Dr. Scionti can describe everything a person needs to know about HIFU. He can talk about the process and the expected medical outcome. He cannot talk about how it feels to a patient. I can.My primary care physician recommended Dr.Scionti when my PSA had climbed two years in a row. I was 72 years old with no other symptoms. My wife and I came to see Dr Scionti twice before scheduling the treatment for me. First to have him explain the procedure. Then, after I had been tested to confirm that I was a candidate for HIFU.
He prepared us for every aspect of the process, and we understood what to expect. It was better than we expected.After the post-HIFU office visit, my wife and I picked up a nice bottle of wine on the way home to enjoy with dinner.That night I slept well, and the next morning after breakfast went for a short, easy two mile run. It has been just over three years since the HIFU. My life is normal. I exercise as always. Sleep through the night. Have no discomfort. For me HIFU was a wise choice. My experience with Dr. Scionti has been excellent.
- D. Snowden
It has been a year since I was treated for Prostate Cancer by Dr. Scionti using HIFU and I am totally satisfied with the results. No ED, no incontinence and a PSA score of 0.2. The procedure went exactly as Dr. Scionti described. I was back to normal within 2 weeks. When I was first diagnosed I explored many options, Dr.’s kept trying to push me towards a surgical option. I kept hearing that “I was young and over time I would heal”. With the surgery option the healing process could take up to two years. At the end of that period I would probably have ED and have to get used to occasional leakage. I wanted to find a more “humane” option for treatment.
If you have been diagnosed with Prostate Cancer I strongly recommend that you get in touch with Dr. Scionti and see if you qualify for the HIFU procedure. I believe that it is the best option for a bad situation.
- Jeffery B.
HIFU Review
Dr. Scionti is one of the most caring and knowledgeable doctors I have ever met. I was diagnosed with Prostate cancer 4 1/2 years ago. My then urologist gave me only the option of surgery with the probability of complications of sexual dysfunction and incontinence. Surgery would necessitate being away from work for many weeks to heal. My life for myself and my wife would be forever changed.
I investigated HIFU on the internet for a different approach to my medical issues. Thank God that I consulted with Dr. Scionti for a different solution to my problem. I had a 3T MRI and a targeted biopsy with Dr. Scionti to accurately localize my cancer. I had the HIFU procedure done on my prostate without any complications of sexual dysfunction or incontinence or pain. I went back to work and playing golf immediately. I am 4 1/2 years post-op, and I have been checked yearly by Dr. Scionti for any recurrence of my cancer with a 3T MRI or an occasional 3T MRI guided biopsy. All is well.
I am so grateful to Dr. Scionti for preserving my life and happiness. His expertise and knowledge of Prostate cancer and treatment are state of the art. Why have sexual dysfunction and incontinence if there is another option?
- Roger L.
HIFU Review
It is not unusual for a Vituro Health patient to travel to visit with one of our partner physicians. In the case of 67-year-old Don Hogue, his prostate health journey took him from Pelham, Ala., to the office of our medical director, Dr. Stephen Scionti, in Sarasota, Fla.
Mr. Hogue learned he had elevated PSA levels in mid-2015 and from there was advised by his urologist to have a biopsy performed. When two of the samples from one side of his prostate came back positive for cancer, he sought guidance from a friend who had recently had a similar experience.
After Mr. Hogue’s three-month post-treatment check-up, we caught up with him to hear his story.
“When I got my news, I thought about a friend of ours from Mobile, Ala., who had recently been diagnosed with prostate cancer and chose to have HIFU therapy done by Dr. Scionti to treat it. His procedure took place before HIFU was FDA cleared in the United States, so he flew to Nassau, Bahamas (where Dr. Scionti previously performed the procedure for a decade) for his treatment. I asked my friend what he thought about HIFU and he recommended it; he is very intelligent and his wife is, too, so I took their advice and looked up Dr. Scionti.
In addition to my friend’s recommendation, I knew I didn’t like the thought of having my whole prostate destroyed, whether it was having it removed or radiation treatments. With HIFU, Dr. Scionti said there was less likelihood of nerve damage and the number one complication of traditional treatments is incontinence and I did not want to go through that. I also liked the sound of keeping half of my prostate functioning.
I went down to Dr. Scionti’s office in Sarasota in November 2015 and had an appointment; Dr. Scionti wanted to do his own MRI of my prostate. He was very nice to my wife and me, and timewise, it all went as planned. After this, we set-up another trip for the actual HIFU procedure, to be done on December 8.
Dr. Scionti treated the side of my prostate where the cancerous cells were with HIFU. It took about 1.5 hours total for the whole procedure. I felt good following it and went back to the hotel. Shortly after, we went home and played the waiting game for three months until I could get another PSA reading.
I just got my PSA checked and called Dr. Scionti and it had dropped more than half, from 2.95 prior to HIFU, now down to 1.25. Dr. Scionti said he was very happy with that result and that it is right in line with the rest of his patients. It is expected to get better on next reading, which is in another three months. My PSA score is lower and I am doing well.”
- Don's story
For 57-year-old Melbourne, Fla., resident Ron R., it was never a matter of if he would ever get prostate cancer; it was when he would get prostate cancer. Life is Great after HIFU.
Coming from a family tree full of the disease – Ron's father, uncle and oldest brother had prostate cancer – he knew his chances were high to also have it at some point in his life, becoming one of the one in seven men who have the disease in their lifetime.
After a suspicious prostate-specific antigen (PSA) test result in February 2016, Robledo’s physician suggested he come back in six months to check it again, but he knew better and pushed for a biopsy. Prostate cancer was detected.
Robledo says his urologist is a surgeon and suggested surgery. Robledo began to research his options and considered proton radiation, which he believed would be better than surgery, but he knew radiation had its own side effects.
Then an acquaintance told him about high intensity focused ultrasound (HIFU) therapy and highly recommended it. This friend had HIFU to treat his prostate cancer in 2015, and had to travel outside the U.S. for the procedure, as it had not been FDA cleared yet.
“Once I started looking into HIFU and learning of its benefits, I discovered it made perfect sense and was the best way to go about handling my cancer. I’ve waited my entire life for this point – I have 20- and 23 year-old grown sons so my wife and I go away for three day weekends and have our marriage and lives again; I was not willing to have some physician go in and take my prostate out with all the complications it comes with – sexual inability and incontinence. I believe life should go on and be kept as normal as possible.
I also chose HIFU because I can have it done more than once. On April 28, 2016, I had my procedure and only about one-third of my prostate was ablated. My HIFU physician, Dr. Stephen Scionti, explained that there is a 40 percent chance I could eventually get prostate cancer on the other side of my prostate, but that is fine because I can choose to have HIFU again, which I could not do with other treatment options.
Being a business owner, HIFU also made sense because I did not have to miss 40 days of work by having radiation, which would have meant treatment five days a week for two months.
As for my procedure, nothing could have gone better – everybody was spot on. After coming out of anesthesia for 1.5 hours, my wife and I went to the car and I gobbled up a sandwich before we even left the parking lot. Within two hours I was in the Gulf of Mexico catching whiting.
I stayed in Sarasota until my catheter came out four days later. There was no pain – it was weird having a catheter and no pain; it didn’t stop me from doing anything.
People who know me and see me daily do not believe I had a procedure because they say I look great. It was a two hour cat nap and that was it.”
- Ron R.'s story
My HIFU Experience
I am 46, so my results may be a bit more optimal than most. I had focal HIFU done on a left side only tumor, 7 Gleason score (3/4), 4.1 PSA on March 20. I ran a mile and a half 4 times in the last week, but I wouldn't recommend running much earlier than that (I walked pretty much right away, but the pounding of running had me a bit wary). I had my catheter for about 10 days. That second week, I played some light tennis with my daughter.
I never had a problem with urinary leakage at all. Pain was also not an issue for me even immediately post surgery. There is no cutting at all if you have a regular catheter instead of a supra-pubic.
Sexually, I was functional as soon as the catheter was removed. I took 2 of the 3 Cialis pills from the original prescription because I thought I was supposed to, but the third one is gathering dust. Ejaculate had blood in it for about a month, and urine did when I over-exerted myself (which typically involved playing tennis with my daughter or carrying something too heavy).
Right now, I am very happy about my health. I went back to work (I am a solo attorney) part time within a week, and eased up to a full load within another week and a half.
Atlantis is okay, but expensive, and everything is charged a la carte. You do want to be near there, though, because that is where the team stays if you have some kind of a problem. I did not, and was taking the $3 ferry over to Nassau the day after my surgery to eat and go shopping. I ate a lot of conch within a couple of days of my surgery -- the natives swear by it as a male aphrodisiac, but I just thought it was tasty and I wanted to eat something local. I have wondered if that might have helped my healing though.
Frankly, I felt better two days after the surgery than the day before. My energy levels had been really compromised for months, and I noticed a difference right away. I am sure some of that was mental, but I don't think it all was. The catheter is no fun, though.
Dr. Scionti is great, the team was great, the facility was fine. I couldn't recommend it any higher. There was a gentleman at the orientation meeting Friday (surgery was Saturday) who was there for salvage treatment because he'd had a recurrence after da Vinci robotic surgery 7 years ago. But that does get to one of the bigger questions -- what can you expect in 7 years? I believe that magic bullet therapy will be killing cancer cells only with little or no side effects in the foreseeable future. See, for example, the ARM-P research currently being done at Yale: http://www.genengnews.com/gen-news-highlights/researchers-design-molecules-that-trigger-immune-response-to-hiv-and-prostate-cancer/67643130/.
I did this to preserve function, buy time, and restore my health in the short term. So far, it has surpassed my wildest expectations, but it has only been 6 weeks today. I submitted a package to my health insurer for reimbursement, but have not yet gotten a response.
I don't think Dr. Scionti would push you in the direction of focal therapy if he wasn't justifiably confident that you are a suitable candidate -- that is one of the reasons I picked him out in the first place. He may be cutting edge, but he is legitimate, and he is not just going to tell you what you want to hear. I intend to continue to follow up with him, even though I will be traveling to from Ohio to New York to do it. The staff at NYU is very user-friendly -- this is not a route them to the procedure and collect the money atmosphere at all.
Good luck to you. I hope I have been of some assistance.
- Tom's story
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's story
I was diagnosed with prostate cancer in 2004. During routine annual physicals and digital rectal examinations (DRE) in 2001 and 2002 a "ridge" had been detected on my prostate, but my urologists expressed no concern; my PSA scores were low. When my wife and I moved to South Carolina in 2003 I wanted to establish rapport with an urologist, and with her assistance I chose Dr. Stephen M. Scionti.
Dr. Scionti conducted a DRE on July 9, 2004, found an abnormal spot on my prostate, and recommended that a biopsy be performed. My PSA reading at that time was 2.2, down from 2.9 the previous year. A biopsy on July 20 confirmed the presence of cancer in the right lobe of my prostate, Gleason score of 6 (3 + 3). Magnetic resonance imaging (MRI) followed and confirmed that the cancer had not spread beyond the gland.
I had read that prostate cancer was the second most common form of cancer in men, second only to skin cancer, that there was a 50% chance of developing some form of cancer during one's lifetime, and that the incidence almost doubled every 10 years after age 40. While I was not exactly pleased that I had become a statistic, it did not greatly surprise me considering the odds. "Why not me?" crossed my mind instead of "Why me?" I decided that I would deal with the situation in a positive manner.
My wife and I met with Dr. Scionti on August 2, 2004 to discuss available therapies, e.g., radiation, radical prostatectomy, transurethral resection, hormone, chemo, and the various combinations thereof, along with the side effects associated with each therapy. I did not feel comfortable with the side effects associated with these therapies.
We also discussed cryoablation and its potential side effects and I felt a little more comfortable.
Research on the Internet helped me to confirm that cryoablation would best suit my situation, and my wife agreed. I (we) made my decision in a rational, clinical manner, and without a lot of anguish. I called Dr. Scionti to tell him what I had decided, and on August 9 he started me on short-term hormone therapy to reduce gland size. He indicated that the effects of the hormone would take a few months to wear off. An ultrasound on September 29 confirmed that the prostate was shrinking in size as expected. Cryoablation was scheduled for October 20, 2004.
The procedure was conducted in the hospital outpatient clinic on October 20 as scheduled, and since I arrived early in the morning I was released in the afternoon. The procedure was successful and Dr. Scionti was able to save the nerve bundle on one side. I went home wearing a supra-pubic catheter that proved to be more of a psychological inconvenience than a physical one, and I was very pleased when it was removed a week later. Normal urinary function returned upon removal, and I had no instances of incontinence. I took an antibiotic for several days after the treatment, but I did not require any pain medication. I was bruised and swollen for two to three weeks and had some perineal tenderness. I feel that my recovery was very rapid, and I'm slowly regaining potency. I have had two follow-up visits as of this writing, and my PSA levels have measured less than 0.1. I feel great and my energy level has increased.
I know that many men are reluctant to talk about personal matters such as prostate cancer, and years ago I might not have been as open. I strongly recommend that PSA and DREs be a routine part of all men's physicals.
I would advocate that cryoablation become the standardized treatment for localized prostate cancer.
Curriculum vitae:
- 67 years old at time of procedure
- Retired AT&T
- South Carolina
Treatment history:
Initial diagnosis: July 2004
PSA: 2.2
Biopsy: Positive
Gleason grade: 6
Initial treatment: Cryotherapy October 20, 2004
Results: Two follow-up visits, PSA less than 0.1
- Kenneth Stone's story
Edwin Kaylor Results with Prostate Cryotherapy
Dr. Scionti has been my doctor for years. I had an enlarged prostate, and I was getting regular PSA blood tests. They tended to be high, so I also had annual biopsies. They were negative for cancer but showed some precursors.
When the January 2005 biopsy came back positive, Dr. Scionti arranged a meeting with me and my wife. It lasted about two hours. He went through the various options, the benefits of each, the advantages and disadvantages. He felt that the cancer was contained in the prostate. Since I had such a large gland, surgical removal would be difficult, so in my case he recommended cryotherapy.
Surgical removal would be difficult, so in my case he recommended cryotherapy
He then ordered an MRI & bone scan, and found no evidence of cancer outside the prostate. Since that seemed to be the case, I was a very good candidate for cryo.
In early February, ten days after the biopsy, I had my cryo. The treatment apparently went wonderfully. Dr. Scionti was very satisfied with the freeze. It was supposed to be an outpatient treatment, but the hospital closed the outpatient section before I came out of recovery, so I ended up spending the night in the hospital. I had some swelling, but no bruising or tenderness; I did have a catheter (suprapubic) for about 2-3 weeks. About a week before the catheter was removed, I began urinating normally, which went smoothly. Initially, I had minor incontinence but it resolved itself in about two weeks. Before the catheter was removed my activity was rather limited. I went out to eat, but I was slower to get into sporting activity or exercise.
I feel very good about having chosen cryo. Given that I had such a large prostate for so long, I think it was really the smart option. It seems to me to be a very logical solution. I'm very pleased that Dr. Scionti offers different treatment options and makes intelligent recommendations according to the circumstances-there is not one treatment that's right for everybody.
Curriculum vitae:
- 73 years old at time of procedure
- Retired from a career in finance
- South Carolina
Treatment history:
Initial diagnosis: January 2005
PSA: 13.7
Biopsy: Positive
Gleason grade: 3+4=7
Initial treatment: Cryotherapy, February 2005
Results: First follow-up PSA <0.1
- Edwin Kaylor's story
THE GIFT OF HIFU High Intensity Focused Ultrasound
My husband and I have been married almost 32 years. Ben (not his real name) was a senior executive in the banking industry for 35 years and is now president of a real estate investment company. I own a boutique gallery that sells items crafted by artisans and presented in our signature packaging that has defined our brand. He is an avid outdoorsman and we are active in community charities.
Ben's PSA spiked two years ago and his doctor missed it. A year later it had doubled. He went on anti-inflammatories and the PSA remained elevated, though still in the "normal" range. His PCA-3 test was negative; his doctor indicated that "these things happen sometimes." I did research, and felt that a 3T MRI and targeted biopsy would be appropriate. I emailed Dr. Catalona and he concurred. We arranged to see Dr. Scionti after obtaining a 3T MRI in Boston. We expected the biopsy would not be necessary.
We went straight from the MRI to Dr. Scionti's office and, as soon as he saw the images, he indicated a biopsy was needed. He did a painless, targeted biopsy using the Artemis equipment, and I was relieved that Ben felt nothing. As far as I was concerned, that was a prerequisite. All this occurred right before Thanksgiving. A few days later, Dr. Scionti called with the news-a single small, Gleason 3+3 tumor.
We discussed all treatment options with him, and what other doctors would typically do. There was no way with something this small that we were going to have a radical treatment because of the side effect risks. Dr. Scionti explained about focal treatment. He never pushed us one way or the other, as some doctors do, but all things considered, focal HIFU seemed like the perfect solution. With Dr. Scionti being so well-versed and practiced, there was almost no chance of side effects.
Once we made the decision, I emailed Dr. Catalona again with the biopsy results and to say we had chosen HIFU. He emailed back, imploring us not to do it. However, we felt very good about our choice.
Another big deciding factor for HIFU was Brandon, one of International HIFU's nurses. A few years ago my husband had neurosurgery, and the information the doctor gave me afterward was inaccurate and devastating. Even though my husband is fine, it left me phobic about him going into a hospital again. Brandon understood. He said he would take good care of me as well as my husband, and promised he would make it as easy as possible for both of us. After my husband got the same reassurance from him, he said, "I want Dr. Scionti and I want Brandon." I then felt completely at ease traveling to Nassau, knowing Brandon would be there too. We booked January 25 for HIFU. Now we were ready to celebrate Christmas. Making the right decision and having peace of mind was like a beautifully boxed gift!
HIFU went smoothly. Once the anesthesia wore off, we went back to our hotel and had cheeseburgers that night. Four days later, the catheter came out, and my husband never had a single problem; the same with sexual function. He's the poster boy for focal HIFU.
I want to add how much Dr. Scionti and International HIFU both include the partner in the whole process. This can really calm both parties and can be a deciding factor in the chosen treatment. Let's face it, Dr. Scionti let me sit in during the biopsy and it brought my husband and I even closer and gave us full confidence in Dr. Scionti.
I'm grateful that I didn't give up when the first doctor said there was nothing wrong. If you've been with someone for 32 years, ignorance could cost him his life. This is cancer, and you have to catch it while you can. We'll go to Boston for follow up with Dr. Scionti. I am his biggest fan.
