RP vs RT

Its a while ago so you probably made your choice by now linn. But my journey may be of interest. I had prostate HIFU left side ablation last year. Cancer returned in the ablated field and also on the right so was bilateral, Gleason 3+4 risk group T2C Intermediate.  UCLH advised whole gland treatment required and gave me a choice of salvage prostate removal or RT.  I did not want the RT as 18 months of aggressive hormone treatment would tie me to numerous hospital visits, with many side effects like weakness incontinence etc. After research i am very disappointed in lack of counselling prior to HIFU. This procedure is not approved in US or EU. One NY Study describes recurrence as 35-42% but i was advised 15% chance of failure. The same study referred to the effect on the anatomy of HIFU treatment as "unknown". I dug deeper. In 2018 a study by UCLH suggested cancer recurrence after HIFU in the treated field may be due to fibrosis of tissue leading to reduced blood flow encouraging a more aggressive form of cancer!  I wish i did the research before the HIFU. After the cancer returned bilaterally UCLH advised how technically difficult salvage prostatectomy would because of the nerves and rectum being fused to the prostate gland during HIFU. They insisted all nerves would have to be removed. So total loss of erectile function. This turned out to be the line given out in the NHS to cancer patients but it is due to the increased cost and resources required of a nerve spare op. Ive now been forced to go private with the prof. who also operates at guys and guildford who has now performed a successful salvage prostatectomy with 100% nerves intact and has done thousands of robotic prostatectomies with 'intraoperative frozen section nerve spare'. They only cut out the nerves they need to after doing the histology while your asleep. Its c.£22k.  It is simply unacceptable UCLH do not Counsel cancer patients about the range of research over failure risks, and the consequences if you want to retain sexual function if HIFU failure happens before you decide on it. I am relieved to have the prostate out and relieved to retain the nerves supporting sexual function. I hope this experience can give some perspective to others.