Focal Cryo Therapy for initial treatment

Wow! Your manhood was way bigger than mine. Lols! Mine is 37cc. Was the Holep procedure easy or difficult to tolerate? I think I read where cryo may not be recommended for men with very large prostates. Not sure why? So yes, the Holep reduction should be a plus. You may be a candidate for a focal treatment if needed. You may have told me this before, but I can't remember without searching the forum. I suspect you have low volume of 3+3 or 3+4 and you're actively surveilling? Of course I'm hoping to get lucky and have a one and done procedure. Wishful thinking on my part. More likely be lucky just kicking the can down the road. Anyhow, thank you for commenting. I will continue to post as my Fox Chase adventure unfolds.

Hi Old Salt, Yes, focaltherapy for Pca is "relatively" new, but not brand new. The medium term data is very encouraging for several of the technologies. I believe advances in imaging has been the main driver. Just about all of the major cancer centers now offer some form of focal treatment for qualifying patients. Hifu and Cyro being FDA approved seems the most utilized. In recent years it has been gaining acceptance. There is currently a prostate cryo study at MD Anderson in Texas, but logistically out of the question for me. I am not in a clinical trial. I will most definitely be posting my experience with Fox Chase.

Have not yet discussed details about PSA monitoring. He did articulate that post procedure will require routine careful monitoring, and another biopsy at some point. I'm going to ask him if subsequent PSMA PET scans might be an alternative to biopsies? Seems to me that should be an option? On this note, I've found with several doctors I have dealt with so far they don't seem to champion the PSMA PET scans. I had to practically beg them to write a script. From what I've been reading the PSMA PET scans are a game changer in being able to locate prostate cancer . I have to wonder if it's just reluctance to change or is there a more definitive reason? Perhaps insurance is not covering them? My insurance United Healthcare Choice Plus payed for it.

Looks like May 30th if I don't chicken out. I am concerned that they don't do many of these procedures for prostates. My son tells me to stop worrying and just do something. Maybe they'll electrocute me and end all my worries. Lols!

My Fox Chase doctor stated they do about 4 focal treatments per month for prostate cancer. Including HIFU, Cryo, and IRE. No where near thousands. I'm not sure if they've done any IRE procedures since concluding the "Preserve" clinical trial? They also use Cryo and IRE to treat other types of cancers at Fox Chase so that ups their experience a bit with those technologies. I think focal is a big area of interest to all the major players however. If not, why are they offering it? They know it has much potential or they would not be investing in it. According to my doctor, placement of the probes is a key factor in both IRE and Cryo, but I imagine not the only factor. The technician utilizing the equipment's software would be very important in my opinion. It's a bit of a crap shoot, but I've already waited way too long. The thought of staging with another institution and not being within a relatively local distance is distressing to me. I've read many times to find the best most experienced doctors even if that means travel, but as wise as that sounds, considering with follow up appointments it's logistically impossible for many. As I've stated before, focal is not for everyone and yes there is a higher incidence of recurrence, but the fact that I qualify for it, why not give it a shot. I might get lucky and one and done and have lowered my side effect risks compared to RP or RT as primary treatment. I will still have those options. The down side is; after focal treatment I will be in active surveillance mode. Which the way I'm looking at it, I would still be anyhow no matter which initial treatment I get. Do I make any sense? This doctor I have is very cautious about expressing his opinion even when I ask him directly. He is an oncological urologist surgeon. He has offered surgery as one option along with the others. He even sent me to a Fox Chase Radiologist to discuss radiotherapy. Even after pressing him, he only replies "it's a decision that I have to be comfortable with." My thoughts are "I'm not comfortable with any of them!" Lols! As hard as I have tried to learn as much as I am able, it just seems this decision is a conundrum where logic does not always apply. The amount of information (/ misinformation) and opinions on prostate cancer is daunting. Attempting to navigate it while inflicted with it is incredibly stressful. My stepfather used to tell me "you have to play the cards you are dealt." He was inflicted with Multiple Sclerosis at a relatively young age. It progressed horribly. He never gave up in spirit. He just kept adapting to his symptoms. When I see images of children suffering from cancer, I'm thinking how lucky I am having made it to 67 without hardly a hitch. That said, I'm hoping to beat this thing one way or the other. For me, at this point any of the choices is better than no decision.