targeted prostate region.  While the TULSA-PRO system is ablating the prostate, the physician uses high-precision MR imaging to monitor the tissue heating within the prostate and in the areas surrounding the prostate in real-time, making adjustments to the plan if necessary. This enables the TULSA Procedure to be very controlled and predictable.

The TULSA Procedure is performed in a single session under general anesthesia, which takes between 2-4 hours.

Whether a patient qualifies for the TULSA Procedure will be determined by the treating physician. In clinical trials, ideal candidates consisted of men with low and intermediate risk, organ-confined prostate cancer.

Where can I learn more about the TULSA Procedure?

To learn more about the TULSA Procedure, click here to visit the TULSA Procedure patient website.