Father and brother died of prostate cancer 65 and 55 yrs old, respectively. Myself diagnosed in 2017, treated in Oslo with HIFU. Annual/biannual follow up, and still cancer free in 2026. Had no negative side effects urinary problems, or erectile dysfunction since procedure in 2017.

8 mo out from focal HIFU, had GG4, PSA was 12, now 3.  Ablation covered about 1/4 of gland, plenty margin.    It was a good choice for me, so far anyway.
Update: 10 mo out, clear MRI and clear 12 core biopsy, great news..

Locally here government cancer treatment is only whole gland either radical prostatectomy or low dose bracytherapy.  Non-radioactive focal ablation seems like such a better option long term.

I am a 70 year old semi-retired internist (MD) in USA.  PSA 2.2 in 2017, 2.44 in 2019, 2.8 in 2020, 3.9 in 1/21, 4.5 in 10/21, 11/21 - ExoDx 27 (indeterminate), 12/21 MRI 2 PI-RADS3 lesions (again intermediate), 12/21 Fusion Bx 1/12 positive Gleason 6 in 10% of core.  Plan :  Active Surveillance.  6/22 PSA 4.3, 1/23 5.4, 2/24 7.8, 5/24 TRUS Bx (random), 35gm, 1/12 positive 5%  for Gleason 6. 12/24 10.6.  3/25 PSMA PET localizing uptake to same two suspicious areas as MRI 12/21.  Urologist didn't do and had never referred for focal therapy, but did so after we discussed it.  Saw new urologist 9/25, PSA 12.  HIFU planned, insurance (BC/BS, not Medicare) denied as experimental.  Changed insurance at "open enrollment" at beginning  of 2026.  They covered HIFU.  2/9/26 HIFU left hemiablation "hockey stick" done and uneventful.  Odd that PSA accelerated with Gleason 6 on active surveillance, but I didn't want to wait until I needed radiation or radical prostatectomy.

I had Nanoknife in Nov '25 following two biopsies. 1st showed one lesion Gleason 7 3+4. My PSA went from 3.1 at age 60 to over 7 in 6 months. Therefore I had a 2md template biopsy Gleason 7 4+3 with 2 lesions.
I was offered prostactamy , radiotherapy and brachytherapy plus private Nanoknife.
I decided on Nano.. I had the catheter removed after 5 days, but couldn't pee, so had to self catheter for 2 weeks. MRI looked good, first PSA after 2 months (too early) was 8.7. Surgeon sent me for another PSA a couple of weeks later, and it was 12!! I was sent for an urgent PET CT scan, which came back as ok with no spread. We waited for 3 months post procedure and it came back as 1.2 😊. 3 months later 2.2!! Due another this week.
Side effects are that virtually no semen, erections now pretty good and no urine issues

I am 120 days post radiation treatments, still wetting the bed at night. It comes and goes.

Here in Phoenix, AZ, the VA does not use Nanoknife procedure but could agree to private doctor through Community Care Program.

Waiting for my biopsy results so I can decide if the focal therapy is good for me.. thanx a lot doctor..

great video. I like the targeted approach if appropriate. A former colleague, a public hospital pathology lab manager, frequently checked his PSA and the result was always within the reference interval. PSA has a good 90% sensitivity (10% false negatives) but poor specificity for cancer as you well know.  Fifteen years ago, this former colleague's GP did a digital rectal exam that warranted further investigation resulting in a cancer diagnosis. He was in his late 60s and he opted for total prostatectomy - perhaps not much choice then.  He was unlucky to be in the false negative group and his low results didn't indicate further testing. It seems to me that PSA testing is not a substitute for DRE

I've just had a HIFU procedure here in the UK. All went really well. I was in and out of hospital on the same day and only had a catheter for a week afterwards. Now awaiting my first PSA test in early May? My Gleason was 3+4 and my initial PSA was 19.9.

I knew a 69 year-old who had localized prostate cancer that was treated by blocking the blood flow to that part of his prostate. It was strikingly straightforward and simple for him. I hope if that is my fate someday to be as fortunate.

Gleason 4+3, extracapsular extension, large cribriform. I flew from USA to Sydney to get NanoKnife treatment 6 months ago. I'm very happy with my decision, but true success will take years to prove.

I’m a little late to this episode , but - it must be one of your best. Terrific information - no embellishment.  Valuable insight. Thx

I had the nanoknife procedure in October 2025. 3 months later PSA is 1.2. In April 2026 had an MRI that was clear and now will be scheduled for a biopsy in December of 2026. The only issue that I wasnt made aware of was the side effect of no release of semen during ejaculation. Im learning to accept. The other issue I had was needing to self catheterize a few weeks after the procedure since I couldn't urinate on my own. Unfortunately I got a urinary tract infection from it. Hopefully its all behind me and I wont need the nanoknife procedure again.

Is focal possible for Gleason 4 with cribriform?

From very recent experience I can say that this is an excellent overview.  I had a Nanoknife procedure at Noosa hospital on 9 March.  My MRI report on 16 March concluded "Excellent nanoknife treatment with respect to the previous PI-RADS 5 lesion left base to midgland posteromedial and posterolateral peripheral zone.  No residual tumour".  Per the video, my lesion was unifocal with MRI and PSMA PET scan lining up well to define the tumour and the PET scan showing no metastasis.   11 days after the procedure, I have some urinary urgency overnight but otherwise no side effects - certainly no need for pads.  I realise that with a Gleason 4+5, I am at the high grade end of where Nanoknife is usually performed.  Thus I will certainly observe PSA (although mine was steady at 2.5 for 5 years), MRI, biopsy and PSMA PET scan surveillance as needed - ignorance is definitely not bliss when it comes to cancer.  In that context, my surgeon noted that there is a perhaps 5% chance that I have micro-metastases in my lymph glands which are at present too small to be detected even by PSMA PET - of course I hope that the 95% non-metastasis rate referred to in the video applies to me.  I feel very fortunate that a surgeon experienced in Nanoknife, plus all those scans, were available in a small town like Noosa.  Sadly, at present Nanoknife is not covered by Medicare or the health funds, so I was self-funded.  Given the efficacy of Nanoknife for eligible patients and the fact that it must cost the medical system far less than say a radical prostatectomy, I hope that this funding situation will soon change.

Ì have been diognised with prostate Cancer forthe past nine years the bulk of treatment received is basically Caphiter changes often i would inqùire if that is all that can be done to deal with the problem and was told i may have to live with that for the rest of my life seemingly that is true

I had pro focal laser ablation 15 months ago.
PSA went from 8.5 to 1
I was back at work next day
No ongoing issues, just monitoring via PSA 6 monthly or yearly.
Costly, because the treatment is not yet Medicare refundable but in my case well worth it.

Some 6 years ago, I had HIFU for an internal, localised single cancer of the prostate. I was in hospital for a couple of days, and had a catheter for 10 days or so after. Apart from some moderate pain for about 40 minutes after I woke up, there was no discomfort or disability after. Everything worked perfectly immediately and still does (I am now 73.). PSA was always within the normal - it was about 4 before the treatment and 1.2 after. It has slowly increased I guess with increasing prostatic tissue volume with age, but was stable for a while around 4, but this last year increased to 5.2. MR revealed a new, small focal cancer near where the vesicular gland duct meets the urethra, smaller than the original one. It will be killed off by a new round of HIFU soon - in and out of hospital same day. I am very happy with the whole deal.

Great Information the best on UTube thank you