Smart Choices in Prostate Cancer Treatment: A Comprehensive Look at Da Vinci Surgery and HIFU
Update Date：2025/08/05，
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By Dr. Chiang Pei-Chang, Department of Urology
Being diagnosed with prostate cancer can stir a whirlwind of emotions, but what matters most is actively understanding the treatment options available. For patients with early-stage prostate cancer, modern medicine offers two highly precise mainstream treatments:
Robot-Assisted Radical Prostatectomy (RARP) using the Da Vinci system and High-Intensity Focused Ultrasound (HIFU).
Rather than being a competition of superiority, these two approaches represent distinct treatment philosophies and paths. This article aims to provide a clear and comprehensive comparison to help you and your physician determine the best option for your personal situation.
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Da Vinci Surgery: The Gold Standard for Complete Cancer Removal
The Da Vinci system is one of the most advanced minimally invasive surgical tools available today. Its core philosophy is "complete eradication."
Through several tiny incisions in the abdomen, the surgeon operates robotic arms under a 3D magnified view to precisely remove the entire prostate gland.
The greatest advantage of this approach lies in its over two decades of clinical data supporting excellent cancer control, earning it global recognition as the gold standard. This gives patients a high level of reassurance.
Moreover, the precision of the robotic system helps preserve surrounding nerves responsible for urinary and erectile function, significantly lowering the risk of side effects compared to traditional surgery.
Therefore, for patients in good overall health, eligible for surgery, and prioritizing cancer cure above all, the Da Vinci surgery is a solid and dependable choice.
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HIFU: A Non-Invasive Option Focused on Quality of Life
Unlike the “removal” strategy of Da Vinci surgery, HIFU follows a non-invasive ablation approach.
A special rectal probe is used to focus high-intensity ultrasound waves directly on the cancer cells in the prostate. Like using a magnifying glass to focus sunlight and generate heat, the energy burns and destroys the cancerous tissue.
There are no external incisions and minimal bleeding, making HIFU particularly appealing for its minimal impact on daily life. Patients recover quickly, hospital stays are short, and because the pelvic floor structure remains untouched, the risk of urinary incontinence or erectile dysfunction is very low.
This makes HIFU especially suitable for older patients, those with multiple comorbidities, or those who prioritize functional preservation as their top treatment goal.
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Key Trade-Offs: How Do You Make the Best Choice for You?
Ultimately, the decision comes down to a balanced consideration of effectiveness, function, recovery, and cost.
• Cancer Control vs. Function Preservation:
Da Vinci surgery offers the most robust long-term cancer control data, while HIFU shines in preserving physical functions. This is the most fundamental trade-off between the two.
• Recovery Time and Physical Burden:
Da Vinci requires time to heal after minimally invasive surgery; HIFU, on the other hand, is virtually burden-free. The recovery speed and physical strain are clearly different.
• Cost and Insurance Coverage:
In Taiwan’s current medical system, National Health Insurance partially covers Da Vinci surgery, though some equipment and materials require out-of-pocket payment.
HIFU is currently fully self-paid, making it a larger financial commitment.
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Conclusion: Finding the Best Path Through Shared Decision-Making
No single treatment suits everyone. The best decisions are made through Shared Decision-Making—a collaborative process between doctor and patient.
Be sure to discuss your medical condition, your expectations for quality of life, your physical resilience, and your financial planning in detail with your urology care team.
Only then can you and your doctor chart a personalized treatment course that is not only sound and stable—but also one you can walk with clarity and confidence.