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Thread: Sticky: What I Need to Know about HIFU

  1. #1
    Senior User
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    Sticky: What I Need to Know about HIFU

    Dear Members,

    Use this thread for all further HIFU related discussion. Please be considerate of others' thoughts and opinions, and respectful of the forum community as a whole. A positive and comforting atmoshpere is what we strive to maintain. Any members who do not contribute to this atmosphere will not be allowed to post on the topic.

    Furthermore, let it be clear that this is the ONLY thread for HIFU related discussion for now. Any new HIFU threads will either be moved to this one or will be deleted. All previous HIFU threads have been locked so members can go back and read any of the posts, but will not be able to further comment there.

    The other moderators/admins and I feel this is a necessary step to restore some peace and order in the Prostate Cancer Forum. I apologize for any inconvenience. Thank you for your understanding.

    MODERATOR'S NOTE: THESE COMMENTS ARE FROM 2009, BUT ARE STILL APPLICABLE TODAY, SO I COPIED THEM TO THIS NEW STICKY. WILL DO THE SAME WITH A FEW OTHER POSTS, FROM THE PAST, THAT MIGHT BE HELPFUL. ALSO UNDERSTAND THAT THERE WILL BE NO ARGUMENTS IN HERE. THE POSTS SHOULD ONLY REFLECT VALID INFORMATION, PRO OR CON, REGARDING HIFU, ALONG WITH PERSONAL EXPERIENCES. POSTS THAT FAIL TO DO ONE OF THOSE THINGS WILL BE DELETED. --CHUCK
    Last edited by HighlanderCFH; 11-07-2015 at 03:39 PM.

  2. #2

    I for one

    Speaking as myself, not as a moderator, I think:

    HIFU is a great, promising treatment. I think in a few years it will be very popular in the U.S., and many men with early or intermediate risk cancer will go for HIFU instead of surgery or radiation, and for many of those men, HIFU will be successful.

    (I self-edited this so that the posting was about the treatment, and not a continuation of the argument--Rep.)
    Replicant

    Dx Feb 2006, PSA 9 @age 43
    RRP Apr 2006 - Gleason 3+4, T2c, NXMX, pos margins
    PSA 5/06 <0.1, 8/06 0.2, 12/06 0.6, 1/07 0.7.
    Salvage radiation (IMRT) total dose 70.2 Gy, Jan-Mar [email protected] age 44
    PSA 6/07 0.1, 9/07 (and thereafter) <0.1
    http://pcabefore50.blogspot.com

  3. #3
    Thanks to all the moderators and contributors on this site. It has been a hectic few days here regarding HIFU, so let me add a bit of my story.

    I am a fairly new to most of this and defer to most for my information. While first researching my options regarding my treatment for prostate cancer, I came across an article by Dr. Andrew Weil. He is the founder and Program Director of the Arizona Center for Integrative Medicine (formerly the Program in Integrative Medicine), which he started in 1994 at the University of Arizona. He has become one of the leading proponents of integrative medicine. He is a best selling author and a graduate of Harvard Medical School, and one of the most widely known and respected alternative medicine gurus. He mentioned HIFU as an alternative treatment option for PCa. I trusted him and felt I should have been told about this option and all other by my doctor...didn't happen. My urologist was not real interested in discussing options other than surgery or radiation. Others were too new or not proven.

    I then started my own research, which I think all guys diagnosed should do. My research also led me to Dr. Scionti that does HIFU in Mexico and Nassau.

    I tried to learn as much as possible about the treatment and was glad when I found any information regarding it. As I have previously posted, I consider any information beneficial to me so that I can process it and come to my own decision. I was able to talk to Dr. Scionti and I found him to be straight forward in our discussions regarding my treatment. I would have no hesitation with him doing the treatment and even considered it for a short time. I continued to research to FIND THE BEST OPTION FOR ME.

    I realize information is not knowledge, but I feel I can make a more logical decision with as much input as possible. Even from those that shout non stop about their choice of modality. I got to the point of not paying too much attention to those that are zealots...and they are in every forum with every treatment option. Granted, perhaps not quite as vocal as we experienced here, but they are still out there.

    I am on many forums to gather as much information as I can...and for those of you that are considering HIFU, I urge you to go to all the other forums and do a search on HIFU. Go to a research engine and type in HIFU and read everything. There is a specific yahoo group called HIFU survivors where you can read info there too. My point is there is a lot of stuff to read so that you can decide for yourself.

    For myself, I have decided on Proton Beam Therapy at Loma Linda because it is the BEST OPTION FOR ME! I start treatment next week and hope and pray to have a favorable outcome. I also pray that all that are diagnosed can find the right treatment. It might be HIFU, it might be something else. Once I had made the decision, a huge weight was lifted. Please send out positive thoughts to the Universe and pray to a higher being for me and all those that are in this battle. Thank you for this site and for your input and knowledge. You have helped more than you will ever know.

  4. #4
    Senior User
    Join Date
    Sep 2009
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    124
    I've read and learned enough.

    My decision is to go HIFU, it came when I took my wife in for her mamogram. The doctor showed us the photo and pointed out the area of possible cancer, or calcification, as they both show up as little diamonds, shiney dots. then she had the biopsy, and it was ultra sound guided, because the ultrasound can indeed show the cancer spots. thank God it was calcification, not cancer. But, I now acknowledge the value of the simple ultra sound machine.

    Maybe it hasn't been proven to work 10 years out, but nothing has.

    I just called international HIFU and am gathering up all my data for review by the doctor. I feel very relieved. It's only money afterall, and it's my future I am gambling with. And I have heard that Aetna pays, that's what I have.

    BTW, thanks lauriejo for your posts, although I've found many people at other sites talking with glowing remarks about their HIFU experience as well.

    Here is what I found helpful:

    HIFU for prostate cancer utilizes high intensity focused ultrasound (HIFU) to ablate/destroy the tissue of the prostate. During the HIFU procedure, sound waves are used to heat the prostate tissue thus destroying the cancerous cells. Essentially, ultrasonic waves are precisely focused on specific areas of the prostate to eliminate the prostate cancer with minimal risks of effecting other tissue or organs. Temperatures at the focal point of the sound waves can exceed 100oC In lay terms, the HIFU technology is similar to using a magnifying glass to burn a piece of paper by focusing sunlight at a small precise point on the sheet. The ability to focus the ultrasonic waves leads to a relatively low occurrence of both incontinence and impotence. (0.6% and 0-20%, respectively. According to international studies, when compared to other procedures, HIFU has a high success rate with a reduced risk of side effects.

    HIFU was first used in the 1940s and 1950s in efforts to destroy tumors in the central nervous system. Since then, HIFU has been shown to be effective at destroying malignant tissue in the brain & prostate. Today, the HIFU procedure for prostate cancer is perfomed using a transrectal probe. This procedure has been performed for over ten years and is currently approved for use in Japan, Europe, Canada, and parts of Central and South America.

    It is completely non-invasive, except you do need a supra pubic catheter installed for 2 to 3 weeks.

  5. #5
    Moderator Top User HighlanderCFH's Avatar
    Join Date
    Nov 2011
    Posts
    7,186

    Sticky: What I Need to Know about HIFU

    I received a request to start a sticky on this topic, so I've set it up and we'll see what kind of interest it draws.

    Hopefully it will be of help to those who are considering this treatment.

    I'd like to see people who have experienced it post both pros and cons so others will find it of value as they try to make their treatment decision.
    July 2011 local PSA lab reading 6.41 (from 4.1 in 2009). Mayo Clinic PSA 9/ 2011 = 5.7.
    Local uro DRE revealed significant BPH, no lumps.
    PCa Dx Aug. 2011 age of 61.
    Biopsy DXd adenocarcinoma in 3/20 cores (one 5%, two 20%). T2C.
    Gleason 3+3=6. CT abdomen, bone scan negative.
    DaVinci prostatectomy 11/1/11 at Mayo Clinic (Rochester, MN), nerve sparing, age 62.
    Surgeon was Dr. Matthew Tollefson, who I highly recommend.
    Final pathology shows tumor confined to prostate.
    5 lymph nodes, seminal vesicules, extraprostatic soft tissue all negative.
    1.0 x 0.6 x 0.6 cm mass involving right posterior inferior, right posterior apex & left
    mid posterior prostate. Right posterior apex margin involved by tumor over 0.2 cm length,
    doctor says this is insignificant.
    Prostate 98 grams, tumor 2 grams.
    Catheter out in 7 days. No incontinence, minor dripping for a few weeks.
    Seven annual post-op exams 2012 through 2018: PSA <0.1
    Semi-firm erections without "training wheels," usable erections with 100mg Sildenafil.
    NOTE: ED caused by BPH, not the surgery.

  6. #6
    Experienced User
    Join Date
    Jul 2013
    Posts
    60
    Here is the transcript (or you can listen online) to an hour long interview given by Dr. Scionti from Sarasota who performs HIFU. Informative both about HIFU, FDA approval, and the current unlikely approval by insurance: http://www.curetalks.com/event/rsvp/...n-Scionti/242/
    David W

    PSA:
    1/04: 2.3
    2/09: 3.2
    3/12: 3.9
    5/13: 4.1
    5/14: 4.5
    8/15: 4.9 (10.5 years to double)
    10/15: MRI, two lesions, equivocal suspicion
    11/15: Biopsy positive, in 9/14 cores, both lobes, Gleason 3+3=6
    11/15: CT scan, PCa confined to prostate
    12/15: Researching treatment choices.
    2/16: Scheduled for HIFU on 2/26/16 with TURP laser vaporization 3 days before (to reduce size of prostate to <40 cm)
    2/16: TURP Laser vaporization peformed pre-HIFU even though prostate was <40cc. Uro recommended to minimize risk of blockage post-HIFU
    2/1: HIFU on 2/26/16
    3/16: Catheter removed 3/3/16. No incontinence issues.
    5/16: First post-HIFU PSA 0.58
    7/16: PSA 1.13 (contemporaneous with blood in urine after 30+ mi. bike ride)
    9/16 PSA 1.48
    11/16 PSA back down to 0.59 (Whew! What a relief it is!)
    12/16 PSA 1.12
    1/17 PSA 0.60
    2/17 PSA 0.47
    4/17 PSA 1.03
    7/17 PSA 0.44
    10/17 PSA 0.13
    5/18 PSA 0.24
    9/18 PSA 0.11

  7. #7
    Experienced User
    Join Date
    Jul 2013
    Posts
    60
    I continue to investigate HIFU for possible treatment of my PCa. Here is a good, admittedly bullish article on HIFU from a Canadian physician. Although the article was published in 2011, I think it is a good overview of why HIFU was "ready for prime time" for someone who is considering HIFU. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3235210/#
    Last edited by DaDavid; 12-16-2015 at 08:47 PM. Reason: clarify
    David W

    PSA:
    1/04: 2.3
    2/09: 3.2
    3/12: 3.9
    5/13: 4.1
    5/14: 4.5
    8/15: 4.9 (10.5 years to double)
    10/15: MRI, two lesions, equivocal suspicion
    11/15: Biopsy positive, in 9/14 cores, both lobes, Gleason 3+3=6
    11/15: CT scan, PCa confined to prostate
    12/15: Researching treatment choices.
    2/16: Scheduled for HIFU on 2/26/16 with TURP laser vaporization 3 days before (to reduce size of prostate to <40 cm)
    2/16: TURP Laser vaporization peformed pre-HIFU even though prostate was <40cc. Uro recommended to minimize risk of blockage post-HIFU
    2/1: HIFU on 2/26/16
    3/16: Catheter removed 3/3/16. No incontinence issues.
    5/16: First post-HIFU PSA 0.58
    7/16: PSA 1.13 (contemporaneous with blood in urine after 30+ mi. bike ride)
    9/16 PSA 1.48
    11/16 PSA back down to 0.59 (Whew! What a relief it is!)
    12/16 PSA 1.12
    1/17 PSA 0.60
    2/17 PSA 0.47
    4/17 PSA 1.03
    7/17 PSA 0.44
    10/17 PSA 0.13
    5/18 PSA 0.24
    9/18 PSA 0.11

  8. #8
    Experienced User
    Join Date
    Jul 2013
    Posts
    60
    There is a debate in the medical community over focal HIFU - only treating identified lesions and trying to preserve rest of prostate, along with some functionality. Here is link to article that highlights the debate and summarizes a new article advocating focal HIFU. (Because my PCa is in both lobes, focal HIFU is no option for me.) http://www.medscape.com/viewarticle/853490. Here is opening paragraph:

    Arguments over the use of focal therapy for prostate cancer, which uses ultrasound to treat only the index lesion in the prostate, have heated up. The October issue of the Journal of Urology carries a pro and con couplet of articles. The point of view in favor of focal therapy is from Mark Emberton, MD, who argues that focal therapy is "a legitimate and necessary response to a changing world." The opposing view is from Mark L. Gonzalgo, MD, PhD, who counters that focal therapy "aims to kill cancer while minimizing side effects" but that, on the basis of current data, "the hype...outweighs the hope."
    David W

    PSA:
    1/04: 2.3
    2/09: 3.2
    3/12: 3.9
    5/13: 4.1
    5/14: 4.5
    8/15: 4.9 (10.5 years to double)
    10/15: MRI, two lesions, equivocal suspicion
    11/15: Biopsy positive, in 9/14 cores, both lobes, Gleason 3+3=6
    11/15: CT scan, PCa confined to prostate
    12/15: Researching treatment choices.
    2/16: Scheduled for HIFU on 2/26/16 with TURP laser vaporization 3 days before (to reduce size of prostate to <40 cm)
    2/16: TURP Laser vaporization peformed pre-HIFU even though prostate was <40cc. Uro recommended to minimize risk of blockage post-HIFU
    2/1: HIFU on 2/26/16
    3/16: Catheter removed 3/3/16. No incontinence issues.
    5/16: First post-HIFU PSA 0.58
    7/16: PSA 1.13 (contemporaneous with blood in urine after 30+ mi. bike ride)
    9/16 PSA 1.48
    11/16 PSA back down to 0.59 (Whew! What a relief it is!)
    12/16 PSA 1.12
    1/17 PSA 0.60
    2/17 PSA 0.47
    4/17 PSA 1.03
    7/17 PSA 0.44
    10/17 PSA 0.13
    5/18 PSA 0.24
    9/18 PSA 0.11

  9. #9
    Experienced User
    Join Date
    Feb 2016
    Posts
    86
    Quote Originally Posted by DaDavid View Post
    There is a debate in the medical community over focal HIFU - only treating identified lesions and trying to preserve rest of prostate, along with some functionality. Here is link to article that highlights the debate and summarizes a new article advocating focal HIFU. (Because my PCa is in both lobes, focal HIFU is no option for me.) http://www.medscape.com/viewarticle/853490. Here is opening paragraph:

    Arguments over the use of focal therapy for prostate cancer, which uses ultrasound to treat only the index lesion in the prostate, have heated up. The October issue of the Journal of Urology carries a pro and con couplet of articles. The point of view in favor of focal therapy is from Mark Emberton, MD, who argues that focal therapy is "a legitimate and necessary response to a changing world." The opposing view is from Mark L. Gonzalgo, MD, PhD, who counters that focal therapy "aims to kill cancer while minimizing side effects" but that, on the basis of current data, "the hype...outweighs the hope."
    Hi Da David:

    I was curious as to whether or not you have had your HIFU treatment yet? if so, what are your impressions and where did you have it done?

    Thanks,
    Gio
    Enlarged prostate & protastitis since my 30's
    Completely asymptomatic in terms of sexual/urinary function
    PSA 2008 2.4
    PSA 2011 4.06
    PSA 2105 7.0 (free PSA 0.72)
    PCa Dx May 2015 from biopsy age of 64 (2/12 cores 10% involvement)
    Follow-up MRI guided biopsy in February 2016 DXd adenocarcinoma in
    9/20 cores ranging from 5%-70% involvement
    Gleason scores mixed 3+3=6. And 3+4=7
    2 rounds of High Dose Brachytherapy as Monotherapy at Stanford 4/20/16 & 5/5/16
    PSA August 2016: 2.45 (over 50% drop!)
    PSA November 2016: 1.54
    PSA March 2017: 1.46
    PSA June 2017: 1.45
    PSA November 2017: 1.24
    Told to expect PSA "bounces" typical of this therapy and not to worry unless they go up 3X in a row.
    No urinary, bowel or ED side effects noted. Take an occasional 1/2 Viagra or Cialis if I feel I might need it.

  10. #10
    Experienced User
    Join Date
    Jul 2013
    Posts
    60
    Quote Originally Posted by Lumore51 View Post
    Hi Da David:

    I was curious as to whether or not you have had your HIFU treatment yet? if so, what are your impressions and where did you have it done?

    Thanks,
    Gio
    Hi Gio. I'm flying to Florida today and my HIFU is scheduled for 2/26 with Dr. Scionti. I also have a "green light" laser vaporization scheduled for2/23, which is necessary to reduce my prostate to <40 cm, the max size sonablate can ablate. I do plan to report on my experience and impressions here later.

    David.
    David W

    PSA:
    1/04: 2.3
    2/09: 3.2
    3/12: 3.9
    5/13: 4.1
    5/14: 4.5
    8/15: 4.9 (10.5 years to double)
    10/15: MRI, two lesions, equivocal suspicion
    11/15: Biopsy positive, in 9/14 cores, both lobes, Gleason 3+3=6
    11/15: CT scan, PCa confined to prostate
    12/15: Researching treatment choices.
    2/16: Scheduled for HIFU on 2/26/16 with TURP laser vaporization 3 days before (to reduce size of prostate to <40 cm)
    2/16: TURP Laser vaporization peformed pre-HIFU even though prostate was <40cc. Uro recommended to minimize risk of blockage post-HIFU
    2/1: HIFU on 2/26/16
    3/16: Catheter removed 3/3/16. No incontinence issues.
    5/16: First post-HIFU PSA 0.58
    7/16: PSA 1.13 (contemporaneous with blood in urine after 30+ mi. bike ride)
    9/16 PSA 1.48
    11/16 PSA back down to 0.59 (Whew! What a relief it is!)
    12/16 PSA 1.12
    1/17 PSA 0.60
    2/17 PSA 0.47
    4/17 PSA 1.03
    7/17 PSA 0.44
    10/17 PSA 0.13
    5/18 PSA 0.24
    9/18 PSA 0.11

 

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