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Focal Therapy

User
Posted 11 Feb 2018 at 11:30

I am trying to understand Focal Therapy and I have a few questions. I would appreciate any answers you may have.

Is it confined to one form a wavelength i.e. Sound, or can it be others such as gamma or whatever?

Where is it done on the NHS?

What is the cost if done privately?

That will do for starters.

John

Gleason 6 = 3+3 PSA 8.8 P. volume 48 cc Left Cores 3/3, Volume = 20% PSA 10.8 Feb '19 PSA 1.2

Jan '20 PSA 0.3 July '20 0.1 Jan. 21 < 0.1 Dec 21 <0.01 June '22 <0.01 April '23  <0.01

User
Posted 11 Feb 2018 at 13:30

Focal treatment can take a number of forms. It is not widely used in the UK especially as a first line treatment but more as a salvage treatment for radiation that has failed to do the job, mostly where the cancer is still within the Prostate. The most frequently used form in the UK is HIFU which stands for High Intensity Focal Ultrasound., something I had. Best results are achieved where the cancer is not extensive and is confined to one side of the Prostate. In the USA it is more usually Cryotherapy where an ice ball is formed to destroy the cancer cells. A few men in the UK have this as a primary treatment or as salvage therapy. There is another form of focal therapy called Nanoknife ( Irreversible Electroporation where high charged electrical probes blow holes in the tumour but this treatment has mainly been confined to small scale trials. There are other forms of focal therapy but generally these are not done in the UK. So with focal, gamma rays and other sorts of the usual radiation are not used.

In the relatively few cases where it is done in the UK ,HIFU it is done within trials in the NHS or outside trials privately.  There is a man whose team operate at UCLH in London or privately.  Forum rules prevent me giving his name but he is regarded as the top focal man in the UK. However, his details are given in this link :- http://www.theprincessgracehospital.com/our-specialists/specialist/embma/professor-mark-emberton/

There are a small number of other centres doing HIFU in the UK which can be found using Google.

 

Edited by member 11 Feb 2018 at 13:46  | Reason: Not specified

Barry
User
Posted 11 Feb 2018 at 17:41

Thanks Barry, a good explanation. I don't have private health care so private treatment is probably not an option, it seems that any trials are based in the south at University College London (UCL). There is a trial that is still open, but I wouldn't want to make the trips "down south" if I was accepted.

So, back to A.S. for now, Brachytherapy still looks like a good option for me.

John

Gleason 6 = 3+3 PSA 8.8 P. volume 48 cc Left Cores 3/3, Volume = 20% PSA 10.8 Feb '19 PSA 1.2

Jan '20 PSA 0.3 July '20 0.1 Jan. 21 < 0.1 Dec 21 <0.01 June '22 <0.01 April '23  <0.01

User
Posted 11 Feb 2018 at 18:55

Yes, if you want focal therapy within the NHS the aforementioned linked person is the man who gets to try all those. The NHS work is done at UCL (University College London) although they sometimes write on UCLH (University College Hospitals) headed paper but same difference!

You are correct that several separate visits are required for MRI scan, for preops and for the Transperineal template biopsy given under anesthesia and also the HIFU procedure itself also given under anesthesia. One advantage HIFU has is that it can be repeated but because it does not have long term history it is still regarded as 'experimental'. Various forms of radiation have been assessed over a much longer period and in much greater numbers. Brachytherapy, particularly with seeds, seems to be becoming more the radiation treatment of choice for those for whom it is an option.

Barry
 
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