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User
Posted 25 Nov 2017 at 18:02
Just been diagnosed with prostrate cancer on 23/11/17 stage 2 (thank god) with a Gleason score of 3+4 =7 , also T stage T2 and have now been asked what treatment I want , I’m 59 years old and quite fit , I was wandering if anyone out there has had high-intensity focused ultrasound treatment as I seem to edging towards this as it seem less dramatic than radical prostatectomy any info would be much appreciated
User
Posted 25 Nov 2017 at 19:34

Welcome to the site Mick.

I'm sure you'll get replies as I'm sure somebody else has had HIFU

If you go to Publications on this site, you can view/download information on various PC treatments and there is probably something on there about HIFU

We can't control the winds - but we can adjust our sails
User
Posted 25 Nov 2017 at 23:43

Welcome Mick,

Have you ruled out External Beam Radiotherapy as an alternative to RP ?

I had similar grade and stage and had 20 RT sessions and 2x3months Zoladex earlier this year, PSA down from 9.6 to 0.02.

Worst thing with RT is the travelling to and from. I had a few of the usual side effects with the hormone therapy, but small price to pay.

The Urologist recommended the RT for me even though he would have been the surgeon who carried out the RP if I went down that route.

Best wishes which ever route you take. G

User
Posted 26 Nov 2017 at 01:46

I had External Beam RT back in 2008 and salvage HIFU in 2015. This is not to suggest RT isn't a good option for long term success . The success of RT as with any treatment has more to do with how well the cancer is contained and how well the treatment is carried out as well as the type of cancer the individual patient has, some tumours being more radio resistant for example.


Much is known about External Beam RT which is often given in conjunction with HT. Low and High Dose RT although newer seems to be becoming increasingly preferred by suitable candidates. You will doubtless be aware that EBRT is usually given in a standard 37 fractions or 20 fractions of a higher dose. The two forms of brachytherapy involve an operation for radioactive seeds to be implanted or for radioactive probes to be inserted and removed at the end of an operation.


HIFU is still regarded as experimental because long term effects are not yet know. It has more usually been given in the NHS as salvage treatment for failed RT within a trial, although in some cases it has been given privately as a primary treatment. The widely recognized top man in the UK is on record as saying results are better where only one side of the Prostate is affected. The operation is carried out under anesthesia, and my experience was that I could walk about London a couple of hours after coming round post op. In fact it was easier walking/standing than sitting. It took two or three further days for the swelling to reach it's peak and then another three or so to gradually subside. Comfort improved considerably when the catheter was taken out a week post op. I can't say whether the HIFU was a complete success because subsequent scans show there is a suspicious area within my Prostate and an Iliac node and I may well have a further more advanced scan to ascertain this.


Incidentally, a full template transperineal biopsy was done prior to the HIFU which is normal and usually done under anesthesia. Also, you would have to check you are a suitable candidate for HIFU because there are several reasons why a man might not be.


Just as a general comment, I am struck by the number of members who have joined us saying they were keen bikers, (push or motor) and runners.  I wonder whether there is a higher incidence of PCa among men who engage in these activities.


 

Edited by member 26 Nov 2017 at 13:35  | Reason: Not specified

Barry
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User
Posted 25 Nov 2017 at 19:34

Welcome to the site Mick.

I'm sure you'll get replies as I'm sure somebody else has had HIFU

If you go to Publications on this site, you can view/download information on various PC treatments and there is probably something on there about HIFU

We can't control the winds - but we can adjust our sails
User
Posted 25 Nov 2017 at 23:43

Welcome Mick,

Have you ruled out External Beam Radiotherapy as an alternative to RP ?

I had similar grade and stage and had 20 RT sessions and 2x3months Zoladex earlier this year, PSA down from 9.6 to 0.02.

Worst thing with RT is the travelling to and from. I had a few of the usual side effects with the hormone therapy, but small price to pay.

The Urologist recommended the RT for me even though he would have been the surgeon who carried out the RP if I went down that route.

Best wishes which ever route you take. G

User
Posted 26 Nov 2017 at 01:46

I had External Beam RT back in 2008 and salvage HIFU in 2015. This is not to suggest RT isn't a good option for long term success . The success of RT as with any treatment has more to do with how well the cancer is contained and how well the treatment is carried out as well as the type of cancer the individual patient has, some tumours being more radio resistant for example.


Much is known about External Beam RT which is often given in conjunction with HT. Low and High Dose RT although newer seems to be becoming increasingly preferred by suitable candidates. You will doubtless be aware that EBRT is usually given in a standard 37 fractions or 20 fractions of a higher dose. The two forms of brachytherapy involve an operation for radioactive seeds to be implanted or for radioactive probes to be inserted and removed at the end of an operation.


HIFU is still regarded as experimental because long term effects are not yet know. It has more usually been given in the NHS as salvage treatment for failed RT within a trial, although in some cases it has been given privately as a primary treatment. The widely recognized top man in the UK is on record as saying results are better where only one side of the Prostate is affected. The operation is carried out under anesthesia, and my experience was that I could walk about London a couple of hours after coming round post op. In fact it was easier walking/standing than sitting. It took two or three further days for the swelling to reach it's peak and then another three or so to gradually subside. Comfort improved considerably when the catheter was taken out a week post op. I can't say whether the HIFU was a complete success because subsequent scans show there is a suspicious area within my Prostate and an Iliac node and I may well have a further more advanced scan to ascertain this.


Incidentally, a full template transperineal biopsy was done prior to the HIFU which is normal and usually done under anesthesia. Also, you would have to check you are a suitable candidate for HIFU because there are several reasons why a man might not be.


Just as a general comment, I am struck by the number of members who have joined us saying they were keen bikers, (push or motor) and runners.  I wonder whether there is a higher incidence of PCa among men who engage in these activities.


 

Edited by member 26 Nov 2017 at 13:35  | Reason: Not specified

Barry
User
Posted 26 Nov 2017 at 08:36

Hi there,

We too wanted something less dramatic but had to go private and travel overseas to get it - a focal laser ablation (FLA) .

We are 8 months post with no regrets ( no continence problems, fully functional and clear scan at the 6 month point).

I have seen 1 member get a focal treatment as part of a trial at KCH in May 2017 but nothing else.

We were offered a private HIFU in London as a primary treatment and same consultant is doing the post FLA monitoring ( BUPA pay for the monotoring but declared the FLA itself a 'lifestyle choice' so that was 'out of pocket funded) .

That's all I can add about 'less dramatic' other than AS which we were offered but told the size of the G 6 tumour was a concern for long term AS.

My husband is 54.

I do hope a focal treatment starts to be offered in the UK for appropriate cases of course.

User
Posted 27 Nov 2017 at 22:08
Hi Micky I was diagnosed earlier this year with almost identical Gleason and T score as your own. I was offered 3 options RP, brachytherapy or 20 fractions of Hi dose RT. I chose the latter of 20 sessions with the VARIAN True beam machine on the NHS at East Surrey Hospital. This followed 3 monthly implants of Zoladex. Side effect for me were very well tolerated during the month of treatment which finished at the end of September. Six weeks after treatment PSA is currently less than 0.1 and next test is in 4 months. I'm 66 and retired so daily trips to the hospital was no problem for me, it was good meeting the same guys each day during the treatment all in the same boat together almost like a Gentlemen's Club all offering support for each other. I chose this route as I felt it had less dramatic side effects and I could pretty much carry on as normal.
What ever route you choose I wish you well.
If you don't know where you're going any road will take you there!
 
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