Search results for "Cryotherapy"

You’re right to raise those points about the removal of the prostate. It’s quite crazy to think that it’s removal can still cause reoccurrence but I suppose the chances are lower.

Interestingly while radiotherapy was offered as an option it was clear that this is not what they were recommending, mainly due to the long term impacts. They said that in his age and health position, it would be better as a second line of defence.

Thank you for your focal insights. There certainly seems to be lots of options.  I’ll take a look at the toolkit

Great news on the remission! I hope all remains well.  

Lucy 

Thanks Julian for taking the time to reply! You’re right, the news was shocking but as you say, it’s early and he’s lucky to have these options in front of him. I think we’re so used to taking advice from medical professionals that it’s hard when the choice is suddenly with you. 

The PI-RADs was a 4 and I believe there were 6/17 cores that came back as problematic, all within the left side I think.

You raise a good point about the worry never fully going away. Thank you for your thoughts on the focal therapy. 

I  wish you all the best with your active surveillance. 

Lucy

Lucy,
The risk of biochemical failure after Prostatectomy is about 25% to 40%. This varies depending on the grade, position and extent of an individual's case, the skill of the surgeon and to a lesser extent whether there are other factors, such as the surgeon causing some cancer cells to break away during removal of the Prostate leading to seeding. So Prostatectomy is not necessarily an end to treatment.

You make no reference to radiotherapy, this being the usual alternative offered, so there must be some reason for this, I would think.

I had HIFU, in my case as a salvage treatment for failed Radiotherapy, although it can be given as a primary treatment. It took two sessions to put me into remission, which I still am. A couple or so hours after my second HIFU, I was driven 200+ miles home. It's a very easy procedure with milder side effects than Prostatectomy, so lower risk of incontinence or Erectile Dysfunction. (The latter in my case had suffered due to the Radiotherapy). Where the HIFU probe cannot reach to focus on the tumour, Cryotherapy is the usual alternative, although Nanoknife, Irreversible Electroporation, is a more recent treatment that can be used more widely in the Prostate. The objective with Focal Treatment, is to treat only significant tumour(s) preferably, but not essentially, on one side of the Prostate so the Prostate retains as much function as possible. Where Focal is not successful, Radiotherapy or Prostatectomy can be done after it.

Dad has been diagnosed at any early stage so he can take his time in considering his options. He may find it helpful to take a look at 'The Tool Kit' https://shop.prostatecanceruk.org/our-publications/all-publications/tool-kit?limit=100&_ga=2.206109653.795867346.1564408880-1013787081.1564408880

Whichever, treatment is given - they all have their pros and cons - the man will be monitored for years to come by way of PSA and MRI at increasingly longer intervals.

Edited: by member 28 Aug 2026 at 01:05  | Reason: to highlight link

Your dad is much younger than I was (aged 74) when diagnosed, also with Gleason 3+4, and his PSA level at 4 is very low so certainly no rush to make decisions.

Gleason 3+4 is regarded as favourable intermediate PCa. I would ask what his MRI scan showed, ie PI-RADS or Likert score was? How many cores in the biopsy were taken and how many contained cancer? A Gleason score of 3+4 means that the majority of the cancer seen is pattern 3 which is very slow-growing, if at all.

The question is, how much pattern 4 is contained? If this is less than 5% then, as in my own case, this is generally regarded as 3+3 so active surveillance could come into the mix, although I appreciate at your dad's age and life expectancy he would prefer treatment. However, and sorry if this sounds pessimistic or alarmist, those who have undergone treatment need to be monitored for many years afterwards because of the risk of recurrance so the worry never really goes away anyway.

The usual NHS treatments are RT (with unpleasant HT for months), brachatherapy or radical prostacetomy, all of which have pretty ugly long-term side effects.

You mentioned focal therapy (HIFU, cryotherapy or in some situations nano-knife) and he is indeed fortunate to get an NHS rereferral as it's mostly only available privately for patients with insurance or self-paying many thousands. I certainly wouldn't rule it out as the side-effects are much less severe than the other options and it's usually done as a day case.

I checked this out thoroughly for myself and found I was eligible and it would be my treatment of choice if my own cancer changed after over four years on active surveillance. It's true that HIFU is relatively new, although statistics over 20 years or so have proved it's success. The only proviso is that it sometimes, in a minority of cases, it needs to be repeated which isn't generally a problem.

Hope that's helpful and with all good wishes, Julian

There may be a further option for you if you are a suitable candidate but it is seldom mentioned because few hospitals can offer all or any forms of it. I am referring to Focal Threapy. The most common forms of this are HIFU (High Intensity Focal Ultra Sound) which kills cancer by heat, Cryotherapy, which freezes the cancer cells or Nanoknife (Irreversible Electroporation) which uses electricity. There are other forms of Focal Therapy but this would mean being treated abroad, so I will not detail them. Then there are two types of Brachyherapy which can be by placing radioactive seeds (Low Dose) or by inserting radioactive probes into the cancer cells and removing the probes almost immediately during an operation, (High Dose). Focal generally has fewer side effects but requires a specialist to check your suitability . HIFU may require two treatments. All the aforementioned treatments can be done on the NHS

https://www.youtube.com/watch?v=tkueqxHuVn4

https://www.youtube.com/watch?v=8h8tnVENMSY

Edited: by member 23 Aug 2026 at 22:20  | Reason: to highlight links

That is an excellent video Adrian has posted and it was one of the participants that gave me HIFU on two occasions for failed radiotherapy and has now done over a thousand HIFU procedures, which essentially is the same as for HIFU given as an initial treatment. It quite often takes two treatments to do the job and you have to be carefully selected and found to be suitable. They also do Cryotherapy in cases where the cancer is in a position where the HIFU probe cannot reach or Nanoknife (Irreversible Electroporation), a more recent procedure, which can be used more widely in the Prostate.

As regards the HIFU procedure, I started my journey home about an hour after coming round from the aneasthetic and was driven home about 210 miles from London to Devon. The next day there was some swelling and I had to sloutch back when sitting, rather like after having a biopsy to lessen pressure on the tender parts. The catheter was removed a week later and I was almost back to normal. Some 5 years on, I am still in remission.

HIFU generally has less incidence of incontinence and erectile dysfunction than surgery. However, in some cases where HIFU has proved unable to do the job, RT or Prostatectomy may be required and this is made more difficult after HIFU (Like Prostatectomy after Radiation)

That is absolutely brilliant news that your surgeon took the HIFU suggestion seriously, Roger! It must be a massive weight off your shoulders to have a more localized, less invasive option on the table instead of leaping straight into a highly complex salvage prostatectomy.

Barry and francij1 definitely gave you some golden advice there. Keeping the treatment focal with something like HIFU or cryotherapy makes an immense difference in preserving your quality of life, especially since shielding yourself from permanent incontinence is a major priority.

Getting the MRI and targeted biopsy knocked out next is the perfect game plan. It will map out the exact coordinates of those remaining localized cells so the team can see if the tumor margins are a clean match for focal ablation.

Take it one step at a time, mate. You successfully advocated for yourself and completely shifted the trajectory of your treatment plan—that's a huge win in itself. Wishing you the absolute best of luck with the upcoming scans, and please do keep us posted on how the biopsy results turn out!

From my reading of what you say, it looks to me as though you had HIFU administered twice as Focal Treatment for your Prostate Cancer as I did but I had Radiotherapy as a primary treatment, so HIFU as a salvage treatment for failed RT in my case. I have been told that as I have been subject to heavy radiation and HIFU twice, the Oncologists would not administer further Focal treatment should MRI and increasing PSA show a further tumour even if this was considered significant. It will then be my option to do nothing or have the tumour treated by Hormone therapy or possibly Chemotherapy. Should it be found that you develop Prostate confined significant tumour, you may be able to have further Focal Treatment or Radio treatment. With HIFU, it can only treat where the probe can reach, so another form of Focal Treatment might be necessary, such as Cryotherapy. Well, let's hope you don't need further treatment. So as francij says, important that you have regular PSA checks and probably annual MRI or whatever interval is considered appropriate for you.

I hope things go well for you.

Hi,  Are you on a fast track for the melanoma.  I recall when I had a skin graft in 2007 for a Basal Cell Carcinoma there was a young lady who'd been referred for surgery on her forehead directly by her GP cutting out the Dermotologist.   I've had 2 skin grafts, curettage, cryotherapy and various creams for Actinic Keratosis for 20yrs, in fact when my medical records came on line it turned out I'd had the chemo cream, Efudix, in 1994 without knowing what it was.   It took another 9yrs after my grafts to find a prostate cancer.  I've spent a lot of time outside but the dermotologist said the intense sun of time spent tropical places with weak suncream lets it get deeper and has more effect.  I'm on 800units a day Vitamin D for other treatments and have read that at as you get older you should supplement.  Good luck.