My cancer battla

Rawaan

New Member
It has been some time since I last posted on this platform, so I wanted to share an update on my journey.

As I wrote previously, I was diagnosed in 2023 with prostate cancer (Gleason 3+4, Grade Group 2). The NHS recommended radical prostatectomy as the only option, especially given that I was considered “young.” Requests for focal therapy or genetic testing were declined. I was not comfortable accepting surgery as my only choice.

At the same time, my TRT (which I had been on since 2010) was suspended. I made the personal decision to continue my injections. Instead of rushing into treatment, I began educating myself — reading extensively, following patient forums, and watching many educational videos from PCIR. That period of self-education was crucial. It gave me clarity and confidence about alternative treatment options.

Toward the end of last year, I decided to pursue TULSA-PRO. Before proceeding, I underwent a new MRI. It showed that the cancer had grown compared to 2023, but it was still fully encapsulated — no evidence of spread.

After researching treatment centers, I contacted Alta Klinik in Germany and KIMS in India. After careful consideration, I chose KIMS.

My PSA history: before diagnosis, it fluctuated, but after 2023, it stabilized between 18–21 ng/ml, briefly dropped to 19, and then began rising steadily. By the time of my procedure, my PSA had reached 33.8 ng/ml.

I underwent two procedures:

• Cystoscopy with median lobe resection

• TULSA-PRO (gland ablation)

The day was long. After the first procedure (about 1.5 hours), I remained under anesthesia while a multidisciplinary team reviewed my case in depth. There were five radiologists, several urologists, oncologists, anesthetists, TULSA specialists, cardiologists, and nurses involved in the discussion. The TULSA procedure itself took nearly two hours.

When I woke up, I was transferred to recovery and then to my room. I was discharged the following day with a catheter.

A few days later, the catheter malfunctioned and had to be replaced, which was uncomfortable. Unfortunately, during one of the changes, some urethral trauma occurred. A week later, when it was removed and replaced again using lidocaine gel, I experienced excruciating pain. That was probably the most difficult part of the entire experience.

I am still in the recovery phase.

However, the most important news: the before-and-after MRI confirms that all visible cancerous tissue has been ablated. One month after the procedure, my PSA dropped from 33.8 ng/ml to 0.3 ng/ml.

For now, I feel relief — and gratitude — and I will continue monitoring closely.





I hope this update helps others who are navigating similar decisions.





 
It has been some time since I last posted on this platform, so I wanted to share an update on my journey.

As I wrote previously, I was diagnosed in 2023 with prostate cancer (Gleason 3+4, Grade Group 2). The NHS recommended radical prostatectomy as the only option, especially given that I was considered “young.” Requests for focal therapy or genetic testing were declined. I was not comfortable accepting surgery as my only choice.

At the same time, my TRT (which I had been on since 2010) was suspended. I made the personal decision to continue my injections. Instead of rushing into treatment, I began educating myself — reading extensively, following patient forums, and watching many educational videos from PCIR. That period of self-education was crucial. It gave me clarity and confidence about alternative treatment options.

Toward the end of last year, I decided to pursue TULSA-PRO. Before proceeding, I underwent a new MRI. It showed that the cancer had grown compared to 2023, but it was still fully encapsulated — no evidence of spread.

After researching treatment centers, I contacted Alta Klinik in Germany and KIMS in India. After careful consideration, I chose KIMS.

My PSA history: before diagnosis, it fluctuated, but after 2023, it stabilized between 18–21 ng/ml, briefly dropped to 19, and then began rising steadily. By the time of my procedure, my PSA had reached 33.8 ng/ml.

I underwent two procedures:

• Cystoscopy with median lobe resection

• TULSA-PRO (gland ablation)

The day was long. After the first procedure (about 1.5 hours), I remained under anesthesia while a multidisciplinary team reviewed my case in depth. There were five radiologists, several urologists, oncologists, anesthetists, TULSA specialists, cardiologists, and nurses involved in the discussion. The TULSA procedure itself took nearly two hours.

When I woke up, I was transferred to recovery and then to my room. I was discharged the following day with a catheter.

A few days later, the catheter malfunctioned and had to be replaced, which was uncomfortable. Unfortunately, during one of the changes, some urethral trauma occurred. A week later, when it was removed and replaced again using lidocaine gel, I experienced excruciating pain. That was probably the most difficult part of the entire experience.

I am still in the recovery phase.

However, the most important news: the before-and-after MRI confirms that all visible cancerous tissue has been ablated. One month after the procedure, my PSA dropped from 33.8 ng/ml to 0.3 ng/ml.

For now, I feel relief — and gratitude — and I will continue monitoring closely.





I hope this update helps others who are navigating similar decisions.





Thanks for the update. We don't get enough long-term updates here. I hope you have a complete, speedy and permanent recovery.
 
Thank you all, however, there is another issue that is worth discussing and hearing your opinion on.

TRT Discussion (For Those Interested in the Testosterone–Prostate Cancer Debate)

One of the most controversial aspects of my case is that I remained on TRT throughout.

Background

• On TRT since 2010
• TRT was formally suspended after my 2023 diagnosis
• I chose to continue TRT despite medical advice to stop

The traditional view — rooted in Huggins-era androgen deprivation theory — assumes that testosterone “feeds” prostate cancer linearly. However, more contemporary thinking supports the androgen receptor saturation model, which suggests that prostate tissue becomes saturated at relatively low serum testosterone levels, beyond which additional testosterone does not proportionally stimulate growth.

From a practical standpoint, in my case, at the beginning, it fluctuated between 5 and 7, went to 15, then

• My PSA plateaued between 18–21 ng/ml for a period after diagnosis.
• The latter rise to 33.8 ng/ml occurred while on TRT, but without evidence of extracapsular extension or metastasis on imaging.
• MRI showed progression in volume but still organ-confined disease. PSMA -PET scan shows no metastasis.
• After whole-gland ablation via TULSA-PRO, my PSA dropped from 33.8 to 0.3 ng/ml at one month — while continuing TRT.

This is obviously short-term data and not proof of causation either way. However, several observations are worth noting:
1. The disease remained localized over two years despite continued testosterone exposure.
2. There was no explosive progression or systemic spread.
3. Post-ablation plan is to continue TRT.

If testosterone were acting as a direct accelerator in a simple dose-response manner, one might expect more aggressive biological behavior over that timeframe.

That said, I am not claiming TRT is universally safe in untreated prostate cancer. My decision was personal and based on:

• Quality-of-life considerations
• Long-term TRT dependence
• My interpretation of emerging literature
• Close imaging and PSA monitoring

Going forward, PSA kinetics will be the key indicator. If PSA remains suppressed and stable while on TRT, that will be meaningful. If it rises disproportionately, I will reassess.

For those in similar situations: this is not medical advice — just one patient’s data point in an evolving area of urologic oncology.

I welcome discussion grounded in evidence rather than dogma.
 

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