Dr. Narayan's Experience
From the Beginning Through Followup
With Dr. Narayan, the process of HIFU starts as follows; when you click on this website, you have a choice to go to one of our affiliated physicians depending on where you are located or you can come to Dr. Narayan to be treated. We have a center in Ocala and the Villages. If you are from out of town, we give you a discount because we understand you have to fly down to Florida to get the procedure done. Since the procedure is outpatient, the patient will have to come in the day before, get the pre-operative preparation, which consists of some antibiotics and an enema, and preferably a face to face meeting with Dr. Narayan.
The surgery center is located a few minutes away from a variety of hotels where the patient can stay at, including the Hilton, Marriott, and others. One of our staff picks you up in the morning and takes you to the surgery center. After the procedure, we bring you back to your hotel. You will go home with a catheter for a few days. Dr. Narayan or one of his staff will follow up with you before the catheter is removed or for any questions. The staff are available along with Dr. Narayan as needed any time, to answer any questions or concerns. If you have a urologist who is working with us we will instruct him on catheter removal and follow-up. If you have a urologist who wants to learn HIFU, we will give him free training on how to perform HIFU procedures as per FDA Guidelines. (See HIFU Training for Physicians)
Many patients who call us have incomplete data for accurate treatment of prostate cancer. Our goal is to preserve sexual function and continence, while ensuring highest cure possible for prostate cancer. In this regard we recommend patients to detect their caner early, as soon as there is a PSA rise. While we follow guidelines with regards to Active Surveillance for low grade, low volume cancers, we also have noted that more than 50% of patients who are on Active Surveillance end up on treatment because of cancer progression, refusal to be on Active Surveillance, anxiety issues, and living with a burden of cancer. Men have also issues with need for repeat biopsies and follow-up tests required while on an Active Surveillance program. The American Society for Clinical Oncology has also recommended that men be warned of a need for more extensive treatment if the cancer progresses while on Active Surveillance. We have seen patients who had uni-lateral low risk cancer change to bi-lateral higher risk cancer within 1 year of Active Surveillance. Despite the plethora of tests available, there is still a significant gap in our understanding of which cancers will progress and which ones are safe to watch. The only reason Active Surveillance has become popular is because, until now there was no treatment available, such as HIFU that will allow a man to have a reasonable chance of reserving potency and continence while curing cancer.
Many Urologists will recommend that prostate cancers are multi focal, and there for not eligible for HIFU. Dr. Narayan and Dr. Onik published the first paper on male lumpectomy, which has since been repeated many times worldwide and there is good data on several thousand patients that hemi-therapy and partial-therapy can cure prostate cancer. If you are considering doing nothing other than monitoring, which is Active Surveillance, than HIFU, which is a chance to cure your cancer is a better alternative is in our opinion. In prostate cancer, there is more than 1 right answer for management, and each patient will have to decide what is right for him based on shared decision making with his urologist. We are here to help, and many more patients consult us, than get treatment from us.