Focal HIFU results. Great news!

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New Member

Date Joined Feb 2017
Total Posts : 12
   Posted 8/21/2017 12:14 PM (GMT -7)   
Received Focal HIFU from Dr Hashim Ahmed from Imperial college hospital in London on May 5.

Going in my PSA had climbed to 4.8 and biopsy revealed a Gleason 7(3+4) on the left side and a Gleason 6 on the right side.

The plan was to ablate the Gleason 7 (3+4) and leave the G6 alone. I was told the procedure had little risk of side effects to continence and erection but was advised that the region of the G7 would include destroying at least one seminal vesicle and maybe both.

Post procedure have had no issue with continence at all and urine flow and bladder retention is the same as pre procedure. I have healthy flow and sleep 7 hours a night.

No issue with erection. I even had some morning wood while I still had the catheter in and man that was painful and scary.

I do have less semen when ejaculating and it feels funny but I'm getting used to it.

Just had 3 month follow up. DRE was normal and PSA was down to 1.98!

I will continue with active surveillance with a PsA check every 3 months for at least 1 year and then evaluate after that. Also will continue with changes to exercise and nutrition to reduce risk of recurrence a little.

Thank you to everyone on this board for your ideas and support.

PS. It was very expensive and not covered by insurance.

56 years old

Post Edited (bdubs60647) : 8/21/2017 1:20:21 PM (GMT-6)

Regular Member

Date Joined Nov 2016
Total Posts : 323
   Posted 8/21/2017 12:30 PM (GMT -7)   
That is great news. I'm in the north suburbs of Chicago. I believe (based on your screen name) you live in the Chicago area.

I'm interested in how you ended up choosing that type of treatment.
Age at diagnosis-66 Diagnosed 6/16
RALP 10/16 at U of Chicago, Dr. Shalhav. Experienced internal bleeding post op requiring transfusion of 2 units.
Pathology Gleason 3+4=7, tumor volume 15% Margins negative except for one focal margin, .1mm
PSA @ 6 wks <0.02;16 wks <0.02; 5/17 <0.02

Works Out
Regular Member

Date Joined Dec 2014
Total Posts : 239
   Posted 8/21/2017 3:40 PM (GMT -7)   
Congrats, bdubs.

Wonder if you can advise how you were diagnosed. I have an expat younger brother who has lived in London for over 30 years and he tells me screening is not the norm in the UK and he had to push to be screened.
Born 1953 - You Do The Math

-DX Jan 2015
-PSA (Finasteride reduced) 2/15 - 3.46, 9/14 - 3.38, 8/14 - 2.5, 2/14 - 2.1, 9/13 - 1.7, 12/12 - 1.4

HDR Brachytherapy at UCLA 4/30/15 and 5/7/15

-2 cores positive - 30-40%
-Gleason 7 (3+4)

Post Procedure PSA's

8/15 3.5
11/15 1.9
2/16 2.6
5/16 1.4
8/16 1.0
11/16 0.7
2/17 0.6
5/17 0.4

New Member

Date Joined Feb 2017
Total Posts : 12
   Posted 8/21/2017 9:07 PM (GMT -7)   
I live in Chicago. I had no symptoms but was screened by GP without asking. That result was a PSA of 4.3. That began a journey that included two biopsies and an MRI before any disease could be located.

I don't know that I would have chosen to be screened. I'm not one of those men living with great gratitude for the screen. But once I had the results it seemed prudent to treat and I chose the most low impact way I could. I'll live with this as a chronic disease that requires ongoing surveillance and management.

All the best.

Veteran Member

Date Joined Apr 2014
Total Posts : 542
   Posted 8/22/2017 3:18 PM (GMT -7)   
bdubs: Sounds like great results. I am curious as to why you left the G6 since you were already having the procedure? Your SE's sound very similar to RT guys. You had the advantage of having way less of an invasive procedure. Here's to many more low PSA readings and please keep us posted.
Age 65, Steadily rising PSA with a jump from 3.32 to 4.3 in 5 months, April 2014 Bx May 9, 2014 4/12 cores 3%, 15%, 30%, .5mm, 3mm, 5mm G3+4=7 PI not id'd Vol25g Ultrasound Findings: No discrete nodules. BT 7/16/14 81 pSeeds, nausea, urine blood, burning, 1/2 day, bruising, mild urinary/bowel 2 wks PSA: 8/14 1.19, 10/14 .41, I/15 .36, 4/15 .33, 7/15 .37, 11/15 .35, 5/16 .15, 10/16 .16, 5/17 .04

New Member

Date Joined Feb 2017
Total Posts : 12
   Posted 8/22/2017 8:42 PM (GMT -7)   
i read a lot of material and spoke to doctors and was just personally more comfortable with the focal ultrasound vs RT.

As far as the G6, treating physician said it was not necessary to treat a G6 lesion and I preferred to keep as much natural working gland as possible. it was consistent with my plan of treating this as a chronic disease. I wanted to get as little treatment as possible and monitor it.

New Member

Date Joined Feb 2017
Total Posts : 12
   Posted 12/6/2017 7:10 PM (GMT -7)   
Just had my 6 month PSA. 1.90 very grateful.

Tall Allen
Veteran Member

Date Joined Jul 2012
Total Posts : 8951
   Posted 12/6/2017 10:24 PM (GMT -7)   
Since, as you said, you are treating it as a chronic disease and monitoring - essentially active surveillance, are you following an active surveillance protocol? That is, will there be a confirmatory biopsy (mpMRI-targeted) within a year and periodic follow-up biopsies? Is there a trigger PSA? Do you have a local Uro that you're working with on the active surveillance?
Allen - not an MD
•PSA=7.3, prostate volume=55cc, 8/17 cores G6 5-35% involvement
SBRT 9 yr onc. resultsSBRT 7 yr QOL results
•treated 10/2010 at age 57 at UCLA,PSA now: 0.1,no lasting urinary, rectal or sexual SEs
my PC blog
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