Prostate Cancer Treatment

News, Blogs, and White papers

Posted by Dr. Stephen Scionti on Apr 23, 2014 12:37:30 PM

Andy Results from High Intensity Focused Ultrasound (HIFU)

My name is Andy and I wanted to share my experience with PCa and specifically the treatment method I choose which is called High Intensity Focused Ultrasound (HIFU). I will also share my personal story which ranged from intense fear to elation it has been quite the journey.

Background:
I am 45 years of age and African American. I had been lax about going for physicals but began to get serious about it a year ago. My PSA results were considered above average and fluctuated between 4.0 and 6.2. I was given several rounds of antibiotics and in December, 2006 my PSA dropped to 2.0 and we thought all was okay.

April, 2007
I went to the doctor for a prescription for a sleep-aid because I had two international trips coming up for work. Because I am over 40 and in a high-risk group (African American) my doctor wanted to do another PSA test even though the last one showed 2.0. This test showed a PSA of 6.6 and I was referred back to the urologist. A free PSA test was done and I had a score of 7. I then went in for a biopsy and received the news on a Friday afternoon…my stage was T1c and a Gleason of 6 (3+3) and 7 (3+4). I was devastated, while I was no model for health I ran marathons and stayed fairly active. I was scheduled for a bone and CAT scan and a chest X-Ray which showed nothing of concern.

Finding a solution...
The urologist said that I should have treatment in 3 months or so. Instead of grieving my wife and I began to do research. My wife searched the internet in the day while I was working and found out about the HIFU procedure which is non-invasive. My first priority was removing the cancer cells and second was preserving the nerves and having no continence issues. We did a lot of research and found that for the early stage cancer HIFU had remarkable results. The downside is that it is not FDA approved here in the U.S. The procedure was performed in Puerto Vallarta, Mexico by an American Urologist who is very experienced with HIFU. We scheduled the procedure and then began to figure out how to pay for it (the cost is relatively expensive but there is financing).

Getting ready...
I have a very busy job and I found myself diving deeper into work to get everything done by the time of the HIFU procedure in mid-May. I scheduled two-weeks off of work and told just a few close people in addition to my Manager. I admit I was worried about being considered "damaged goods" or being sidelined at work. I continued on with my life and even ran a marathon a week before the HIFU procedure. I tried not to think about the upcoming procedure but found myself having small bouts of anxiety in the evening. My wife and I went to Puerto Vallarta a few days in advance of the procedure with the intent of sightseeing. We actually hung out at the pool and beach, enjoyed good Mexican food and talked a lot about our future. We stayed at the Westin Hotel and enjoyed fireworks on the ocean every night. While it was a great environment, I could not enjoy it because I was so worried about the PCa.

HIFU procedure.
The night before the procedure, we met the urologist at the hospital. Even though we were in Mexico the HIFU staff all came from the U.S. We were given an orientation of what to expect and asked a load of questions. The following morning a HIFU van driver picked us up at the hotel along with two other couples who were having HIFU done the same day. We went to the hospital and our wives bonded in the waiting room. The procedure itself was painless…I was given a mild sedative and an epidural. I woke up two hours later in a recovery room with a superpubic catheter in (goes in though the stomach). We left the hospital an hour later and went back to the hotel. Because you are on a liquid diet the previous 24 hours, I ordered a filling dinner from room service and slept the rest of the evening. The next day we relaxed and went to the pool even though I was very uneasy because I had a leg bag on due to the catheter. We had planned to fly back home in two more days but all I wanted to do was get back to my own home and recover there. We changed our flight and flew home the following day (two days after HIFU).

The real work begins.
I used a leg bag in the day and a larger night bag while sleeping. I wore this for a week and then the second week began to train my bladder. I would attempt to urinate normally and then use the catheter to remove any urine left in the bladder. At first I could only get out a few drops and then within a week I was emptying about 75%. I had the catheter removed about two weeks after HIFU. Because HIFU is non-invasive the Prostate tissue is eliminated though your urethra. This was somewhat painful and there was burning as the tissue came out. This lasted about one month total. I also had some mild urgency and this became better with time. I also began taking Cialis to restore the "manly function". For the first six weeks after the Catheter came off, I had a mild case of leakage. If I could not get to the bathroom quick enough, a small amount of leakage occurred. All in all the first two months after HIFU were not too much fun but manageable.

Emotions set in...

Because I was so focused on the task of taking care of the PCa, I did not have the time to digest what was going on from an emotional standpoint. Once the physical trauma became less I then started to think about "why me". I became very depressed and felt like a victim in some ways. What helped was speaking to men dealing with PCa issues; I realized that there is a fraternity out there and I was not going though this alone. I also spoke with a therapist and began working on dealing with anxiety. Things became better and I began running again. The other benefit was that I began to appreciate the "real" things in my life. I spent more time talking with family and spending true quality time with my wife. I started to see that I was changing and my wife said that I seemed to be a "deeper" person.

Now what.
Well at this point, HIFU worked – at two and a half months and six months, I had a PSA test and both have come back as “undetectable”. I have begun running again and have adopted a healthier diet. There are no real issues with continence and the potency is returning. I am looking at the PCa as a hill I have to cross in this marathon called life. I know that this is a long-term issue and I will continue to have my PSA checked every three months for the next year and less frequent after that.

Recommendation.
I recommend everyone who is dealing with PCa to get informed before making a decision. Consider all options. It was a blessing my wife found HIFU on the internet. Talk to other men dealing with PCa use a support group like UsToo or a therapist to help with the emotional side. Enjoy the people in your life because each day is precious. Participate in the things we say we don't have time for, exercise/eat healthy and lastly spread the word on early detection. 

~ Andy

Topics: HIFU Patient Stories