Steve F lives in California, USA. He was 54 when he was diagnosed in October, 2015. His initial PSA was 3.30 ng/ml, his Gleason Score was 7a, and he was staged T2b. His choice of treatment was HIFU (Focal HIFU). Here is his story.
As a prostatitis/CPPS (chronic pelvic pain syndrome) sufferer for 10 years, I had been in/out of many a doctor's office searching for relief. Convergence of paths with other sufferers landed me in the office of Dr. Duke Bahn, a radiologist in Ventura, California. Dr. Bahn's treatment for prostatitis is an injectable of antibiotics, anti-fungals, anti-virals, and steroids. I had two occasions where I was injected, the last 7 years ago, and experienced moderate releif; nothing permanent. Fast forward to 2015, I began to experience fatigue/health issues accompanied by increased CPPS symptoms. Blood tests showed increased systemic inflammation, but doctors couldn't pinpoint cause. Developed uveitis as well during this period. Had no idea why my CPPS increased at the same period, but thought it might be a good time to pay Dr. Bahn another visit for a general prostate check, and possibly another injection. October 2, 2015 I saw Dr. Bahn and proceeded to his color doppler ultrasound room where he laid me on my side for the standard DRE before injection, and his words to me were, you have a nodule and it would be wise to have a biopsy. I squirmed a while trying to process the news and how to react, and in a moment of calm decided to trust Dr. Bahn's advice and move forward with the biopsy. The results came back a few days later as Gleason 7, stage T2b cancer on right side only with a tumor of 1.2 cc. I brought the report to my Kaiser Urologist and was recommended for surgery. I immediately went into action to gather as much information on prostate cancer, my status, methods of treatment, and prognosis. A colleague of mine has Gleason 6, had been going to a prostate cancer support group, and invited me the following week. What I heard from the varied experiences of men in the group gave me great hope and put the breaks on any immediate treatments or rushed decisions to *get rid of my cancer*. The next day I cancelled my appointment with the Kaiser surgeon (to the dismay of my urologist) and notified all docs at Kaiser aware of my condition that I was doing my research and would be in contact when ready with my decision. Soon after I learned about 3T multiparametric MRI screening, and asked my Kaiser urologist if he could get authorized for me this MRi at UCSF. He did, and the results matched that of Dr. Bahn's ultrasound and biopsy. Diagnostically, I had the best information on my cancer technology could provide. The more I attended the support group, the more I learned about alternatives to radial surgery, specifically focal therapies. Dr. Bahn had suggested cryotherapy as an option, but the research I had done left me unsure about potential side effects, specifically incontinence, impotence, and aggravated CPPS. Focal laser ablation then entered as an potential option after being discussed in group. I researched this treatment and found great potential, but also began to find recurrance in many men posting on a prostate cancer information/support site. I stopped the scheduling process with a top FLA doc to continue my research. My next path was HIFU, specifically focal HIFU for my particular case. Though HIFU's history is hit/miss with ultrasound guided whole gland therapy, I began to develop trust in the efficacy of a practitioner of MRI guided focal HIFU, Dr. Stephen Scionti in Sarasota, Florida. I learned he had performed over 1000 HIFU cases in the last 10+ years, and more recently had 200+ cases of MRI guided focal HIFU under his belt. I contacted his office and received a call from his personal cell phone that evening. I explained my case, and he said to mail a disk of my MRI to him and he's get back to me with his recommendations. I did so, and in our next conversation he said I'd be a good candidate for focal HIFU given my cancer was on one side only, was not close to the nerve bundle or urethra, and was not of high grade (3+4 with 10% or less 4 in samples found). He recommended whole hemi ablation on my right side given some biopsy samples below the tumor showed 3's. On April 22, 2016 I arrived at Dr. Scionti's surgical center for my procedure. It went without issues, and I left his facility at 2:30 that afternoon with catheter in place and my fantastic brother waiting with passenger door open. We went back to our rental for some rest, then out to a local restaurant for much needed nourishment after a 2 day fast. I flew back to California on April 24 (a little challenging with catheter), and had the catheter removed April 26 at Kaiser. I urinated immediately afterwards, and was authorized to go home without. My urologist came in to talk about my procedure, and agreed to seek authorization for both 6 month and 1 year follow-up 3T MRI's at UCSF. My first PSA will be at 3 mo. post procedure. So far, so good. I will provide all follow up stats in the coming months and years.
Steve's e-mail address is: firstname.lastname@example.org