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Gleason 3+4 A.S. or treatment?
Prostate Cancer | Last Active: Jan 13 12:14pm | Replies (33)Comment receiving replies
@jeffmarc appreciate the response as always. Do you know whether men with an enlarged prostate (i.e. 70 ml or higher) are disqualified as candidates for treatments like HIFU and or SBRT?
Replies to "@jeffmarc appreciate the response as always. Do you know whether men with an enlarged prostate (i.e...."
@ezupcic
Somebody else replied about HIFU. I guess it depends on the size of the prostate and other issues as to whether or not treatment is available. This is focal therapy and here is a comment about it from PCRI.
At the 11/1/2025 PCRI conference the following was said by Matthew R. Cooperberg, MD, MPH
What about focal therapy?
* The energy modality matters much less than the accuracy of the imaging - which is not there yet.
* Overall focal therapy is associated with minor side effects, but high rates of recurrence both in- and out-of-field.
* Focal therapy is not really a replacement for surgery or radiation; it is better considered an adjunct to active surveillance
For SBRT there is no such limit. They can work with any size prostate. If the cancer is spread outside the prostate, they frequently do not like to do surgery so radiation is the best solution. There are cases where IMRT plus brachytherapy can be more effective than SBRT.
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@ezupcic Somebody on this forum had a prostate size of about 100 and did Tulsa Pro. The benefit for him was he treated the cancer and his enlarged prostate at the same time. Tulsa Pro can actually be used as a standalone just for BPH. My Prostate was only 45cc and I ablated 30 percent with Tulsa. No doubt I am peeing much better these days!