First, I wish you the best regardless of your choice. My comments are merely to share my present results and the method I chose to combat my prostate cancer.

I had a 12 core biopsy. 5 samples positive for cancer...2 Gleason 8's, 2 Gleason 7's a 3+4 and a 4+3 and 1 Gleason 6. My Decipher score was .71. I too had a pretty good size calcification in my prostate. I was 64 years old when I was diagnosed and had treatment. I will be 67 in March. My pre-treatment PSMA PET scan indicated my cancer was confined to my prostate. The high and intermediate grade were on the left side and the low grade was on the right side. I spoke with a number of doctors who offered virtually every form of treatment. In the end, I chose TULSA PRO. I am in good shape for my age, and the radiation oncologist I spoke with was the only doctor who refused to treat me...saying that since I was young enough and in good health...I should have my prostate removed. He had not heard of TULSA PRO. After I chose that method, he asked to be updated and I have sent him every PSA Test and my MRI's and PSMA PET scan. He has been impressed with the results.

Since my treatment, I have had numerous PSA tests (every three months and they are steady). I have had three 3T MRI's and recently had a post treatment PSMA PET scan. Everything is clear...no cancer is visible on the scans and due to the stagnant PSA tests, that too looks to be a positive. I recognize that I had high grade prostate cancer and that my Decipher score indicated that my cancer had a propensity to spread. But, I still chose TULSA PRO. Due to your calcifications, you may or may not be a candidate for that procedure. Several of the doctors in Florida offer TULSA and other procedures such as cryo or HIFU all in one location. Your Decipher score is really low. I am not sure how that ties into Gleason scores...but, it might be worth exploring and maybe get a second read on that biopsy of a Gleason 7. I recognize that it would be rare for that biopsy number to be downgraded...but, I sure wish my Decipher score had been that low. With that said, all of my functions work perfectly and I do not need medication.

Because I was not a part of a trial, my doctor had some latitude during my TULSA procedure. He was able to ablate my cancer area several times. I believe in the trials only one swipe of that area is permitted. Since my procedure, algorithms in the software have been improved that provide for a "boost" over the cancer zones. It is my understanding that they have also improved methods for cooling the urethra....which should minimize post treatment strictures. In other words, the TULSA results should improve over the original trial numbers.

The doctor did mention that he would have to approach one of the nerve bundles that control one's sex functions. He did and it does not make a difference. As mentioned, I don't need any medication for anything. My prostate went from 57cc to 20cc. So, I no longer have the urge to urinate at night like I did prior to my procedure.

I recognize that I had high grade cancer and that it has a tendency to return. If it does, I have been told they can TULSA my prostate again or have other procedures if I wish. After my recent PSMA PET scan and PSA tests, my doctor mentioned we can now move on from tests every 3 months to tests ever 6 months. I was having a PSA test every three months and MRI's every six...plus the recent PSMA PET scan. Regardless of what treatment you might have, I would guess you will be under a similar protocol.

Deciding what to do is difficult. Given the information I had at the time, I would make the same choice again. I would encourage you to search out a study of over 3,000 patients recently completed in Europe. It was a head to head between HIFU (similar to TULSA) and prostate removal. The 30 month results indicated that HIFU was more effective at preventing cancer re-occurrence. Without digging it up again, I can't recall what grade groups of prostate cancer they reviewed. But, it is worth a look. It was a large scale head to head study...so, it should be accurate. A head to head is now ongoing between TULSA and prostate removal. If the results are similar, that might be a game changer.

Again, I wish you success in choosing the plan that is right for you and much happiness in the coming years.