My story really starts back in 2003 when during a routine health check, the doctor indicated that my PSA was a little high at 2.9 and suggested that I keep an eye on it which I did not - I was then aged 55.
Following another medical in 2007, my PSA had risen to 4.1 and my GP being on the ball referred me to a urologist who examined my prostate and said it was normal and that as my PSA was not that high to keep an eye on it. Also said that as I was approaching 60, the PSA was OK for my age.
I next had a PSA test in 2008-9 when my PSA was found to be 6.2 so a biopsy was called for which found cancer on the Gleason scale of 3+3 present in some of the samples and some 3+4 present in one small area. The urologist, being a surgeon suggested that the prostate be removed to reduce the risk going forward.
Having heard of the side effects, I looked around at alternatives which included both Brachy and HIFU. In communication with one of your mentors - I am looking at HIFU - will send full blog in due course.
David Mansfield
I established that the best HIFU practitioner in the UK was Mr (now Prof.) Mark Emberton so approached him and straight away he put me at my ease. Following further MRI scans he confirmed that the area giving the high reading - the 3+4 was confined to the front left lobe so focal HIFU on that area would solve the issue.
I am having HIFU treatment that this coming Friday [September 10, 2010] - scary...!
The operation was carried out at 6pm following which I recovered with little pain at 7.30 pm had a three course meal at 8.30 pm and went home at 10.00 pm. The only sign that I had an operation was the suprapubic catheter which remained in place for three days and was then removed by the district nurse.
My subsequent MRI confirmed that the area had been correctly zapped by the HIFU and my three month PSA was 0.90 and six monthly 0.70. I have absolutely no side effects from the operation and lead a normal life playing golf and hill walking. I therefore feel blessed that I made the right choice.
In the UK, HIFU is still classed as experimental so only available privately so need to have private health insurance as the overall cost is some £20,000. Following my recent review by Prof Emberton he wrote to my GP stating that the results were "fantastic" and whilst not saying that I was cured, he nevertheless indicated that I should not have problems in the foreseeable future but will still keep an eye on me.
Against the background of my prostate cancer last year, my wife sadly, and out of the blue, developed bladder cancer and despite valiant attempts to save her, she sadly died in March this year.
So, therefore mixed blessings.
David Mansfield
It is now two years since my HIFU operation and whilst my PSA has moved around a little from 0.70 to 1.5, I have absolutely no side effects and in all respects lead a normal and active life.
I am due to have a further MRI scan at the end of September and a follow up visit to Professor Emberton in early October. At the moment I have no fears regarding this as I feel perfectly fine.
I will of course update following my next appointment.
David Mansfield
Following my last update, I have undergone a further MRI ahead of a meeting with Prof Mark Emberton at the end of 2012. Having reviewed the results, Prof Emberton indicated that the cancer is no longer evident and whilst there were one or two points of interest which will be kept under review, there is nothing that caused him concern.
Its three years since my operation and over two and a half years since the loss of my dear wife to cancer. I am now in a new relationship which as many of you who have suffered from prostate cancer are aware is trepidatious. I need not have worried as everything is in full working order so to speak and the operation has had no affect on either my bladder function or my libido. I am therefore extremely fortunate and count my blessings for choosing the right treatment for me.
Well a year on and my PSA remains low at 1.7 and I feel great having walked the length of Hadrians Wall a couple of months ago so fitness levels continue to improve - pity about the golf though!
The new relationship continues and Rosemary and I now live together in what can only be described as a fantastic fulfilling relationship and she being a widow herself, fully understands. There continue to be no side effects to the HIFU with everything in working order with the occasional "turbo boost" of Cialis (recommended by the Prof) which owes more to my age rather than my operation.
I will be seeing the good Professor in a month or so for my annual check up and MRI but am not at all fearful.
Well it's now five years (September 2010) since HIFU with Professor Mark Emberton in London and I feel fine.
My latest PSA was 1.9 and the MRI scan showed no evidence of the return of the cancer, indeed, the readings showed no change since last year. Prof Emberton indicated that there was now no need to see him every year so unless there is a dramatic change in PSA levels, then there is no need for him to see me until 2017 which is fantastic.
On a personal level, I bless the day that I made the decision not to have surgery or Brachy all of which were being given as the "right" course of action for me. Fortunately, the location of the cancer made me an ideal candidate for HIFU and I am so glad that I made the choice. I am fully continent have no side effects no leakage, no frequent night time bladder calls, and with my new partner, have a fulfilling physical relationship. So, I consider myself a very lucky man indeed. I am now fully retired at the age of 67 and enjoying life to the full including mixing lots of cement by hand and laying a patio at our new home.
I would say to any man in my situation should look around for alternatives and then choose the best solution for you. By all means listen to the professionals but make your own treatment choice.
It's now almost 6 years since I had HIFU and I am hoping that this nightmare is almost over. My PSA has reduced to 1.6 and remains fairly constant. Professor Emberton has indicated that I can probably take a break from MRI this year and has no concerns . Having retired I am (for my age!) in good health and continue to lead a fulfilled life in all respects with my new partner. So I suppose what I am trying to say is get checked early get the right treatment by which I mean the one that is right for you and hopefully you can beat this dreadful disease. Good luck.
It is now a year since last reporting; a year which has been most fulfilling. Rosemary and I got married in April and our marriage is a blessing for us both and is fulfilling in every respect. Personally there are no issues and my PSA remains at 1.9 which is fine and no obvious signs of the problem recurring. I keep busy and fit in retirement chopping logs, building a garage and walking as well as travelling around the country and Europe in our caravan. Obviously I keep a close eye on "the walnut" and will for as long as I live and in this respect am due for an MRI in January which will be shortly after my 70th birthday and following which I will see Prof Emberton for a chat. Hopefully there will be no issues but either way I will let you know.
Well it's just over 8 years since I had HIFU under Professor Emberton in London since which time I have seen him about every year and more recently every 18 months and have an MRI ahead of the visit. I am pleased to say that at my last visit in the spring of this year, the MRI was normal and he told me that there was no sign of any recurrence and the prostate looked normal and my PSI ranges between 2.0 and 2.3 currently being 2.1. He initially showed some concern about an increased blood vessel in the area of the treatment but this has been unchanged now for over 5 years and so he does not think that it's an issue. I am due to see him again next July.
On a personal level I feel fine and approach my 71st birthday full of confidence and all aspects of my life are OK and married life with my new wife is full of fun and fulfilling in every aspect with HIFU having no effect on my sexual health or libido. I continue to be thankful that I chose focal HIFU as a treatment and that it proved to be a suitable treatment for me.
So another year has passed and a further MRI which still shows a small treated area of my prostate has a blood supply whereas it should all be dead tissue. My PSA has risen this year as well from 2.32 to 2.72. Met with Professor Emberton who seemed un fazed and indicated that we should keep an eye on it and if it goes above 3.0, he will consider a needle biopsy on the area to ascertain what if anything is going on. However, in fairness, there has not been any change for 9 years. Otherwise in good health and on a fitness programme so not too concerned. So another PSA test in the spring and autumn and then a further MRI and a meeting with the professor - keeping my fingers crossed. Happy New Year to all.
So it's been a while since I last posted but in fairness with the Pandemic and other matters my Prostate has been low down on my list of worries - not that there are many I am still keeping fit and was running daily till recently but decided to take a break. My PSA remains low for my age (74) at 2.89 but as a precaution, I am going to see Professor Emberton in a month or so but in the meantime will have an MRI to check that all is well. I will report back in a month or so following my appointment.
So, following on from my recent MRI scan, I met with Professor Emberton to review the results. Whilst he still has slight concerns about the blood supply to that part of my prostate which had been zapped 12 years ago, he indicated that as nothing appeared to have changed since my MRI in 2018, and my MRI had not altered, he decided on watchful waiting for another year. I will have a further MRI next September and a follow up meeting but I am really not worried as I feel in great shape.
Since I last reported, I have been well and as active as my aging body allows me to...! I am not on any medication and have taken on two active poodles who keep me on my toes and allow me to go for long walks in the lovely countryside where I am fortunate to live.
It has been a year since my last MRI and during that period, and for no apparant reason, my PSA spiked in the spring from 2.9 to 4.2 and all the usual alarm bells sounded. Professor Emberton was not that concerned and he suggested two further PSA tests be taken between spring and winter and these showed a gradual decrease to 3.75. Still higher than before but dropping. An MRI took place in October followed by a visit to see the Professor in November.
The MRI showed the the signal from the left hand side of my prostate had increased, albeit marginally, and whilst it was inconclusive, Professor Emberton was not unduly concerned as I have always had a signal from that area since my HIFU in 2010. Initially he was considering a biopsy to check the source of the signal but decided to defer unless my PSA rose again above 5.0.
Going foward I am hoping that my future treatment will be in the hands of Professor Emberton at UCHL where his NHS team operate. I will have four monthly PSA tests and if they spike again he will undertake a biopsy. Otherwise all is good and in my 14th year since my HIFU operation and thankful that I took that treatment option.
David's e-mail address is: d.mansfield AT btinternet.com (replace "AT" with "@")
