Snap (aside from the sporty job)! Age 59, recently diagnosed with very localised cancer — one core out of 49 samples from template biopsy Gleason 7=3+4, with 15% tumour volume and Gleason 4 10% of the adenosarcoma. One abnormal area on MRI, PSA 6.1 up from 4.0 four months ago. Nothing near nerves or capsule. Actually feels very frustrating to have found tumour in just one core, but on other hand shows how sensitive and accurate template biopsy is.
Consultant surgeon gave me the whole range of options including AS which I'm less keen on on account of the Gleason 4 component and rising PSA (at least between last two tests, prior to which it was always around 4), and that at this stage it's so localised.
Surgeon was also rather dubious about HIFU, but as previous poster said this is a natural attitude from any professional regarding 'their' discipline. I've done a lot more reading about it and it does have higher outright failure rate vs RP/RT, but it can be repeated on failure. It's also possible to opt for surgery if it fails, with nothing like the same difficulty for 'clean' surgery that is posed by trying radiotherapy first. There are no really good long term studies, but it does hold up very well in terms of recovery from treatment (not much worse than from biopsy so pretty trivial), and lower rates and shorter periods of UI/ED if at all, but you do need catheter in for couple of weeks while prostate calms down from the heat! Also read that HIFU treatment is being refined, as it becomes possible to image and target very well defined areas of disease.
But the consultant is not narrow-minded about surgery. He wants me to see an oncologist should I decide on treatment, though I imagine the conversation with oncologist will be much more about some kind of radiotherapy treatment than HIFU.
It's a dilemma isn't it. I did read that it's becoming a more common treatment in Europe now or at least more common as a primary rather than salvage treatment, along with more interest in very localised treatments where appropriate. What also makes decision hard is that being a surgeon made consultant lukewarm about HIFU, but as a surgeon has a fantastic reputation for robotic RP so thinking of going that way just as it seems so fortuitous to be in that consultant's hands (robotic or otherwise).
Sorry if this doesn't help your decision (or mine) at all, but that seems par for the course in opting for any prostate cancer treatment doesn't it unless things are more advanced. One good thing is that whatever you choose, the fact that HIFU is an option is good news at this stage.
Edited by member 14 Feb 2018 at 22:37
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