Surveillance or Focal Therapy

Low risk prostate cancer is usually monitored with active surveillance (AS). Some evidence suggests no differences in health-related quality of life (HRQoL) and wellness between men undergoing AS and those receiving treatment. However, other studies have shown a significant subset of patients suffers from anxiety or depression related to disease uncertainty. Many patients are given an "all-or-none" binary choice between monitoring or radical treatment. Focal therapy (FT), however, is a potentially less intense treatment option that exists between these extreme choices but is not always presented to the patient due to provider variability. This study seeks to define the proportion of newly diagnosed low/low-int risk prostate cancer patients who elect to pursue HIFU or surveillance when presented with all treatment options devoid of persuasive rhetoric using an animated explainer video. Secondary outcomes will include anxiety score and decision regret.

Inclusion criteria

• Gleason 3+3 (GG 1) or 3+4 (GG2)
• ≤4 cores
• T1c-T2
• Prostate < 60cc
• MRI non-focal or PIRADS 3-4 in peripheral gland
• Absence of significant anterior disease

Exclusion criteria

• Anal stenosis
• Prostatic calfcifations
• Latex allergy
• Gleason grade group 3-5
• Multifocal or anterior disease
• Prostate > 60 cc