After initial diagnosis, I considered all available options. In the light of the
Partin tables, RP (Surgery) seemed to be a poor option. At that time, urologists
would not complete the surgery if lymph nodes tested positive for prostate cancer
in the operating room. Current thinking by progressive urologists is to remove
the prostate and its primary tumor anyway. Metastatic PCa reponds better to treatment
with the primary tumor removed. CT abdomen and pelvis and bone scans negative.
Some abdominal nodes slightly enlarged.
PSA went to 0.16 ng/ml and remained
low until 2004. Went on intermittent Hormone therapy [Lupron]. Subsequent bone
scan and PET and CT all negative. Nodes did not change size with rise or fall
of PSA, ruling out PCa as cause of enlargement. Biopsied an enlarged node from
neck, discovered a non-hodgkins lymphoma, low grade, not life threatening.
Wanted
to do something other than Lupron. Discoverd HIFU,decided to go for it in Mexico
with Dr. Geo Suarez.
PSA
pre procedure was 7.5 ng/ml, post procedure it was 2.5 ng/mml, +60days 3.5 ng/ml,120days
5.1 ng/ml 150 days 5.6 ng/ml.
A
12 needle biopsy showed cancer in 10% of one core from the right apex. Dr. Suarez
wants to re-treat, says 3% need it. But HIFU left me impotent and somewhat incontinent.
I am not anxious to cause further degradation of urinary function!
I
am considering that option or Dr. Onik's cryotherapy. Oncologist and Uro recommending
Prostascint scan for distant metastasis prior to any decision to futher treat
prostate tumor.
During the last month I've had a tough prostatititis, with
severe retention. Had a TURP 48hrs ago. Removed necrotic tissue and the radiation
seeds. While healing from TURP,I'll be considering further salvage treatment options.
Since
my TURP on Jan 19,2007 I have had to return to the ER twice for severe urinary
retention due to bacterial infection and stricture. A Foley catheter was inserted
and left for ten days. I was also placed on ampicillin for the infection.
After
talking to Tom, I find this condition exists for a number of HIFU patients. He
had to have the urethra stretched and self cath for six weeks or more. His advice
was to stay on the antibiotic for at least six weeks. This seems to be good advice
as each time I go off the antibiotic, the infection returns. One theory is that
the Prostate is protected by a membrane which prevents the antibiotic from reaching
the prostatic tissue. The infection resides there and reinfects the urinary tract
whenever the meds are stopped.
I
removed the foley last Monday and began to try to self cath. This has only been
marginally successful as there is some blockage which stops the catheter from
going in all the way to the bladder.Using a small, 12fr, straight tip catheter
sometimes releases some urine flow and dislodges necrotic tissue which sometimes
plugs the catheter and sometimes is discharged while urinating. Today, while I
continue to leak urine, I am unable to get a stream started, nor get a catheter
to release any urine flow. I fear I am headed for the ER if I get too uncomfortable
from retention tonight.
Would
I choose HIFU based on my experience? Hell NO! It was expensive, did not kill
the tumor and left me with a debilitating condition that does not seem to have
a solution.
I
have not been able to urinate since my TURP on Jan19,2007. After many indwelling,
trans-urethral catheters were inserted and removed, I had a Superpubic tube put
in my bladder on March 2nd.My local Urologist could not answer my two questions,
why can't I urinate? nor what are we going to do next?
I
went to Mayo Clinic for evaluation March 20,2007. The urologist there concluded:
1.
Infection is not the cause, though I have high colonies of bacteria at times,
that may be cronic.
2.
The tissue damage from the TURP has to heal as it is very inflamed.
3.
The tissue in the area does not heal well due to radiation and HIFU effect.
4.
Worst case: Remove bladder, prostate and lower bowel, leaving me with both a colostomy
and urostomy .
Guys,
there is a reason HIFU is not approved here. If you are a radiation failure, stay
away from HIFU.
Fred
Gillick and Nancy live Park Ridge, Illinois, USA although he has not stated that.
He was 57 when diagnosed in September 1996. His initial PSA was 25.4 ng/ml, his
Gleason Score was 4+3=7 and he was staged T2c. His choice of treatment was Brachytherapy
+ External Beam Radiation.