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by Richard Payton   |   July 24, 2019

How I Stayed on Track Thanks to HIFU Treatment

A Runner’s Hurdle 

I enjoy running because it not only helps me stay fit, but it’s also a great stress reliever after long hours of work at the Payton Company, an Austin software firm I started in 2002. But at age 57, I was almost stopped in my tracks by prostate cancer.  

My journey began when I got the results from my regular annual physical in May of 2018. That’s when I found out that my PSA level had exceeded 4 and was increasing fairly quickly compared to my prior PSA tests, so my regular doctor recommended that I see a urologist. I found Dr. Lucas Jacomides at Greater Austin Urology who performed the biopsy and gave me the diagnosis. 

Of course, I was concerned when he said I had prostate cancer. But my attitude was that if you have an elevated PSA and you know it’s a threat, you have to take the next step. Wishing it wasn’t elevated wouldn’t change it. 

Finding The Best Treatment Option

Like the estimated 160,000 men diagnosed with this disease every year in the U.S., I had to make decisions about what kind of treatment to pursue. I knew I wanted to avoid the side effects, in particular, of incontinence and erectile dysfunction that often accompany prostate cancer treatments. 

To evaluate my treatment options, I largely relied on the information that my doctor shared with me while also considering my personal needs and those of my family. 

The first option was active surveillance, or “watchful waiting,” which is commonly offered to low-risk prostate cancer patients because their disease typically progresses slowly. But I was not a fan of that approach because you don’t really know what will happen if you wait and watch it. Since I’m relatively young and I expect to live at least another 30 years, it didn’t make sense to put off treatment.

Recognizing that I wanted to address my condition right away, my doctor told me about the two other common approaches to treating the disease: radical prostatectomy and radiation. Neither the process and recovery, nor the potential side effects of those two options were attractive to me.

At that point, he told me about HIFU and I was a good candidate for it because my cancer had not spread beyond the prostate. Basically, HIFU uses concentrated sound waves to destroy the diseased tissue in the prostate. Urologists manipulate ultrasound imagery to guide a probe during the procedure so they can avoid damaging healthy tissue – which helps prevent the two very unpleasant side effects.  

Unfortunately, the HIFU procedure was not covered by insurance and I would have to pay for it out of pocket. That was not great news, but I also knew that I want to be around to enjoy my savings, and I wanted to survive! I also didn’t like the idea of locking in potentially bad outcomes – like not destroying all of the cancer and a possible lifetime of incontinence. I was too young for that!

And I also wanted to keep running while keeping up with my business and other activities such as my involvement with Rotary International.

Most of all, I wanted to be around for my family. Especially with one daughter in high school and the other in college, I didn’t want to miss spending time with them before they leave home for good. And, once we become empty nesters, I also didn’t want to miss the opportunity to travel with my wife of 27 years.

Navigating HIFU

Ultimately, I opted for a procedure called high-intensity focused ultrasound, or HIFU. Though other options might have seemed more likely to my doctor or others, the anticipated treatment and recovery experience plus likely comparative outcomes made it a clear choice for me. I made the right choice! One week after HIFU I returned to running, with no significant pain or side effects to get in the way. 

My doctor explained if the cancer recurred at some point in the future, he could re-treat it with HIFU. And, the other traditional options would still be on the table. Also, I could undergo the HIFU procedure on an outpatient basis instead of staying in the hospital. As it turned out, I only had a catheter in for four days once it was over. The best part was that I could go back to running and my other activities.

Since undergoing HIFU, my health has steadily improved, and not only did I run a week after the procedure, I even completed the 2018 Turkey Trot 10k race with my daughter a few weeks later.

The Importance of Being Proactive

I’m glad that I didn’t put off my annual physical, including the relatively uncomfortable prostate exam. I know some men are reluctant to get that exam and I don’t understand it – because I’ve never heard a good argument for not going through with it.

Just as runners spur each other on when the trail gets rough, I hope my story will encourage other men to take care of their prostate health. Get tested, explore treatment options, and don’t procrastinate about taking whatever steps are needed to stay healthy – and stay in the race!