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

Posted by cxracer @cxracer, Jan 12 8:46am

We're all here for the same reason, so I'll try to keep my introduction short.

I'm 50, still very young (IMO), full of energy, extremely active, healthy, and have a satisfying and active sex life with my wife. I began chasing increasing pelvic and low back pain in mid-late 2025 that I attributed to bicycle riding and racing. PSA scores of 6.2 and 6.6, followed by CT, MRI and biopsy confirmed Gleason 3+4 cancer, (Favorable Intermediate). Local urologist is a surgeon and recommends surgery / removal. Local oncologist is a radiologist, refers to it as Unfavorable Intermediate, and recommends EBRT and ADT (hormone therapy).

I'm an analyst by trade and don't like either of these options, due to their side effects directly impacting my quality of life, which I hope to be as long as possible.

I'm working with my local urologist and insurance company (BCBS) to provide me with an approved out-of-network referral to Mayo (Rochester), and in the meantime have a Mayo consult scheduled for Jan 15th. I have no idea what treatment options will be recommended, but I pray to God they're better than the two antiquated ones that have been recommended locally.

TULSA looks extremely promising to me, as well as HIFU, and I believe I am a qualified candidate for both.

Are there specific questions you all suggest I ask in my consult? Any other treatment options I should ask about specifically? Do you need me to provide additional specific info about my cancer in order to provide quality feedback?

Thanks in advance, and I've already gleaned a ton of info from reading may of the discussions here.

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

jeff Marchi | @jeffmarc | Jan 16 1:45pm

In reply to @tdoriausername "@jeffmarc Do you know if the TULSA Pro procedure is performed at the Mayo Clinic in..." + (show)

@tdoriausername
Mayo Clinic offers the TULSA-PRO procedure across its main campuses in Rochester, Minnesota, and Jacksonville, Florida,

jcf58 | @jcf58 | Jan 16 3:54pm

In reply to @tdoriausername "@service1010 HIFU does not seem as precise in delivery of the Ultra Sound. TULSA Pro probe..." + (show)

@tdoriausername I agree. I did Tulsa and described it as HIFU on steroids. It seems to be much more precise. My Radiologist said Tulsa gives him a level of precision he has never had before when using ablation to treat cancers.

jcf58 | @jcf58 | Jan 16 3:56pm

In reply to @tdoriausername "@charlesprestridge I have always leaned toward TULDA Pro. I even applied for the clinical trials but..." + (show)

@tdoriausername Medicare and my BCBS supplement covered all of my cost for Tulsa at Mayo.

service1010 | @service1010 | Jan 16 5:58pm

In reply to @tdoriausername "@service1010 HIFU does not seem as precise in delivery of the Ultra Sound. TULSA Pro probe..." + (show)

@tdoriausername Great explanation. Thank you

service1010 | @service1010 | Jan 16 5:59pm

In reply to @charlesprestridge "@cxracer Just watched a good video. You can search for it on youtube. Dr Geo podcast..." + (show)

@charlesprestridge Watched. Really good vid

tdoriausername | @tdoriausername | Jan 16 8:17pm

In reply to @jcf58 "@tdoriausername Medicare and my BCBS supplement covered all of my cost for Tulsa at Mayo." + (show)

@jcf58 Hi: Would you mind saying which Mayo clinic performed the TULSA Pro for you and what were the results of the treatment? Thanks.

tdoriausername | @tdoriausername | Jan 16 8:21pm

In reply to @jeffmarc "@tdoriausername Mayo Clinic offers the TULSA-PRO procedure across its main campuses in Rochester, Minnesota, and Jacksonville,..." + (show)

@jeffmarc Guess I'm out of luck. I live near Phoenix, Arizona.

jcf58 | @jcf58 | Jan 16 8:53pm

In reply to @tdoriausername "@jcf58 Hi: Would you mind saying which Mayo clinic performed the TULSA Pro for you and..." + (show)

@tdoriausername
Rochester-July 2024. Gleason 4+3, 30% of prostate ablated. PSA of 8.6 prior and holding steady at 0.7 ever since. Mayo declared no evidence of disease in July 2025. Zero side effects.