Active Surveillance or Treatment?

Hi Roger,

As Andy has said only you can decide whether to continue with AS or opt for treatment and if so which treatment option to have. In your position I would ask the consultant whether he/she felt that AS for a further period would be a good choice. Should this be the case you will defer possible side effects that any treatment can have. However, if the cancer does advance you would not wish to miss the opportunity of best chance of 'cure'. It is therefore important that you be carefully monitored.

I cannot say whether HIFU would be a good option for you now or in due course. Some parts of the Prostate are awkward to reach using this system but it is proving more successful if only one side needs treating. As with all types of treatment there are pros and cons to all treatments. In the UK HIFU has largely been used in trials and mostly as a salvage treatment for failed radiotherapy. Some men have had it as a primary treatment (especially if done privately) but it's still regarded as experimental as long term outcomes are not yet known. It is certainly worth enquiring about HIFU (as well as other alternatives) but you might have to travel further afield to find a specialist to discuss this with and a treating facility.

i

Sometimes the scan can be wrong - John was diagnosed with T1 tiny volume so small that it didn't even show up on the scan. When he had the op, they found that the cancer was extensive, throughout the gland and spread into his bladder. No one has ever been able to explain why the scan was clear.

if done properly, AS includes annual scan anyway, which would give some peace of mind. If you do decide to look at treating, brachytherapy may be worth looking at ... not as radical as RP or IMRT but less experimental than HIFU. Early data on HIFU suggests that it is a good salvage treatment but not always a reliable primary treatment.

Edited by member 10 Sep 2016 at 10:48  | Reason: Not specified

Andrew,

It is always advisable to carefully research a treatment option before having it, more so if it is new or relatively so compared to long established alternatives. This should be well beyond an article written in a newspaper although such an article can enlighten men about other possibilities to consider. It has more impact as a personal story and I see nothing wrong with this. As with any treatment one should never look on one outcome as applicable to all.

I was aware from my research and consultations leading to my having HIFU last year within a closely monitored study, that a 'fusion' technique was being developed by Professor M E (widely regarded as the top HIFU man in the UK) and others. He leads a team at UCLH and is associated with Nuada. Here is a video showing planning and use of the 'fusion' technique at Biopsy. Consultants are being trained by Professor M E and his team so that HIFU and advances in the procedure may be more widely available. :- https://www.youtube.com/watch?v=0P_ZimxDSso