So what about HIFU????

the.wife said:

True, I really know very
True, I really know very little about this cancer, but reading that Larry said his gleason was "changed to 3+3 (7) post surgery" sounds like he still has it. Hold on, how does 3+3=7 ?

If you did HIFU your back up plan would be anything out there, ultrasound doesn't mean you can't do surgery or radiation or more HIFU, if it fails the first go. HIFU can kill cancer outside the gland. Did you talk to a real qualified HIFU doc Larry, or just a regular urologist?

Anyone who understands all of it is spending too much time being consumed by it, unless they are getting paid!

If you just don't know Larry, then think it's all gone until they prove otherwise.

The.wife...If I said 3+3 7
The.wife...If I said 3+3 7 Post surgery that is a typo It was 3+4 7 Post surgery. What that means is .....At Biopsy time pre surgery they took 12 samples and graded as 4+3 7 from the samples. After Surgery they have the entire PROSTATE To grade and changed it to 3+4 7 for the overall. That does not mean that I still have cancer. That was the final Gleason Score.

Yes I talked to A Qualified HIFU Doc. I don't recall his name but he did his procedures off shore in the Bahamas. I actually talked to them 3 times and read all there reserach.

Don't forget that with Proton, HIFU or radiation scar tissue will be preformed which makes follow up surgery more difficult.

Larry

the.wife said:

Randy, I’m no reinvention,
Randy, I’m no reinvention, but I’ll get lost, and be back in 6 weeks after my sweeties treatment, as I know you must want to know about a new treatment that has less side effects - so you can inform men, if it goes poorly I’ll be back in that case as well, I am only about the truth. It’s sad this is the only way we can find out about HIFU, as my doc was a creep, he wouldn’t have ever told me.

I certainly don’t know that much about PC, but I know enough to give my sweetie the treatment with the best odds of working and no side effects.

Good luck guys, stay away from Randy in Indy selling surgery, the old fashioned way to get PC. Trew was right on, why take the chance of surgery?

The.wife Not sure what you
The.wife Not sure what you mean by staying away from Randy....He gives solid advice from his experience and Surgery is not old fashioned...DaVinci is very state of the art for surgery. Why take the chance of surgery you ask? Any treatment carries a risk....have you even looked at the risks associated with HIFU? Here are just a few that I found with a quick internet search:

From...www.hifumedicalcenter.com/WhatisHiFu/PossibleSideEffects/tabid/81/Default.aspx

The side effect profile potential for complications exist with high-intensity ultrasound as it does with every prostate cancer treatment. Some patients will experience urinary urgency and mild discomfort lasting one to four weeks. A urinary strictures may occur in up to eighteen percent of the patients with retention in 0.6 percent. Erectile dysfunction is found in 20 percent unless nerve sparing is elected. A rectal fistula has been reported in one percent...

from: www.cancerhelp.org.uk/type/prostate-cancer/treatment/high-intensity-focused-ultrasound-for-prostate-cancer:
the most common problems reported after HIFU were infections in the prostate area and incontinence.

From: www.prostate-cancer.org.uk/info/prostate_cancer/treatment_hifu.asp#6
Sexual problems
Studies show different figures for the number of men who find it difficult to get an erection after HIFU treatment. The number of men affected may be as low as one in five (20 per cent) or as high as four in five (77 per cent). However, these figures are no worse than for radical prostatectomy or radiotherapy 3.

Again we all wish you and your 'sweetie' the best in your battle. Just remember to read the facts.

Randy...Keep giving the advice...Each person has to weigh the risks and then decide. Hifu is not for everyone as you know!

Larry

the.wife said:

Dr. Suarez is the HIFU father in the U.S.
Thought someone may be interested in who Dr. Suarez is, he is THE guy who brought HIFU to the U.S.

He has actively volunteered his services to his community and is the past president of the League Against Cancer (www.leagueagainstcancer.com), a Miami based non-for-profit organization in which doctors volunteer their time and services, as well raise donations to treat cancer victims who have limited or no economic resources. The organization received the President’s Community Volunteer award in 1990, by former President George H. Bush. Several years later The United States Congress commended Dr. Suarez for his continued community volunteer activities, and again was personally recognized by President Bush in 2002 for volunteer spirit and for changing the lives of so many.

Dr. Suarez was the first American urologist to clinically practice HIFU outside the FDA clinical trial sites. Shortly thereafter, he and business partners founded USHIFU and the International HIFU Centers which currently operate throughout Canada, Mexico, South and Central America, the Bahamas, India, and South Africa. Under Dr Suarez’s guidance, USHIFU and International HIFU Centers have provided training to over several hundred urologist and treated over 1,000 patients.

As he is still treating men with HIFU, he certainly hasn’t been fired by the company that owns the Sonablate.

Dr. Suarez is a Board certified urologist who practices in Miami, Florida, and is a former faculty member of the University of Miami department of Urology. Dr Suarez completed his training in general surgery at Northwestern University, Chicago, Illinois, and his urology residency and fellowship at Tulane University School of Medicine, New Orleans, Louisiana. He has received numerous awards including the S.E.S American Urology Association prestigious Montague Boyd award for excellence in research. He is an active member of numerous medical societies including the Societe Internationale D’Urologie, the European Urology Association, the New York Academy of Sciences and the American Urologic Association. He is a fellow of the American College of Surgeons and the American Academy of Pediatrics.

I don’t like it when people talk about someone without knowing both sides, this is a respected surgeon who wants to honor his Hippocratic Oath by treating men with HIFU.

Dr. Suarez has said, "This is really my passion, We can't differentiate between a biologically aggressive [prostate] cancer and a nonaggressive cancer, so we're overtreating everybody with radical surgery and radiation, often with devastating side effects“.

He is my hero, anyone who takes such radical moves to forward cancer care is a great guy, because of him prostate cancer may someday be the gentle cure it should be. and we see why Dr. Koch is so jealous of Dr. Suarez.

Dr. Suarez
From the NY Times, January 18, 2008

Despite Doubts, Cancer Therapy Draws Patients
By STEPHANIE SAUL
PUERTO VALLARTA, Mexico — Some weekends, more than a dozen American men wait at beachfront hotels, anxious for their turns in the treatment room at a small private hospital here.

They are medical tourists with prostate cancer. And they are queued up for the latest therapy — one advertised with pictures of couples strolling on the beach and pitched as a way to treat the patients’ disease while preserving their sex lives.

The treatment is called high-intensity focused ultrasound, or HIFU (pronounced HIGH-foo). And instead of using surgery or radiation, it attacks the cancerous tissue by heating the prostate to temperatures near boiling.

Tropical beaches aside, there is a reason that hundreds of American men have traveled out of the country to receive HIFU. It is not approved in the United States. And its growing popularity has some cancer experts voicing caution. They argue that there is not yet enough evidence that the treatment stops cancer over the long run and they say the side effects are not as minimal as described by US HIFU, the company sponsoring the offshore treatment weekends.

The company is attracting attention for its aggressive recruitment of American doctors who will go through training and perform the treatments. The company charges patients $25,000 to $30,000, a fee that is usually not reimbursed by insurance. Of that, the company pays the doctors $5,000 to $7,500 — several times what physicians earn for conventional prostate cancer procedures in the United States.

Critics worry that financial motives might influence medical decisions.

“The people doing the treatments down there, they’re just printing money,” said Dr. Thomas A. Gardner, an Indiana University School of Medicine urologist who has been involved in clinical studies of HIFU and who, despite his concerns, is enthusiastic about its potential. “Anytime anyone’s printing money, doing what’s right for the patient gets a little blurry.”

But Dr. George M. Suarez, medical director of US HIFU, which is based in Charlotte, N.C., defends the company’s fees, which are less than the cost of some other prostate cancer treatments. And he says he recommends the treatment because he believes that it works as well as surgery or radiation, with fewer side effects.

Nearly a quarter-million cases of prostate cancer are diagnosed in American men each year, and newer detection methods and increased vigilance mean that more cases can be caught while the disease is still curable.

Even earlier detection is expected with the advent of new genetic tests, like one announced Wednesday, that can identify which men are at high risk. Despite such advances, though, doctors still cannot predict which cases of cancer will spread. And so most cases are treated, even though most prostate cancer is slow-growing and in many cases would be harmless if left alone.

The company says it has treated more than 1,000 men in its centers since 2004. Stephen R. Puckett Sr., the company’s chairman, said that those patients “should have the right to choose their medical treatment and to choose where to have it.”

One of those patients is Gary Crissman, 54, a manufacturer’s representative from Pittsburgh, who was among five Americans treated at the small private hospital here one weekend in December.

Mr. Crissman said he had considered surgery and radiation, but worried about the common side effects of both — sexual impotence and urinary incontinence.

“I didn’t want to have the problem of potentially leaking, and I didn’t want to have the problem of erectile dysfunction,” said Mr. Crissman. Afterward, he said, his procedure was such a pain-free “breeze” that he celebrated with a Mexican buffet dinner in his hotel’s restaurant.

Positive patient testimonials can be found on the company’s Web site, which also lists the company’s treatment sites elsewhere in Latin America and the Caribbean and affiliates in Canada.

Not every customer has a good experience, though.

“The US HIFU site makes it all sound rosy; they give you none of the side effects and none of the bad results,” said Fred Gillick, a Park Ridge, Ill., real estate executive who received the treatment here in April 2006.

Mr. Gillick, 69, says the procedure left him impotent and he must wear a catheter at all times. Worse yet, he said, the treatment did not eliminate his cancer.

“Guys, there’s a reason HIFU isn’t approved here,” Mr. Gillick said in a Web posting on a cancer support site.

Even patients whose testimonials appear on the company’s Web site do not always have good outcomes.

Charles A. Reinwald of Tequesta, Fla., said Dr. Suarez treated him in the Dominican Republic in June 2004. Mr. Reinwald’s statement on the site, written a short time later, applauded HIFU for what he said were minimal side effects.

But three and a half years later, Mr. Reinwald, now 82, said in an interview that his cancer was not cured. Still, Mr. Reinwald, a retired lawyer who is the founder of the Cancer Cure Coalition, an organization seeking new cancer treatments, said that HIFU should remain available and that he had not asked the Web company to remove his testimonial.

The company declined to discuss individual cases.

Dr. Suarez, who is also an owner of the company, said he set up a HIFU machine in the Dominican Republic five years ago after learning about the technology at a urology conference. That led to the formation of the company with Mr. Puckett, who previously founded the MedCath Corporation, a national chain of cardiovascular specialty hospitals.

Although the company’s international treatment sites are outside the jurisdiction of the Food and Drug Administration, the company is sponsoring F.D.A.- approved clinical studies in the United States geared toward getting approval of the therapy. The treatment is approved in the European Union and Canada, where some American men have also traveled for treatment at centers operated by various providers. But there is skepticism among leading American doctors, as well as the American Urological Association, which has said there is too little long-term data to evaluate HIFU.

The head of the prostate cancer program at Memorial Sloan-Kettering Cancer Center, Dr. Peter T. Scardino, said the procedure might prove useful for some special cases, but “for the treatment of the average ordinary prostate cancer, I think it’s a second-class form of therapy.”

Dr. Scardino is among prostate cancer experts concerned that when HIFU treatment preserves sexual potency, it is not eradicating the cancer.

The primary treatments for prostate cancer have an impotence rate approaching 50 percent, as well as a lesser risk of urinary incontinence. Dr. Suarez and Dr. Stephen Scionti, who performs many of the company’s HIFU procedures in Puerto Vallarta, said that they could reduce impotence rates to the single digits.

But some doctors are skeptical of those figures.

Dr. Cary N. Robertson, a Duke urologist who has studied HIFU, said published research suggested that up to 50 percent of patients who undergo the therapy might lose all or part of their sexual function.

The company says that improvements in the equipment since those studies were completed have reduced impotence rates. There are also questions about whether HIFU’s long-term cancer cure rates are as high as those with standard therapies.

Citing a shortage of long-term data on the procedure, Dr. Scionti, who is based in Hilton Head Island, S.C., acknowledged, “We don’t know what the results are in 10 or 15 years.”

In the treatments done in Puerto Vallarta, after patients are sedated and given spinal epidurals, they lie on a surgical table with their legs in stirrups. The treatment is delivered through a probe inserted into the rectum.

During the treatment, doctors monitor a video screen image of the prostate. Because each dose of highly focused ultrasound is delivered in short spurts to small areas, it can take several hours. Mr. Crissman, the patient who described the procedure as “a breeze,” said the only discomfort was the catheter, inserted directly into his bladder through an incision below his navel, that all patients wear for about two weeks.

“Let’s say they didn’t get all of it,” he said. “The procedure can be redone if necessary. At a later day, I still have the options of surgery or radiation.”

In a telephone interview three weeks after the procedure, Mr. Crissman described his condition as so far, so good. “Everything works,” he said.

the.wife said:

Randy, I’m no reinvention,
Randy, I’m no reinvention, but I’ll get lost, and be back in 6 weeks after my sweeties treatment, as I know you must want to know about a new treatment that has less side effects - so you can inform men, if it goes poorly I’ll be back in that case as well, I am only about the truth. It’s sad this is the only way we can find out about HIFU, as my doc was a creep, he wouldn’t have ever told me.

I certainly don’t know that much about PC, but I know enough to give my sweetie the treatment with the best odds of working and no side effects.

Good luck guys, stay away from Randy in Indy selling surgery, the old fashioned way to get PC. Trew was right on, why take the chance of surgery?

I have already posted this
I have already posted this before but just to be certain. I do not wish any harm on anyone...ever. Additionally, I sure hope everyone fighting this peculiar beast can find first the cure and second the aftermath that they can live with and be happy about their choice. I always call it like I see it...and usually I would like to think I am right...but sometimes like everything in life people can be wrong with their judgements made....If I was not right in this case then I apoligize...and my bad. But having said that I do believe there has been enough information with links posted here by Kongo, Maria, Larry and to most certainly without one shred of doubt cast a caution for ANYONE considering HIFU as to the ultimate goal of A.) getting a CURE for cancer and even B.) having minimal side effects. And again I stand here today post surgery as many men (not all) but many who have excellent results in both continence and sexual function. So wife..I really do wish you and expecially your husband the cure and least amount of side effects...but for me.... the evidence researched and presented to me would not have HIFU as my choice treatment.

Have a great day!

Randy in Indy

hopeful and optimistic said:

Randy
You are doing fine.....a note is not required....I don't have any problems with your posts,in fact most of them are pretty good, and I've been reading them since you started posting here.........Is it possible that wife is a disruptive force, who formally posted here under a different name about HIFU, driving everybody nuts......i'm not saying yes or no....I just wonder.

Ira

Ira, LOL...yes...I suspected that a while ago...Look above
about 3 or 4 posts.


LOL

Randy in indy

Kongo said:

One Last Note on Dr. Suarez et al
The Chairman and CEO of HIFU International, where Dr. Suarez is the co-founder and medical director, is a 28 year hold history major from Vanderbilt. He founded the company when he was 23.

This one comment is enough for me to question HIFU
Coming from one of the most prolific figures in Prostate research and treatment Dr. Walsh at John Hopkins

"Walsh said, "There is no good evidence at this point that HIFU can effectively cure prostate cancer without significant side effects."

The US has not approved it because why....because of lack of evidence and research proving the claims of cure and side affects.

Randy in Indy