My PSA was stable at 1.6 over 10 years (2006 - 2016). In 2017 it went up to 2.5 and in 2018 to 3.2. My urologist recommended a MRI followed by a targeted biopsy. From the 12 regular biopsy cores only one came back at Gleason 7 (3+4), from the targeted area 2 cores were also at 7 (3+4). My urologist said that a prostatectomy is the treatment with the highest chance of beating the cancer. I agreed and the surgery was scheduled for 3 months later. I joined two UsToo support groups and educated myself more about prostate cancer. 1 week before the scheduled surgery I decided to postpone the surgery for 6 months and go on active surveillance instead. After getting 4 more opinions (2 urologists, oncologist and a naturopathic physician) and more investigations I could not see myself to undergo surgery with all the side effects. In April 2019 I found out about a non-invasive procedure, offered as a clinical trial at the Mayo Clinic in Rochester, MN: MRI guided focal cryo ablation. 2 weeks later I was invited for more check ups to see if I am a candidate for that trial and another week later I had that procedure. One night in the hospital, 2 days with a catheter, no pain, no side effects at all. The cryo ablation killed about 30% of my prostate and the expected PSA was 1.1. It actually is at exactly that number and stable since then. I have PSA tests every 3 months now and a MRI every 6 months. I am very happy that I did not let my urologist rush me into surgery and that I do not have to deal with any side effects.

Yesterday I had my 2 year check up since my treatment. PSA has been stable at 1.0 +/- 0.1 over the last 2 years (as expected) with quarterly tests. The MRI, done every 6 months, also showed a healthy prostate with about 1/3 inactive from the cryo ablation. From now on I have PSA tests every 6 months and MRI once a year. I am very happy that I decided to go with the ablation and not surgery. For early stage prostate cancer that is really a great option since there are no side effects at all.

This week I had my 4 year check-up. Everything looks good! The MRI shows stable-appearing post ablation changes to the right peripheral zone without specific MR findings to suggest local recurrence. Also the untreated portions of the prostate gland is without suspicious lesion by PIRADS criteria. My next check up is in November (PSA only) and then the 5-year check-up in May 2024 (PSA and MRI). If everyhting is still good in one year I change to annual check-ups going forward.

Heiner's e-mail address is: hje1956r AT gmail.com (replace "AT" with "@")