My Update since HIFU treatment August 2024
Last year, I met with numerous specialists to explore all treatment options for my prostate cancer diagnosis. I consulted with experts in radical prostatectomy, radiation, TULSA, and HIFU
, and I wanted to share a brief update on how I navigated these decisions and where I am today.
🧑⚕️ Consultation Highlights
Dr. Christian Pavlovich – Johns Hopkins
- Recommended
radical prostatectomy
- Did
not support HIFU
, citing surgery or radiation as the gold standard - If I pursued HIFU, he preferred
Dr. Alvin George
over Dr. Scionti due to insurance network coverage
- Recommended
Dr. Kevin Choe – Inova Radiation Oncology
- Specializes in radiation but
advised against it
due to my age and concern over long-term side effects
- Specializes in radiation but
Dr. Malhotra – Potomac Urology
- Recommended
radical prostatectomy or radiation
- Recommended
Dr. Jonathan Hwang – MedStar Washington Hospital Center
- Recommended
radical prostatectomy
- Recommended
Dr. Collins – MedStar Georgetown
- Specializes in radiation but referred me to
Dr. Hwang
for surgery due to my younger age
- Specializes in radiation but referred me to
Mayo Clinic – Dr. Pathak (TULSA)
- I was
declined for TULSA
due to tumor location; however, I believe they may not have reviewed updated imaging that suggested otherwise. Dr Scionti also said I was better HIFU candidate than TULSA
- I was
Dr. Vladimir Ioffe – Greenbelt Radiation Oncology
Strongly advocated for radiation therapy
, presenting options likebrachytherapy and CyberKnife
✅ My Decision: HIFU with Dr. Stephen Scionti
After carefully weighing the pros and cons of all options, I chose High-Intensity Focused Ultrasound (HIFU)
with Dr. Stephen Scionti
, despite him being out of network. While Dr. Alvin George
was in-network and also specializes in HIFU, I felt more confident with Dr. Scionti due to his deep experience, approachability, clear plan, and overwhelmingly positive patient reviews
.
- My procedure was completed in
August 2024
- It was
in-and-out same day
- I had a
catheter for one week
— initially a concern, but ultimately just a minor inconvenience - I returned to
full activity the following week
- Most importantly: I have had
no side effects
andfull sexual functionality
, which was a top concern in my treatment decision
📉 PSA Results Post-HIFU
3 months post-op
: 0.84 ng/mL6 months post-op
: 0.64 ng/mL (nadir)9 months post-op
: 0.86 ng/mL- These results are all
well below the 4.0 ng/mL threshold
, showing astrong response to treatment
and no sign of recurrence at this time
🤖 Research Support
I also want to note that ChatGPT
was a fantastic resource throughout this process — helping me research, clarify terminology, and prepare better questions for each specialist as well as this board.
Every person’s diagnosis is different, and there's no single "right" choice — but after seeking multiple opinions and weighing all outcomes and side effects, I’m extremely happy with my decision and my results so far.
Comments
-
at age 51 i would have it removed look up the gold standard for prostrate cancer and men expect to live more than 10 years. It is surgery you’re playing with fire. The best way to be cancer is to get it out of your body. I did radiation. I totally regret it. it came back. I didn’t think twice about salvage surgery. I am one year free and hopefully it’s gone for good. Good luck with your treatment.
0 -
All the options are still on the table if anything changes so Ill just continue monitor but quality life now with no side effects is worth the risk for me. There is still a chance of reoccurrence even with removal.
0 -
I had one lesion/area on the right that showed the cancer cells from MRI and further confirmed by the PET scan.
Advancements in imaging and energy focusing have significantly enhanced HIFU, allowing for sub-millimeter precision to ablate cancerous tissue while also creating a controlled margin of coagulative necrosis around the target zone to ensure local containment and reduce recurrence risk.
0 -
My post was largely based on recommendations from the American Urological Association:
Clinicians should inform patients with intermediate-risk prostate cancer considering whole gland or focal ablation that there are a lack of high-quality data comparing ablation outcomes to radiation therapy, surgery, and active surveillance. (Expert Opinion)
However, I did come across a recent paper (2024) describing the results of a fairly large French study that compares outcomes from HIFU with prostatectomies for intermediate risk prostate cancer patients.
0
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