Considering HIFU

I had RALP two weeks ago. It went well and margins were clear but I am still in the 'wet stage' of course. HIFU was mentioned to me only as a salvage procedure, if necessary. But I confess that now I wish I had researched it myself. Following a TURP in 2017, I was diagnosed G3+3 in just 1% of cores tested. Last year, my PSA rose and I had a perineal biopsy. This showed that my PCa had increased to G3+4 in 75% of 20 cores taken from a around my prostate. A fair increase. Does anyone know if HIFU may have been a feasible option, or should I stop kicking myself for not exploring the option before RALP? 

Based on what you have said, it seems that HIFU would not have been a suitable option for you which is probably why you were steered away from it in the first place. With 15 positive cores, best place for your prostate is a petrie dish!

Try to look forward rather than back

Thank you Lyn. For me, that was a very reassuring and  uplifting response. And no, I don't think I have the resilience to cope with a recurrence. So, minimising the chance of one must have been the right choice.

I'll put my concerns to bed now. 

"They all offer shades of advantage and disadvantage. Having made a choice, the one thing you can control now is your attitude to it. Be at peace with your decision."

Shades of advantage and disadvantage.... I love that, olefogey

Edited by member 21 Nov 2021 at 22:22  | Reason: Italics

I'm just wondering if I should look into HIFU or Cryo (maybe private or trial), is it likely to be suitable, or am I just delaying things and best to crack on with surgery while cancer is still contained?

Obviously a bit of a shock to lose my prostate at 57 years old, but if that is the safest/best option then I can live with it. But I don't want to find out later, after it has been removed, that I could have kept it...

All thoughts welcome :-)

So I am almost certain to now have HIFU next month as after AS for 2 years my PSA doubled to over 8 in 4 months about 20 month stable . Left smallish lesion around 8mm with 3+4 and less than 10% position also another 5 mm but no positive cores. I am 71 with other health issues from polio as a kid so most other treatments are likely to have not good effects on me.

Somewhat anxious but it’s obviously not going away and my logic was less side effect chance, can repeat possibly down the line if needed and all other options not that great for me.

I think that looking at the research across the globe HiFU isn’t that  new and there are quite a lot of research reports and it is slightly less effective in preventing recurrence down the line it’s a good first option for low to intermediate localised PCa. I also think the expert use of MpMRI just before the procedure and a urologist who is expert and done a lot of them makes for a better outcome maybe than the ‘average’ especially in earlier studies.

Let’s hope I manage the GA as I have some breathing issues but that’s my main issue as I take the plunge in a few weeks !

Edited by member 26 Nov 2021 at 00:45  | Reason: Typos

Best of luck with the HIFU.

Having read tons of stuff I could see nothing to suggest HIFU was significantly poorer in recurrence but maybe there are other sources I have not read.

Thanks LynEyre, much appreciated

I think I'm T2, will check.

I suspect RP is best for me, think I'm going to tell NHS to go ahead with that, 6-8week wait, but in meantime get private consultation on viability of HIFU

Oh that's a bit of a b****r. With my wonky bowel configuration I was kind of hoping proton beam might be more of a get-out-of-jail-free card, rather than a punt on the gee-gees 😄