Arizona Mayo Urologists for RALP or HIFU

Posted by jtmarti1 @jtmarti1, Oct 19 11:24am

I'm 48 w/ a 1.2mm lesion, 2 biopsies confirming a Gleason score of 3+4, 2.6 ongoing PSA. I was recently recommended to strongly consider either a RALP procedure or focal treatment (HIFU) in the near future to avoid the risk of the cancer spreading (vs. remaining on AS).

I really like Mayo AZ, but wanted to reach out to this forum to see if anyone has had either a RALP or HIFU procedure at Arizona Mayo. If so, which Dr did they choose, what was their experience pre/post surgery, etc. Thank you in advance for those that provide inputs, I have found this forum to be very beneficial in my learning process. Given I'm only 48, really worried about these procedures, Dr selection process .. given I'll be living with the results for many years to come (hopefully). Feel free to private message me as well.

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

jeffmarc | @jeffmarc | Oct 19 1:05pm

You do not want to remain on action surveillance now that you know you’ve got cancer with a Gleason 7. if you do nothing it will spread and probably get worse (higher Gleason).

At your age a prostatectomy would probably not be the best choice. Doing HIFU would give you the option of multiple other treatments if it came back, and it might cure it. It would also give you a good chance of being able to still get an erection. Surgery makes that possibility iffy.

I had surgery, HIFU wasn’t available 14 years ago or I would probably have picked it.

tuckerp | @tuckerp | Oct 19 2:58pm

I cant really answer. I had surgery at Banner in Mesa. I switched to Mayo after the surgery. My urologist is Wolters. Not sure he is the surgeon. Or the correct type of urologist. I have found Mayo to be very thorough and I am completely satisfied. I did not have surgery there because at the time (2019) they did not take Medicare. They now take Medicare but do not take Medicare advantage. Make sure to check your insurance.

Climber | @stevemaggart | Oct 23 7:55am

Given the small tumor size, a relatively low 3+4 gleason score, and your youthful age, I would be heavily leaning towards radiation over RARP. I'm 67 and had a NNS RARP at Mayo (Phoenix) with Dr. Abdul-Muhsin on 6/24/24 for 2 @ Gleason 4+5 tumors, stage pT3a, with CP4 identified. I think my surgeon did an excellent job given my situation, but I'm permanently impotent, though improved, I have significant incontinence, and at my first 3 month PSA, count was 0.26 so reoccurance is probable. I doubt at 47 you want to deal with those issues! Check out the numerous applicable videos with Dr. Scholz at the Prostate Cancer Research Institute. They will give you excellent information to assist your decisionmaking.

Colleen Young, Connect Director | @colleenyoung | Oct 28 5:59pm

@jtmarti1, you might be interested in this related discussion:

- First Appointment at Mayo Clinic in Arizona
https://connect.mayoclinic.org/discussion/first-appointment-at-mayo-clinic-in-arizona/
I'm also tagging fellow members @themurfs @dwheels8 @jerryegge @rick137 @hbnapu @dandl48 who have had care at Mayo Clinic in Arizona.
@jtmarti1, how are you doing?

themurfs | @themurfs | Oct 28 6:14pm

My husband, now 65, had RARP at Mayo in Phoenix this last June on the 5th. His surgeon was Dr. Scott Cheney. He is an excellent surgeon and was able to do nerve sparing. My husband is not incontinent and has able to get an erection. It's not as strong as it was but it's getting better all the time. His recovery went well and pathology provided a much more definitive diagnosis (he was bumped to from a 4+3=7 to a 4+5=9). He now has the option for radiation as treatment should his cancer return. He does not regret his decision of having surgery verses radiation and hormone deprivation. We HIGHLY recommend Dr. Cheney and MAYO in Arizona! They were all wonderful there and we have zero regrets. If you would like more detailed into, like where we stayed and how surgery and recovery went please feel free to ask. Wishing you the best! The hardest part for us was making the decision on what to do! God bless you as you travel this road!