By Steven Machaud
I was finally at the threshold of retirement, working less and transitioning into my second act that was supposed to give me the time and freedom to travel, dabble in music, sing in community choirs and basically enjoy life with my husband of 27 years, John.
I was about to retire my career in psychiatric social work and return to my love of music – for which I earned my first degree from Eastman School of Music, where I always dreamed about conducting my own choir. However, at age 66, I learned he had prostate cancer. Now I would be conducting a search for the right prostate cancer treatment.
During a routine PSA test in 2017 at Rochester General Hospital, my urologist, John Valvo, M.D., was concerned about my test results. Doctors consider PSA levels of 3.9 or lower to be normal, any my PSA score was 5. After a biopsy, Dr. Valvo confirmed the prostate cancer diagnosis.
Like many people, I was touched by cancer that came with a huge loss. We learned my mother had pancreatic cancer and then died six months later, so it prompted me to be very diligent about getting my annual physicals – and PSA tests. Prostate cancer in most men is slow growing, and if detected early can be treated and beaten. In fact, most men my age and older will have prostate cancer at some point as they age.
Since my prostate cancer was detected early, I did a lot of investigating into my treatment options. At first Dr. Valvo explained the typical ways to manage prostate cancer. I could choose to have him keep an eye on the cancer — watchful waiting or active surveillance. But even though prostate cancer is slow growing, I wasn’t comfortable living with a diagnosis of cancer. I wanted treatment as soon as possible.
Typically, prostate cancer is treated with surgery and/or radiation, but both of these standard options more typically result in serious side effects of urinary incontinence, erectile dysfunction and even penile shrinkage.
On the other end of spectrum was radical surgery, which involved removing the entire prostate, or radiation. I met with a radiation oncologist, who offered me a treatment called brachytherapy. However, due to my enlarged prostate, I would have to be treated with hormones to shrink it before being seeded with high doses of radiation beamed into my body. This option did not appeal to me.
Dr. Valvo mentioned another, newer treatment called high intensity focused ultrasound (HIFU), which was going to be offered at Rochester General Hospital in the fall of 2019, and said I was a good candidate.
I always had faith in doctors, having switched careers to the healthcare field in 1989. I valued their expertise and had gotten good advice over the years. So when Dr. Valvo explained HIFU as an option, I took heed. I also did not want the negative side effects of the standard treatments. HIFU seemed like it could offer a better quality of life post-procedure, compared to all the other options. I definitely did not want to have to manage the common side effects from radiation like incontinence and penile shrinkage. After learning more about the HIFU procedure, I was at ease knowing to would spare the healthy portion of my prostate and the nerve endings attached to it.
HIFU uses high-frequency sound waves directed at the cancerous tissue through an ultrasound probe inserted into the rectum. No incisions are made. No radiation is emitted. The high intensity sound waves heat up and destroy the cancerous tissue. I remember Dr Valvo telling me to think of holding a magnifying glass above a leaf on a sunny day. The sun’s rays shine through the lens and cause the leaf to burn. The concept of how HIFU works is similar.
I went in for the HIFU procedure in October of 2019. The device fused magnetic resonance images with my biopsy data and real-time ultrasound imaging, which is presented in 3D on a large screen. The doctor drew a precise contour around my diseased tissue, then destroyed the tissue in that area.
After the procedure, I didn’t have any discomfort accept having to wear a catheter for four days. For a few weeks after the procedure, I had some bleeding when I urinated, which was expected.
At my follow-up appointment, Dr. Valvo explained that he targeted the more dangerous cells and he will continue to monitor my prostate. I’m scheduled for a biopsy in three months and I can always repeat the HIFU procedure if the more dangerous cancer cells return, unlike radiation and surgery, which offer no other options once the patient has had either procedure.
I would recommend for men to explore more non-traditional prostate cancer treatments like HIFU, instead of settling for standard treatments. My quality of life is as good as I’d hoped it would be as I move into the next chapter of my life.