Where to start? Everybody is entitled to an opinion but it makes sense to have a more detailed knowledge of HIFU, what it sets out to do and it's appropriate applications before trying to cast aspersions and suggest men have a different treatment, which was one of the suggestions by a poster here and a charge that can be levelled at some urologists and radiologists even.
So let's start with Peter's comment about the largest HIFU study to date and carried out in 6 centres not being peer reviewed. The authors of this study include the most highly regarded and respected focal orientated urologists in the UK and indeed who are known Internationally, so I think the results of the study would not be contested. I am not an expert but first started to look at HIFU in 2007 and have personally discussed aspects of HIFU with 3 of the authors of that study and indeed had my HIFU administered by one of them. This is in addition to watching many lectures on the subject, so my opinion is not superficial. I wouldn't have had HIFU without carefully considering it and I see it is now supported by The Royal Marsden as well as UCLH so that's the UK's top two cancer hospitals.
Of course one has to consider old cases because that's the only way to check how successful treatment has been and is proving because HIFU is a treatment for early and not advanced PCa, Gleason 6 and 7 patients with early staging will be the majority of patients treated. It's only classed as experimental because it lacks long term assessment that only time can provide.
It is acknowledged that many men have radical treatment with associated side effects unnecessarily (overtreatment). This is because if left untreated their PCa would not have developed in their natural lifetime to the point that it would have impacted them. (This is one of the reasons given for not having a national screening programme). HIFU is a niche treatment for suitable men between AS and and radical treatment. It means they have treatment with relatively minor side effects that may provide a cure or at least beat back the cancer for some time with the possibility of repeat HIFU or more radical treatment subsequently if required. So some men will be spared from the debilitating effects of radical treatment.
As regards HIFU not being a proven cure Andrew, I did suggest that you check the YANA site where men had not experienced a recurrence for over 8 years and I am sure that some of the focal urologists could relate cases for longer than this. But what period would you consider necessary for a treatment to be considered a cure? We know of men who have gone 10 years after RT and were even told they had been cured and then had a recurrence. So it can happen years later. Radiotherapy eradicated the cancer in my Prostate and I had much stronger RT than you get in the UK, yet a tumour subsequently grew in it. HIFU burnt this out but another is growing so this may need further focal treatment. Let's agree you see it differently to me but there are a growing number that see it like me. A considerable number of men who have Prostatectomy also need RT and HIFU or other salvage treatment after failed RT so why not accept that HIFU like other treatments will have some failures.
Incidentally, HIFU costs less than surgery as mentioned by Professor M E in the webcast link Lyn. I think those considering HIFU or commenting on it, would do well to view these two videos, (the other one being tagged 2) even though they are a few years old and learn more about the treatment.
See next post as this rotten forum format will not allow me to paste in the link here!!!
Edited by member 13 Jun 2020 at 01:27
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