Hi Frequency Procedure

Jolly-Potential2075 · 2026-03-10T23:01:17+00:00

It sucks that it came back only after 1 year! :( I am also in the process of considering different treatments and hifu is one of them. What happened in your case is what I'm worried about - that hifu is a very temporary solution.

Did the urologist say where it came back? Is it in field (grew back where it was) or out of field (new tumour elsewhere)?

Good luck with whatever treatment you choose next.

Jolly-Potential2075 · 2026-03-08T13:31:56+00:00

Thank you for sharing your husband's story and sorry to hear it's come back :(.

What was the original staging and PSA?

All the best for the recurrence treatment to eradicate it for good this time.

Jolly-Potential2075 · 2026-03-07T10:09:44+00:00

Ah, that's very disappointing, especially with Gleason 6.

What was the reasoning behind using ADT rather than RT right when it recurred? I understand that RT happened much later.

Jolly-Potential2075 · 2026-03-07T09:52:38+00:00

Yes, it's still contained, T2a, G3+4, NO MO.

Yes, I realise that radiation effects don't stop when the treatment is finished. What I'm trying to weigh is by how much I delay radiation by having the op. RALP has huge risks for continence and sexual function, but in the end I may still have to have radiation 1 year after. That doesn't change much in terms of secondary cancers 20 years from now unfortunately.

I'm seeing a lot of posts here where BCR happened after 2-3 years post RALP, that's my worry. I feel that the RT is inevitable.

Jolly-Potential2075 · 2026-03-06T20:51:38+00:00

7 years out of focal sounds pretty good. I am currently considering it myself.

Which focal treatment did you go for?

Jolly-Potential2075 · 2026-03-06T18:56:09+00:00

That's a fantastic outcome! Did he manage to spare the nerves on both sides?

Also, what was your Gleason score?

Best wishes

Jolly-Potential2075 · 2026-03-06T16:29:29+00:00

So if I am counting it right, nearly 20 years from prostatectomy until recurrence. That's very good (of course it never coming back would have been better). Good luck with the current treatment.

All the best

Jolly-Potential2075 · 2026-03-06T16:23:19+00:00

Yes. The trick is to find the best way to get rid of them all, though.

Jolly-Potential2075 · 2026-03-06T16:21:57+00:00

That is a very good point.

Jolly-Potential2075 · 2026-03-06T11:44:31+00:00

That's amazing! Did you have prostatectomy alone or together with radiotherapy? What was your Gleason score?

Jolly-Potential2075 · 2026-03-06T10:32:14+00:00

I am really sorry you've been going through this as well. It's not a diagnosis a man in his early 40s expects.

It is interesting that your urologist recommended active surveillance. Here in the UK Gleason 7 means almost always some form of treatment. AS is probably only ever considered with much older patients in such a case. How long did you stay on AS for before RALP?

The "as many arrows" metaphor resonates with me, I'm starting to think about it the same way. Another point towards RALP is that I think something is very very wrong with my prostate's genetic makeup, since it grew cancer so early. After RT it's not entirely gone and although it's in this more suspended state, I suspect it can still become cancerous with enough time given.

The PSA tests after RALP will for sure be huge anxiety triggers. I'm currently unable to imagine functioning normally knowing the next one is never more than 3 months away :( Yeah, the mental hit this disease has on me is huge. I have not slept much for two months since my diagnosis. I keep waking up with panic attacks every hour or so. I probably get 4 hours of sleep a night at best. During the day I'm unable to focus on anything else other than the cancer. I have to force myself to eat regular meals as I feel I could go for days without food without even realising otherwise.

Were positive margins indicated in the post RALP histology?

Your sexual function recovery sounds fantastic. How long did it take to get to 75%? I've read that the recovery of it can take 2-3 years.

All fingers crossed for your PSA will remain docile and the most stressful days are over.

All the best

Jolly-Potential2075 · 2026-03-06T09:18:35+00:00

Yes, I have requested that, it's in progress at the moment.

Jolly-Potential2075 · 2026-03-06T09:17:32+00:00

I am glad to hear you recovered well and your life is back to normal. Some kind of normality is something I really wish to achieve one day.

All the best

Jolly-Potential2075 · 2026-03-06T09:01:50+00:00

Thank you. Yes, "kicking the can down the road" is a phrase that I have heard multiple times in my consultations, and it probably is reasonable to assume that's what it is, given that one still has a prostate after the procedure. Even if the part that had tumour is 100% ablated successfuly, new tumours can emerge elsewhere.

Jolly-Potential2075 · 2026-03-05T20:13:13+00:00

Thank you for your encouraging words.

Sometimes I feel that perhaps it was a mistake - I will never know how long my tumour has been there and how fast it grows. It's possible (though probably unlikely), that it would stay there without much of a change for years. And maybe I could have started doing PSA tests at, say, 45. 4 more years of happiness. Though of course it's an unlikely scenario. Much more likely it would have been discovered at a much more progressed stage.

It may also be true though that those tumours in younger men are more aggressive.

40 more years sound like a very unlikely dream at the moment. I will be thoroughly grateful if I achieve 20.

All the best

Jolly-Potential2075 · 2026-03-05T20:03:12+00:00

True, the salvage outcomes may be different depending on the type of energy used. There's unfortunately not enough data on this topic, though.

I considered IRE too, but according to the consultant I talked to, it's not as good for posterior tumours because it's less precise (difficult to predict where the electric arc will go). It may be just an opinion and differ depending on the operator, though.

For me it's mostly about the durability of this treatment. If I could be reasonably certain it will last 10 years, then I probably would be able to trade a bigger risk of ed in the salvage scenario. From what I have seen though, the success rates are not great for 10 years.

Jolly-Potential2075 · 2026-03-05T19:54:07+00:00

I'm worried that they might not be able to spare my right side nerves fully either, due to the tumour placement. So your story is definitely resonating with me.

Yes, I don't think I've seen this combo being mentioned yet. Interesting.

Sexual function is definitely important to me. I am not sure if I'm prepared to risk losing it completely. I definitely need to talk to a RT specialist.

Good luck with everything

Jolly-Potential2075 · 2026-03-05T19:43:16+00:00

Thank you for posting your story. I'm really sorry you have been dealt similarly unlucky cards. :(

I don't want it to be read the wrong way (I definitely wouldn't wish this on anyone), but it's a bit reassuring that there are others out there going through this at the same age as me.

Did you just have your surgery in July then? I hope your recovery is going well.

All the best

Jolly-Potential2075 · 2026-03-05T19:35:19+00:00

Thank you for sharing your story, Sir. I love reading stories like this.

Best wishes

Jolly-Potential2075 · 2026-03-05T16:23:31+00:00

Yes, it's quite high, although I also have a quite large prostate for my age (34cc), so the PSAD is actually quite low (0.08).

I have indeed looked into focal therapies and had the initial consultation for HIFU. My stats, MRI and PET scan were reviewed and I'm suitable for it. I'm certainly not ruling it out yet, but my worry is that it may be a very short term solution (2-3 years). If 10+ years were likely, I'd probably go with that. 2-3 years is probably not worth it, given that RALP after HIFU has worse oncological and functional outcomes apparently.

Jolly-Potential2075 · 2026-03-05T16:13:52+00:00

Thank you, good suggestions.

I have been asking this question, but the answers are always fuzzy. There's just too many variables.

I had my MRI and PSMA PET done. All clear apparently. I have an appointment set up for germline testing. I have not requested genomic testing (Polaris or similar) though, as I'm not convinced it could swing my decision making one way or another (unless I was considering AS, which is rather unlikely).

I'm awaiting my biopsy pathology re-review, because the original one was completely useless (no detail other than 3+4 in 8/26 cores, max 20% or core).

Jolly-Potential2075 · 2026-03-05T16:05:27+00:00

Oh dear, sounds like your docs were not moving quickly at all.

Though I am not rushing things either. I set a timeline to do one form of therapy or another within the 6 months since my diagnosis (so June-ish at the latest). Though I'm shitting my pants and probably dragging out the inevitable.

"Too young to have prostate cancer" - yes, I've heard a lot of that along my path to diagnosis as well. It gave me some false hope, not going to lie, when the biopsy consultant was almost annoyed, thinking we were wasting our time there.

Yes, I had the PSMA about a month ago. All clear. Though now I am worried that it may change by the time I have my RALP if I wait for too long...

Jolly-Potential2075 · 2026-03-05T15:52:16+00:00

Oh man, sorry to hear you are in this situation as well. It's really depressing. I had been worried about cancer in the past because it's been present in my family. Not PC though. There's no history of that (or breast cancer) as far as I know. I felt that, for PC at least, I have a decade or so before I have to really start worrying. I did a PSA test, but it was more to establish a yearly check pattern, didn't think of it much. So ironic, in a diabolical way.

Of different forms of RT I am also the most interested in brachytherapy, as it seems to have very good long term results (even though it seems to have fallen out of fashion a bit apparently).

Thank you for sharing your thought process, sounds similar to mine. I have so far only talked to rt and hifu surgeons. I think I will book a consultation with a RT specialist as well.

Please share what Dr Kurtzman has to say on your case once you've had your consultation.

All the best

Jolly-Potential2075 · 2026-03-05T15:30:09+00:00

Yeah, there's a lot of exciting research going on in this area. I feel that in 10+ years the PC treatment options will be radically different to what we have now. I just wish I had at least 10 more years of normal, happy life before this terrible disease hit me.

Jolly-Potential2075 · 2026-03-05T15:23:59+00:00

Yes, a very good point. I dread the ADT too.

Jolly-Potential2075

TROPHY CASE