50 and Full of Life. Need advice. TULSA or HIFU or what?

Great to see that you are doing a lot of research to decide on your treatment plan. I was five years older than you when I was diagnosed with Gleason 7 (4+3) and had to assess my life goals and treatment options. My highest goal was life for 30+ additional years free of prostate cancer, with continence 2nd and erectile function 3rd.

I ended up deciding on a radical prostatectomy at a center of excellence, Mayo-Rochester. If you want the best possible outcome and least chance for negative side effects (incontinence, ED, infections, etc.), you must go to a center of excellence for the treatment plan you chose. In addition, it is vital to do your research on the surgeon/oncologist/etc. to ensure you have the best possible and most experienced doctor. I did not want the department head, best instructor, or the surgeon who wrote the best books. Rather, because I chose surgery, I wanted the most experienced surgeon, who had done thousands of successful robotically assisted radical prostatectomies. This surgeon was doctor Igor Frank at Mayo-Rochester. What an amazing individual and surgeon. When I first met with him, he did not push surgery but rather wanted to ensure I chose the procedure that best aligned with my situation.
As I said, I was 55 when diagnosed. Also, I was/am very fit, very active, eat healthy, and not overweight - From my research, this does make a difference in outcomes and potential negative side effects. For my situation, there were absolutely no long term side effects . Obviously, immediately after the surgery, there was some incontinence, but this subsided and was tackled over about two months - I kept a pad underneath me at night for several months, but this was more to make me feel comfortable in case unexpected incontinence occurred. Doing all of your post surgery physical therapy is crucial. I did not do professional PT, but rather did my own at home. For myself, I had no erectile disfunction at all. Unwanted night time erections with the catheter were not comfortable, but tolerable.

Good luck with your treatment decision and I pray all goes well for you.

Jim

@cxracer

Just watched a good video. You can search for it on youtube.

Dr Geo podcast

What is HIFU, How it works & Who’s the best patient for this treatment - 158

Dr Matthew Cooperberg was very good.

He stated a few times:
- Focal therapies like HIFU will be better (most of the time) for the patient as far as incontinence and erection.
- There is no 10-15 year data to compare risk of cancer reoccurrence (Focal Therapy vs RP). His words are much better than what I just wrote.

For me, it was a good informative video.

Best Wishes.

@charlesprestridge
I have always leaned toward TULDA Pro. I even applied for the clinical trials but didn’t make it. I would choose TULSA over HIFU if I had the money but nobody will accept Medicare and my plan G supplement as payment. They all want $30K or more to do it. Ssd

@charlesprestridge
I have always leaned toward TULDA Pro. I even applied for the clinical trials but didn’t make it. I would choose TULSA over HIFU if I had the money but nobody will accept Medicare and my plan G supplement as payment. They all want $30K or more to do it. Ssd

@heavyphil Late prostate cancer metastasis to bone is typically treated with Xofigo (Radium-223) or Pluvicto (Lutetium-177) if it’s systemic.

I’ve never heard of HIFU being used for that purpose. But, for an isolated bone lesion it makes sense (instead of surgery or SBRT) - HIFU is targeted, non-invasive, & can be repeated if needed.

@charlesprestridge
I have always leaned toward TULDA Pro. I even applied for the clinical trials but didn’t make it. I would choose TULSA over HIFU if I had the money but nobody will accept Medicare and my plan G supplement as payment. They all want $30K or more to do it. Ssd

@tdoriausername
You might check again. This is from AI

Medicare coverage for the TULSA-PRO procedure in Tulsa is evolving, with new CPT codes effective January 2025 enabling potential coverage, especially when performed in hospital settings, though it's often treated as an outpatient service, and providers might bill separately, leading to out-of-pocket costs, so confirming with your specific provider and Medicare is crucial.

@tdoriausername What are your reasons for saying you would chose Tulsa Pro over HIFU?

@tdoriausername
You might check again. This is from AI

Medicare coverage for the TULSA-PRO procedure in Tulsa is evolving, with new CPT codes effective January 2025 enabling potential coverage, especially when performed in hospital settings, though it's often treated as an outpatient service, and providers might bill separately, leading to out-of-pocket costs, so confirming with your specific provider and Medicare is crucial.