HIFU/Nanoknife

Sorry you join us due to your diagnosis. There are very few members who have posted that they had Focal Treatment and of these some like myself had it, (HIFU in my case), as a salvage treatment for failed Radiotherapy. So you may not get a great response. You are also in a bit of a grey area as regards how far immediately outside the Prostate Focal treatment will be given. I think this link is relevant. https://www.nature.com/articles/s41598-021-93340-3.

It is not clear whether you have had your MRI, Biopsy and histology considered by a specialist Focal Therapist to ascertain your suitability for one of the forms of treatment. If you are seriously considering this and you have not yet done so, I suggest you get a referral to UCLH in London who have the most experience in the UK. They may treat you within the NHS or provide a more informed view on treating privately.

I was originally graded Gleason 3+4=7 but after previous treatment RT, this was subsequently changed to 4+3=7. My staging was T3A. I had two applications of HIFU within a study on the NHS. (Two applications are sometimes required with HIFU). It is a very easy procedure. I am presently sub PSA 1 some 19 years after initial diagnosis with clear MRI this March.

Do let us know how you get on.

Edited by member 02 Jul 2026 at 02:35  | Reason: to highlight link

The foregoing is true of Focal and Prostatectomy.  I was told they would not treat with  Focal Therapy other than if cancer was believed to be within the Prostate or immediately outside as described in the link I supplied earlier. UCLH were not going to give me a second HIFU because some Choline in a scan was showing in an Iliac node. However, the size and shape raised doubt and a subsequent PSMA scan I had didn't show cancer in the suspect node and I got my second HIFU.  I would think if cancer is suspected clear of the Prostate, they would want to treat all with RT.  But it all depends on what the experts see and believe because there are different ways to tackle it, some more suited to an individual than others.  Suggest you ask to be told all options and follow ups if an option does not effectively work.  

For T3a 4+3 cribriform, this does sound like a high risk cancer, so I would be looking to hit it hard first time, with the hope you then don't need any more treatment.

I would be asking about HDR Boost (which UCLH do) with hormone therapy plus ARPI. HDR Boost is a radiotherapy protocol where you have about 60% of the normal external beam radiotherapy dose + 50% of the HDR Brachytherapy dose. Where the risk of micro-mets (mets too small to show on any scans) is considered high enough (which is likely with cribriform), the external beam can be expanded to cover pelvic lymph nodes too. This was an option in my case (not due to cribriform though) which I took.

HDR Boost gets a high dose of radiotherapy into the known cancer, and a low prophylactic dose into the area where micro-mets might be residing. In spite of its high dose, it tends to have a low side effect profile relative to the dose delivered.

Hi y'all,

 my UCL results below:=

Right anterior Gleason 3+3, 0.6mm

Right mid Gleason 3+4, 6.1mm

Left anterior Gleason 3+3, 3mm

Left mid Gleason 4+3, no evidence of perineural invasion or extraprostatic extension

Left posterior PZ target Gleason 3+4, 2mm

Initial PSA 8.91

Multifocal Visible disease

Bone scan - no metastases

Medical History, Bowel cancer initally T3, after pathology T1. Lap interior resection, anastomottic dehisence Hartmans repair, Peritonitis in all 4 quarters, colostom, reversed. Ileostomy, reversed. Hernia at incision site repaired. Retrograde Ejaculation.

So, 5 tumors not 2 ruling out focal therapy. MDT team said it was unanimous that hubby cannot have radio therapy now or EVER, as his abdomen is a 'hostile battleground' so radical prostatectomy is his only option. Not what we hoped for.

Attending UCL pre op on the 31st July and face to face with consultant. 

In the meantime, our original referral to Eastbourne hospital have given us an appointment on Tuesday 28th July with the oncologist. I said that we'd been referred to UCL (by Eastbourne urologist) who had accepted the referral. I explained UCL wanted to do the prostatectomy as he couldn't have the hormone therapy followed by RT, to which they said 'why cant he have RT? we don't understand why UCL have said that ' and want us to attend the appointment anyway and discuss with them.

We are very confused!