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User
Posted: 19 Aug 2025 at 00:18

I note that your local Trust will not do a Prostatectomy and nor will UCLH in your case. However, it seems you are prepared to have it in London, so could try another of the main hospitals there. We have had several members speak well of Guys for example.

Cryotherapy is not often mentioned in the UK but is done more frequently in the USA. I knew somebody who had it and it was successful in treating his cancer but when I last met him in London about a year after the procedure, he was still struggling with ED.

 

Edited: by member 19 Aug 2025 at 12:05  | Reason: Not specified

Barry
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    User
    Posted: 18 Aug 2025 at 15:18

    hi

    I was diagnosed with PC on May 25. After my biopsy I was given a Gleason score of 3 +3 which meant the only treatment on offer from my Trust was Active Surveillance. I was not happy with the treatment on offer and asked to be referred to UCLH for possible acceptance for focal therapy ( Nano Knife ). I was offered the chance of treatment but had to go to London for a targeted Biopsy. The results came back with a Gleason 3+4, which meant the treatment on offer would be Cryotherapy, this is due to the position and size of the cancer. I asked if RARP could be offered, the answer was yes but I could only have this at my local Trust.

    With this new info, I went back to my trust for further consideration due to the increased Gleason score. The Trust group met and decided to stick with the original treatment of AS. I am not happy with this news, what is the point of catching it early if they won't treat it.

    For the time being I am considering the offer from UCLH. My hesitation is due to the complications with Salvage treatment on recurrence. Has anyone experienced cryotherapy?  Any advice? Would be welcome 

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      User
      Posted: 18 Jul 2025 at 13:24

      As regards life time dose of EBRT, Lesley's husband had 20 fractions under one arm of the CHHiP trial. (I can't remember the precise figure without going through my papers but it was about 3 Gy a fraction or slightly under, so lets say about 60 Gy in total, giving a calculated similar effect to the standard 37 fractions of 2 Gy totalling 74 Gy). So l believe there is potential here for Lesley's husband to have further radiation within his life time dose providing the paths over which the original EBRT were delivered can be avoided.

      It was a great disappointment to me when my first HIFU failed to completely vaporise the tumour in my Prostate but the second application seems to have done the job, at least for the time being. The side effects of HIFU are generally mild and it is an easy procedure. The tumour has to be where the HIFU probe can reach otherwise Cryotherapy or Nanoknife (Irreversible Electroporation) are alternative Focal Treatments in the UK. Interestingly, a variant of HIFU called Tulsa Pro is being done on a small scale in some countries. This is where the probe is fed through the Ureter and the tumour is ablated outwards from within the Prostate rather than from outside the Prostate inwards via the Rectum as with standard HIFU. So with Tulsa Pro anywhere in the Prostate can be reached. I don't know whether Tulsa Pro has been used as Salvage Treatment yet and only time will tell whether this or other forms of Focal Treatment such as Focal Laser Ablation (FLA) among other focal options will be better. Only time will tell and it might be horses for courses as with other forms of treatment. A leading UK Focal Specialist says there is a limit to the number of types of focal treatment he can master and he uses what he is most comfortable with.

      Edited: by member 18 Jul 2025 at 21:45  | Reason: Not specified

      Barry
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        User
        Posted: 04 Jul 2025 at 18:29

        Nick,

        Good that you have made you decision and I certainly would not suggest you change it.  (I have never suggested that a man opt for any form of treatment).  However, from what you say, and also what a few others have said, Consultants are often prejudiced agaist Focal Treatment.  It is approved by NICE, who hospitals look to for guidance for 1) use in Clinical Trials and 2) In Centres of Excellence.  It is also available on the NHS at designated Centres. It is correct that long term outcomes of HIFU are still to be evaluated but Cryotherapy was approved for treating PCa in the USA back in 1999. 

        Barry
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          User
          Posted: 03 Jul 2025 at 15:27

          Good plan to visit consultants specialising in all 3 disciplines Tony. You can then ask more detailed questions. A case can be made for and against all forms of treatment. Surgery and Radiation (of which there are several types and combinations) set out to kil lall cancer cells by removing the entire Prostate or causing all cancer cells in the Prostate to be irradiated thereby causing death to them over time by damaging their DNA so they can't effectively divide. On the other hand Focal Treament treats only cancer lesions that are considered significant and may require two applications to complete the job. Also, while a man still has Prostate there is a possibility that in time a further lesion may develop. The advantage of Focal treatment is the it helps preserve function, generally has fewer and milder side effects and is quickly done, you generally have a cup of tea and go home the same day or the next one. In need you can have follow up Prostatectomy or Radiation although this is made somewhat more difficult any treatment to the Prostate.

          I had two applications of HIFU, although if not where the probe can reach it would be Cryotherapy or Irreversible Electroporation in the UK. You do of course have to be a suitable patient which is more critical with Focal Treatment. I found the catheter when in place for a week made me a little sore but apart from that it was a doddle! I had HIFU as salvage treatment for failed Radiotherapy and for 4 years now my PSA has not exceeded 0.05, 3 follow up MRI scans have been clear and I have been told I am in remission. Focal Treatment can be also be given as a primary treatment for suitable men. This is a very good recently posted video about the 3 main types of treatment. Forum rules don't allow me to be specific but the hospital in this video is the leading one in the UK for Focal Therapy and I am very grateful for the HIFU I had there. https://youtu.be/zYTU94-8pTc?si=bo5KTm0p2Jzczlqf

           

          Edited: by member 04 Jul 2025 at 00:19  | Reason: to highlight link

          Barry
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            User
            Posted: 12 Jun 2025 at 17:42

            Good afternoon,

            My husband was diagnosed 16 years ago.  Gleason 3+4.  PSA 5 rose to 9 before starting on hormone treatment for three months before receiving 20 sessions of EBRT as part of the CHHiP trial.  PSA remained low< 1 for many years but then started increasing and triggered the 2 threshold.  Referred back to hospital and having had PET scan, cancer has been detected in his prostate (PSA now 5).  He has been offered referral to Mount Vernon Cancer Centre for inclusion in the RO-PIP trial; or Royal Marsden for consideration of salvage radiotherapy on the MR Linac or referral to UCL for consideration of HIFU or cryotherapy.  They have suggested looking at the options on prostate matters website, which we have, with another appointment with consultant in two weeks to make decision. It would be great to hear from anyone who has had these treatments?  Thank you.  Lesley 

             

            Edited: by moderator 12 Jun 2025 at 18:03  | Reason: Not specified

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              User
              Posted: 09 Apr 2025 at 00:48

              The two treatments offered are those most frequently offered and both have pros and cons which the patient shoud carefully consider. There are other forms of treatment which mainly come under the description of Focal Therapy. It is not widely administered and sometimes has to be repeated but usually side effects are considerably less severe. A prerequisite is that a patient's histology, tests and scans need to be assessed by a Focal Specialist to ascertain whether he is a suitable candidate. Focal Therapy can be used as as a primary treatment or as a salvage treatment for failed RT. Examining this possibility would most likely delay treatment, particularly if surgery was your husband's final decision as surgeons normally have waiting lists. With Surgery the idea is to remove the Prostate, which is the opposite of Focal Treatment which aims only to anilalate the significant tumouts, thereby preserving function. It has to be said that Focal Treatment as with pther forms of treatment has it's failurers and successes, so also needs to be well considered before being chosen. There are other forms of Focal Therapy but the ones used most oftenin theUK are High Intensity Focal Ultrasound (HIFU) and Cryotherapy depending on the tumour location, with Nanoknife (Irreversable Electroporation) being a more recent alternative.

              Edited: by member 09 Apr 2025 at 00:50  | Reason: Not specified

              Barry
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                User
                Posted: 30 Jan 2025 at 14:53

                I had irreversible electroporation on the 3rd December, HIFU or Cryotherapy wasn't an option according to two urologists. I had a catheter for a week as the cancer was near the urethra.  Two week ago I had urine analysis and everything is ok. I stopped peeping blood three weeks ago still eyaculating blood ( very little as I have dry eyaculación) after the electroporation I had normal eyaculación but after two week dry ejaculation again ( which is a shame because no matter whatever the urologists say that has nothing to do orgasm it is much more pleasure to ejaculate something). At the end of February I'll have my PSA checked and hope is goes down from the last result which was 9'5. 

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                  User
                  Posted: 02 Dec 2024 at 13:50

                  4 days ago I had cryotherapy to kill cancer in my prostate, 2 days after procedure my scrotum and base of penis are showing heavy bruising and some swelling, is this anything I should worry about ? Has anyone else had a similar experience ? 

                  Edited: by member 02 Dec 2024 at 14:01  | Reason: Add information

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                    User
                    Posted: 08 Oct 2024 at 21:33

                    CNS sent me the rejection reason:-

                    PSMA PET is only indicated for patients with BCR where salvage treatment (surgery/RT/cryotherapy is being actively considered. It is not indicated to decide on use of HRT post salvage.

                    she also sent me the criteria list and the most obvious one, is “should have at least two consecutive PSA levels of 0.2 or greater” My husband only has one which makes me question why the oncologist requested the scan so early.

                    Edited: by member 08 Oct 2024 at 21:50  | Reason: Not specified

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