Posted 5/28/2018 4:07 PM (GMT 0)
Tomorrow morning, bright and early at 6 AM, I will arrive for my Focal Laser Ablation procedure in Houston. Been vacationing in Cabo with my wife for the past 5 days. Booked the trip to Mexico before I decided between RALP and FLA, thinking it might be the last time we would be on vacation where everything below the belt worked as expected.
We leave Cabo here early afternoon, arrive in Houston around 5 pm, will check into the hotel, eat a nice dinner and will likely not sleep a wink tonight. I am however expecting everything tomorrow to go as planned. Should be on our way back to home to Dallas Wednesday afternoon, and back at work this coming Monday as if nothing happened.
It was a tough decision between my two preferred treatment options. Although I did briefly consider SBRT, I really felt as though RALP was a better choice. However, FLA, was attractive because it was middle ground between the active surveillance I have been on for the last 4 years and full treatment. I anguished over what to do for the past 8 weeks since my recent biopsy. Until that biopsy (my 2nd in the past 4 years), I had just a tiny amount of G6. However, my PC was upgraded to a G7 4+3 in two cores & a 3+4 in a random core directly adjacent to my only lesion visible that necessitated the biopsy. The other 6 cores from the biopsy were clean. Only two of the three targeted cores came back positive for PC (one targeted core was non cancerous, 5 more random cores negative as well)
Considering that I only have one visible 14 mm lesion after multiple MRI’s over the past 4 years, my doctors feel I likely am one of the few with unifocal PC. Of course this could change/progress at any time even after my FLA procedure. However, I am willing to roll the dice and choose FLA in hopes that my PC can be cured with this course of treatment. My urologist thinks I should go for RALP (he is a surgeon after all) but acknowledges that FLA could do the trick. His concern is not the procedure, but the follow up care. We do agree that I will need to continue to be closely monitored just like my AS regimen of the past 4 years.
My Interventional Radiologist also agrees with the follow up protocol of an MRI & biopsy 6 months from now to make sure there is no residual cancer in the lesion. My IR believes I have maybe a 75% chance this singular FLA treatment will be all I ever need moving forward. It would be great if he is correct, however, I realize all I may accomplish is kicking the can down the road before I end up getting a RALP a few years down the road anyway. Nonetheless, we’re doing this!
The deciding factor for me was the chance to avoid the short & long term side effects of RALP or Radiation. Although I fully expect my insurance to deny payment here, the $23k in my opinion was worth spending for a few more years worth of normal sexual function. Even if another lesion pops up in a subsequent MRI, I can always have it zapped with FLA for another $11k down the road. Pretty good value in my opinion to avoid a date with a robot.
Anyway, wish me luck!