HIFU

[Medone]

Recently diagnosed 3+3 ( grade 1 ) . My Dr advised first TURP then HIFU treatment .

PSA 4.3 . volume of Prostate gland 57 cc .

Has anyone experience of HIFU treatment .

Please share your experience . AS also another option .

[pkafka]

Are you having urinary problems? Is that why they suggest a TURP? With such low PSA I would stick with AS if your doc is willing to work with you. HIFU is still quite new and there are not enough docs with experience in the US in my opinion. Remember, AS is a Treatment. It is not ignoring things, it is ACTIVE S..., Anything else might give you unpleasant side effects to deal with.

[Medone]

Thank you ,no serious urinary problems so far .

[Sisira]

May I please know your age? Is the advice coming from a Urologist? What is your cancer burden ( If you have done a needle biopsy, how many cores were positive )? Do you have any significant PCa related symptoms?

GS 3 + 3 generally warrants Active Surveillance before any aggressive treatment is considered.

I think it will be more prudent to seek the second opinion of a reputed oncologist specializing in treating PCa. I also concur with pkafka regarding the proposed treatment.

Sisira

[Medone in reply to Sisira]

Thank you for your reply , I am 65 , " Nature of Specimen , A -Left PZ mid , B-Left ant Pz .A- seven cores of tissues largest 14mm , B seven cores of tissues largest 12 mm .A -seven Benign prostatic cores with atrophy and focal intraluminal polymorphs. B -adenocarcinoma Gleason 3+3 in 1 of 7 cores less 1 mm ( less 10% ) .Elsewherethe cores shows focalintraluminal polymorph. 14 prostatic biopsies from 2 sites ,max tomour length less 1mm .neither perineurial nor lymphovascular is seen .

[Sisira in reply to Medone]

Hello Medone,

You are 65 yo and your pathology looks favourable with your cancer being low risk.

You are entitled to ask the question " Can my cancer be cured? " And then with the reply of a good Onco proceed with the most appropriate treatment to achieve that end. ( in this context I would consider for myself though the treatment may sound unduly aggressive - Robotic surgery to remove the cancer entirely whilst retaining both sex nerve bundles, which is quite possible by an expert surgeon in this field )

If you wish to follow the path of Active Surveillance, ask the question " How can I put my cancer into long term stable remission ( PSA undetectable and PCa symptom free ). Take the required less aggressive treatments whilst maintaining the quality of life to put your cancer into remission. Active Surveillance doesn't mean doing nothing.

If at all you want to get the benefits of the action of food and supplements, start now itself. Give up read meat and dairy products and also direct sugar intake. They promote cancer growth and metastasis. Start on a Mediterranean diet.There are good supplements like Green tea,Brocoli, Coliflower, Lycopene( cooked red tomato ), Pomegranate, Omega 3 fish oil, Soy ( May be few more but not everything some people take ) These will help to retard the growth and metastasis of PCa and also enhance your immunity as they come into your system on a daily basis without any side effects. Check your Vitamin D3 level and maintain the level between 60 - 80. Supplementing may need daily intake up to 4000 - 5000 iu . Have a regular exercise program and maintain your required healthy body weight. Do your regular blood check ups.

You have received good reply from wso Peddie worth paying attention to because he has undergone HIFU treatment. Get more details from him as to when he did it, his pathology, PSAs, and the current progress. On the surveillance side you have a good reply from S103462.

Finally, learn as much as possible by researching and reading on PCa. Be your own Advocate/Manager of your decease although you take treatment from doctors. I would like to recommend the following two books which you can order fro Amazon.com.

1. Dr.Patrick Walsh's Guide to Surviving Prostate Cancer ( You have A - Z everything and excellent book )

2. Beating Prostate Cancer : Hormonal Therapy & Diet by Dr.Charles "Snuffy" Myers ( Reputed Oncologist specializing in the treatment of PCa who himself is a PCa survivor )

Hope my inputs will help you to start a safe journey leading to a happy end!

You have my Best Wishes.

Sisira

[Medone in reply to Sisira]

Sisira , Thank you very much.

[Hidden]

No need for a TURP, unless your urethra is blocked. If your Uro actually did suggest it, I'd be looking for a new one. For one to need a TURP, one must have been radiated already. The radiation is what causes the walnut, to choke off the urethra. TURP is a messy way they cut pieces of the prostate away to open the urethra. If, by chance, you have to have this procedure in the future, don't!!! Look into having a Urolift done. No blood, non-invasive, and your back to peeing like a Russian Racehorse in no time.

Joe

[Hidden]

I had HIFU 'surgery'. TURP is routinely advised prior to HIFU, as the procedure causes tissue swelling that blocks things off. TURP helps in that regard. I had already had TURP 10 years prior, for an enlarged prostate. I believe that your prostate is too large for HIFU. My prostate shrank from 34 to 27 after a couple of months of eligard, which was a good thing. My Urologist/HIFU surgeon (Dr Lazar in San Franscisco) told me, if memory serves, that 40 is the upper limit for HIFU. I suggest that you talk to a HIFU surgeon and get his opinion 1st hand. I've had no quality of life side effects with HIFU, but had to pay out of pocket -- no Medicare or insurance coverage for it. My gleason score was 8 -- aggressive cancer, with a very palpable (DRE) tumor. PSA was only 2.7.

[Medone in reply to Hidden]

Thank you , may I know what age you did TRUP and What age HIFU ?

May I know what your Dr mean off '' 40 is the upper limit for HIFU '' .

[Hidden in reply to Medone]

Age 66 for HIFU. Age 55 for TURP. There are limits to how far the HIFU transmitter can penetrate or focus. Here's a link:

cancercompass.com/message-b...

I'll admit to being confused over prostate measurement units: cc or grams?

[Medone in reply to Hidden]

Thank you.

[S103462]

We've decided to stay w/active surveillance. As slow-progressing as PC usually is, in no hurry for radical treatment and all that goes along with that.

I'm 62y/o; diagnosed in May 2012; PSA had risen over many years to 4.1, then spiked (once) to 5.9. Had biopsy; T1C, Gleason 6(3+3); 2nd opinion confirmed results. Had bone/CT scan - negative for metastasis. We decided on active surveillance.

As someone else pointed out, this is really active. Started PSAs/DREs every quarter; PSA remained in the 4.x range; repeated biopsy in May 2014; Had biopsy sent for Oncotype DX testing; Results were: (1) Freedom from high grade disease: 74%; (2) Freedom non-organ-confined disease: 71%. Decided to remain in AS. Went to PSA/DREs every 6 months - remains in the 4.x range. Just had a biopsy in October 2016 - no change.

Will continue with the regimen until some number changes. Will also search out another (or different) DNA test, to justify (or not) whether AS continues to be a reasonable choice. Hoping that in the years to come, other treatments will be available to maintain good quality of life.

[Medone in reply to S103462]

Thank you ,very helpful info. Enjoy and log life .

[rococo in reply to S103462]

Thats not a bad proactive outlook. Some have even used some forms of horme therapy till better treattments became available.

[pjoshea13]

If I understand your situation correctly, active surveillance [AS] is the obvious choice, & I'd be wary of a doctor pushing anything else.

25-30% of men on AS do progress, & I would want to know as much as possible about my cancer up front to avoid unnecessary annual biopsies. There aren't many options, but the 4Kscore test would interest me:

4kscore.com

If the probability of aggressive cancer is very low, I'd be happy with AS & skip the annual biopsies if PSA is behaving.

If the risk is very high, I would get treatment.

4K is not covered by insurance in the U.S.

There may be other tests out there with sufficient sensitivity to make a decision.

-Patrick

[Medone in reply to pjoshea13]

thank you.

[habaeb]

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