I want to share my HIFU experience hoping that others will consider this procedure as a possible prostate cancer treatment option in addition to the options currently offered in the U.S.
In 2008, following a PSA test of 4.7 and a subsequent prostate biopsy by urologist Dr. Mark Bilowus that identified localized cancer of the prostate (Gleason Score 6-7), I met with Dr. Bilowus to discuss treatment options. Dr. Bilowus went over treatment options and their pros and cons with me including watchful waiting, radical prostatectomy, cryosurgery, radiation therapy, and stereotactic brachytherapy. Another option Dr. Bilowus suggested that I investigate further, which currently is not offered in the U.S., was HIFU.
After extensive reading, research, and discussions with Dr Bilowus and another urologist, I selected HIFU because this treatment was suitable for my prostate condition and offered what I continue to believe are the least long-term, post-procedure complications.
In January, 2009 I flew to the Bahamas, had the HIFU procedure the next day, rested the third day, flew home the fourth day, and went back to work on the fifth day. Although I had the SP catheter in much longer than most patients, it was a minor inconvenience. Three months after the procedure my PSA was <0.1 and I’m hopeful that will continue to be the case in the future. Dr. Bilowus provided excellent care before, during and after the procedure.
Name withheld upon request
July 07, 2009
My prostate cancer was discovered when I least expected it in May 2008, as an extra test – just to be sure nothing was wrong, added on to my annual heart (after angioplasty) check up and blood tests. You can’t predict or control life’s challenges, and we all adapt and meet what the world presents in unique ways. We sometimes need special help and services to overcome our personal obstacles.
Last year, while teaching my spring classes, I got the disturbing results: a high PSA score, meaning - possible prostate cancer. I didn’t have the other usual symptoms (urinary restrictions, discomfort, or a very large prostate). Within a week, my I met with Dr. Bilowus and began learning about my situation. He was very clear, organized, extremely communicative, and positive. He tested again, treated me for possible infection, and biopsied me for prostate cancer. When test results returned positive, he quickly met with me and my wife to explain the 5-6 options for treatment, the risks, and the benefits of each treatment. He was very supportive, there; answering questions, and returning my nervous calls, even if it was late in the evening!
Dr Bilowus was exceedingly frank and open in discussing the various available options. He helped us understand that there are risks, and benefits to all prostate cancer treatments, and that one treatment – HIFU – already available for 10 years in many countries had results that I learned and believed were equal to or better than other options, and with fewer less damaging downside risks and side effects! It was our responsibility and decision as to what was best for me. The HIFU planning, treatment and recovery appeared and proved to be excellent.
Before deciding, I asked other doctors (including my sister – an MD), my brother (who had prostate cancer 5 years before), and read all of the materials I received from Dr. Bilowus, read all the medical research articles I could find, and all the stories I found on the Web. Dr. Bilowus introduced me to other Doctors doing HIFU, and gave me the information on U.S. tests and trails. He introduced me to the support organization and staff who dispelled any remaining doubts. HIFU did not seem to be a great risk, was not a long recovery period, and had fewer risky side effects.
I felt HIFU was much better than surgery, cryo, or nuclear. I was treated on a weekend/Saturday in the Bahamas, returned on a Monday; the aftereffects were just not that difficult. I missed less than two days of work (one for travel) and did not have to ask others for help with things (driving, bags, and walking). The most difficult thing was dealing with and wearing a catheter, but it did not really limit what I could do at work or at home. My prostate "ordeal" was truly more frightening than difficult, more inconvenient than dangerous, and now I'm a true survivor with all quarterly PSA tests after a year showing less than 0.1.! I thank Dr. Bilowus for his personal care and concern, and for introducing me to the excellent computer controlled HIFU process. HIFU and Dr. Bilowus were the best care decision I could have made!
June 16, 2009
A little over a year ago, at age 67.5 I was diagnosed with prostate cancer. My PSA went from 3.0 to 4.7, followed by a biopsy with 3 of 12 samples positive with Gleason score 6 (1 with a trace of 7). I had done online research prior to my discussion of my options for treatment with Dr. Bilowus. After he covered the standard options I asked him about this new thing called HIFU. I was surprised, that he had sent a couple of patients for the procedure and he recommended it for me.
I began extensive research of the options and found the research frustrating. It seemed that much of the information on each option was biased toward that option. It was also difficult to find recent study information on HIFU with the sonoblate 500. Although the information from the sonoblate 200 and the abletherm machines was interesting, I considered them to be outdated. The best study I found with the sonoblate 500 was a study in England with only about 200 cases. After my research, I decided that HIFU presented about the same probability of a cure for early stage prostate cancer as surgery or radiation and the possibility of incontinence or impotence was significantly less.
I was initially bothered by comments in Walsh’s book on Surviving Prostate Cancer where he says HIFU does not get close to the Urethra. When I went back to the HIFU website this did not appear to be true. I also discussed this with Dr. Bilowus and he also allayed my concerns. (I do not think Walsh updated that chapter of his book when it was updated or he just did not look at recent data. The book is worth reading for anyone with prostate cancer but is obviously biased to open radical surgery). I chose the HIFU option and scheduled my procedure in Nassau about 3 weeks later. My wife and I flew in on Friday with the procedure scheduled for Sunday. We had a 2 hour delay in Atlanta so was glad I scheduled the flight a day earlier. I had an afternoon procedure, and did not get back to the Atlantis hotel until 9:30 PM. After a meal from room service I slept pretty well. The HIFU staff checked on me the next morning. I walked several miles around the resort shopping with my wife on Monday and we flew back Tuesday. If you have a morning procedure, you could fly back the next day. I returned to work the following Tuesday, but I could have easily gone to work on Thursday.
The catheter in your lower abdomen is a minor annoyance, but really does not bother you, other than, even though you are having night time erections and feel you are ready to return to your normal sex life, it would be a little awkward with the catheter. Mine came out after about 3.5 weeks and things were almost normal within a few days. I did experience some urgency problems when I needed to urinate, but they were controllable. I have a friend who had the DaVinci surgery 6 weeks before me, but after a couple of days my recovery was well ahead of his and he had the same urgency problems.
I just completed my 4th quarterly PSA evaluation and all have been less than 0.1. I feel anyone with prostate cancer should carefully consider HIFU. I am happy to discuss this further and can be reached through Dr. Bilowus.