Prostate cancer diagnosis on March 6

Did you have a mpMRI followed by a fusion biopsy or was this a random Trus biopsy? If the later get a MRI to make sure there was a lucky hit of your only lesion. Focal is good for a single lesion and Medicare covers several options. If you have a (dis)Advantage plan than you will need to go through authorization and there is a good chance it will be denied.

Focal therapy can work with the apparent early case that You have. It is not always successful, but it has a high satisfaction rate. Medicare will cover various types of focal therapy.

Active surveillance may make sense. Definitely get checked out in six months. 30% of a four is a little bit high.

Here’s some more information on active surveillance.

Here is a video with Dr. Laurence Klotz, one of the experts on active surveillance. He can give you answers as to why you would or would not be a good candidate for active surveillance.

Active Surveillance for Intermediate Risk Prostate Cancer w/ Dr. Claire de la Calle | Ep. 288

I was 69 when diagnosed. Gleason score 3+3 in multiple samples. 5 were benign, 2 suspicious, and 5 malignant.
Underwent external beam therapy in October and November 2015, 45 total sessions.
Today my PSA is 0.09; prior to treatment, my PSA was 11.3, and while I have some residual radiation cystitis in my bladder and prostate, I really have no issues.

I had 4+3 at age 65 and did focal in July of 2024. I specifically did Tulsa Pro at Mayo Rochester. I had 30% of my 45cc prostate ablated and I am cancer free at this point. I have had zero side effects and am happy with my choice. Medicare and my BCBS supplement covered the entire cost. Click on my profile for more detail on my experience.

@alanrittel
I had gleason 3+4 with 10.2 psa, 25% of one and 10% of another. Only 1 of the 5 radiation oncologists I spoke with recommended active surveillance as a possibility. All were either at centers of excellence or trained at one. I completed 5 SBRT treatments on February 15,2023 with the Mridian radiation machine which has a built in MRI, so less healthy tissue was exposed and hence fewer side effects. No fused images. What they can see in real time, they could treat. I also had a Decipher, with low risk results and a MyRisk genetic test.
No doctor will be able to predict how quickly something will grow, in 3 months, 6 months or whatever. Although the five doctors advice were carefully listened to, and as I said one dr suggested AS, I wanted it taken care of with treatment as I was not willing to go down that road of possible progression as I felt the risk, if my bodies cancer moved more quickly, was not worth it for me, so I chose treatment and specifically, the MRI based radiation machine. I looked at all options and machine types in the marketplace.

@jim18
I looked at my MRI results taken 1/7/2026 and it was an mpMRI. This was followed by biopsy on 3/6/2026. The procedures were 1. Echography of prostate, 2. MRI/US fusion guidance for needle biopsy using fusion software, 3. transrectal needle biopsy. Cognitive ultrasound fusion guided prostate biopsy using fusion software. Using the MRI fusion software, the ultrasound image was locked with the MRI identified contours of the prostate. Unfortunately the image overlay would not appropriately completed. So Dr. recommended cognitive biopsy. Directed biopsies were obtained of the identified lesion also with 6 on the right and 6 on the left of the prostate.

@mtnman

Am very happy for you. This gives me more optimism.

@jcf58

Am happy for you and encouraged by your results. We live outside of Colorado Springs and my Dr. works at CU Health. CUH also has the Anshutz Campus in Denver which will consult with me regarding focal therapy. Our daughter lives in the Kansas City area so we may also reach out to KU Medical Center. I believe they both have excellent programs.

@bens1
My dr. said I could do active surveillance for now but am desiring a treatment that will get rid of the cancer. We live outside of Colorado Springs. My dr. works at UC Health and is getting a dr. knowledgable in focal therapy at CU Health Anshutz Hospital in Denver to consult with me. Our daughter lives in Kansas City area so we also reach out to KU Medical center. Your situation sounds similar to mine and your news is so encouraging. My dr. is also doing a genetic test of my biopsy samples.

@jeffmarc

Really appreciate your sharing the videos. They are highly informative. The dr. is doing a genetic test to determine how aggressive the cancer is. Once this is known we will discuss focal therapy or perhaps radiation in more detail. Hopefully active surveillance will suffice for now. I checked with AI about the 30% of 4 and it sounds like it puts me at an intermediate risk. So am hoping if necessary that focal therapy will work and another cancer not show up in the prostate.