post HIFU salvage RT

[SimMartin]

is there any research or discussion about the impact on the effectiveness and or difficulties of using RT to prostate after HIFU and subsequent recurrence localised to the prostate? Not just the rate if failure of HIFU but how this effects salvage treatment planning apart from the fact that brachy isn’t usually possible

[Magnus1964]

Try cryosurgery first. you can always go to Radiation if it fails.

[Tall_Allen]

I haven't seen any published data.

[groundhogy]

Why can’t you have brachy after Hifu?

[SimMartin in reply to groundhogy]

it seems that the scaring and necrosis where the HIFU has been mitigates against bracy. So I had to just do RT with 2 years of HT.

I am an unusual case as with two previous targeted biopsies and 3 MpMRI only showed one side G7 (3+4) and so went with HIFU when PSA rose to 7 but 6 months post HIFU was back to 6 so next biospy showed G9 (4+5) and both sides less than a year after the previous biopsy and only 6 months after MRI both saying on G7 and low to intermediate risk.

Told VERY unusual after previous MRIs and 2 biopsies had confirmed only G7. Showed that PCa is rather unpredictable I guess.

One of the reasons (a few actually) I chose to use HIFU was that I was told it doesn’t jump from G7 low risk to high risk U.K. a short time span. Obviously not so in my case.

The bracy boost therefore was not possible.

[groundhogy in reply to SimMartin]

”Showed that PCa is rather unpredictable I guess.”

Or possibly, the MRIs, 12 needle biopsies, and level of professional knowledge has a very high variability.

[RJAMSG]

sometimes it is best to go with devil you know as the saying goes 🙏🏻