Back here after quite a long time away............
A resume of my current situation:- I had hemi-ablation HIFU with Mark Emberton in London at the end of October 2009. The quarterly PSA results since then have been 0.4, 0.5, 0.5, 0.6 & 0.7. Normally, an increase like this would have concerned me considerably, but Mark Emberton said right from the beginning that with half my prostate tissue remaining it is likely that my PSA will rise for some time.
However, when I met up with him for a routine meeting a couple of weeks ago, he suggested that an MRI scan might put my concerns to rest. I had a 3 Tesla scan which incorporates a gadolinium contrast agent. MRI scans are by no means definitive in their results, but it is claimed that this higher resolution Siemens machine used in conjunction with the contrasting agent allows a good radiologist to come up with some reasonably precise results, although micro-metastases will of course most likely not be picked up.
The report following my previous MRI scan in May 2010, seven months after HIFU, read: "You will see that this is completely clear. The necrosis has completely resolved and there is no MR evidence of any residual tumour in the treated left side. The untreated right side, as we would expect, also shows no evidence of any tumour."
I have just received a verbal confirmation of the results of the most recent scan which says that that the scan has a stable appearance compared with the previous scan done in May 2010. It also states that my rising PSA is commensurate with the amount of remaining prostate tissue. Finally there is a comment that there is a 'low probability' of there being any significant tumours present.
So, I'm a happy bunny at the moment, although I shall be even happier once the PSA readings stabilise.
Regarding side-effects, flow and nocturia are still a problem, but they were before HIFU. Mark reckons that the remaining tissue in my prostate is quite possibly tending to push my urethra into the void left on the other side of the prostate, which may be causing at least some of the problems. I shall be going onto Dutasteride shortly to see if that will help by shrinking the remaining prostate tissue. If this proves to be unsuccessful - it will take about 3 months before it begins to work - there is a surgical procedure, probably the equivalent of a TURP, which might be a possibility, although I would have to think long and hard before agreeing to have this.
From the time when I had HIFU until June 2010 I was not in a relationship, so it was a little difficult to assess to what extent ED might be a problem. Once in a relationship, I found that I could get a good erection quite easily, but this would most frustratingly dwindle partway through, and could not easily be reinvigorated. I used Cialis 10 mg for a while with very good results, but for the past few months I have found that I don't need it at all.