Update..1 year post Cyberknife, 2 years post HIFU

[rf3rf3]

Just a quick update:

(brief reminder of my Hx: diagnosis at 50...PSA around 8 (2018). Opted for HIFU to try and preserve erectile function. After HIFU had erectile function but PSA dropped then rose..indicating failure. In 2019 had Cyberknife...PSA was 2.5 pre and 2.4 post...but now in July 2020, PSA down to 0.5.

My takeaways: HIFU may not be the best choice and may have shrunk my junk..and costs 25k cash /not covered. Give it a shot with someone who had done hundreds not tens. Cyberknife easy and works so far...worried about long term issues (peeing normally is over for me but there is some remaining erectile function so far_. Good luck in your choices and feel free to reach out

[Tall_Allen]

I agree. I'm not onboard with HIFU yet for these reasons:

prostatecancer.news/2016/12...

[Hidden in reply to Tall_Allen]

'Heat sink effect' is bogus. Area being ablated is one tiny blip of tissue at a time. Remember that unlike radiation we are talking 'focused'. I was told that the apparatus is able to monitor the temperature reached of this tiny spot during the ablation process. Real time feedback on precise location too. Focal ablation is bullshit anyway -- should be full gland ablation, in order to best attack any and all cancerous or precancerous tissue.

Hating on HIFU, without any personal experience with it, is doing the readers of this site who are trying to come to a treatment decision a disservice. I had HIFU surgery from a very experienced practitioner almost four years ago and I remain very happy with the results. Money well spent.

Here's an interesting news item regarding HIFU in AZ:

phoenixherald.com/news/2638...

Dr Koi is the urologist who performed my biopsy. I was surprised to learn that he has now added HIFU to his bag of tricks. HIFU seems to have met with his approval for him to adopt it.

[Tall_Allen in reply to Hidden]

Heat sink effect is basic physics. Liquids conduct heat. It's thermodynamics. That means that the spot you're heating up may not get enough heat for complete thermal ablation, and areas away from the point of heat are still getting some thermal ablation. This explains why there is incomplete ablation in the ablated areas, and why other areas get toxic amounts of heat.

I'm not "hating on it." I'm saying there are many unresolved issues that will only become apparent over time. I'm sorry that your doctor did not warn you about those issues. He should have.

Remember that the FDA did not approve HIFU to treat prostate cancer, but only to remove prostate tissue. The proliferation of unscrupulous doctors treating patients outside of clinical trials and charging thousands for an uncertain therapy is the real scandal.

[Hidden in reply to Tall_Allen]

I've already explained that the equipment provides feedback as to the temperature reached at the focus point. It's all focused at spots inside the prostate, unlike radiation treatments, so who cares if adjacent tissue is heated as well. Nothing uncertain about the treatment -- it ablates tissue inside the prostate where it is focused. I guess there's no use arguing with you -- you are the world's pre-eminent know-it-all when it comes to prostate cancer and its treatments as well as the evils of supplements.

[Tall_Allen in reply to Hidden]

How long is the temperature maintained at that spot, and how big is that spot? The bottom line is all the fancy equipment in the world doesn't matter if the clinical results aren't there, and so far, they are not.

"who cares if adjacent tissue is heated as well." Well, most of us do because thermal injury to healthy tissue causes damage. That's why the toxicity outcomes are not as good as theory leads one to expect. In fact, no better than radiation.

Perhaps you are hearing a common theme in my comments - only the clinical results matter, and so far they aren't all that good. As Jerry McGuire said, "show me the money!"