In June of this year, I found out my PSA was 12.3. I am 63. For some reason, this is the first PSA in my medical record. I had a couple of more PSA tests over the following 3mo which showed another 12.3 and then 12.8. I had a prostate MRI which was one of the worst experiences in my life. That rectal probe felt like a shovel up my rear end. The urologist gave a vague analysis indicating x1 suspicious area with a potential of cancer and another x1 that was inconclusive. They recommended a biopsy with the needles thru the rectum. I said "no thanks" and began looking for alternate biopsy options. I found a German clinic that does transgluteal vs transrectal prostate biopsies as well as the TULSA treatment for prostate cancer. My wife and I flew there. I had a prostate MRI which identified x1 suspicious area in a different location from the US MRI. They performed a transgluteal biopsy. The results came back as 7b (4+3) intermediate risk prostate cancer. Unfortunately, the tumor was located close to my external urinary sphincter and the Doctor would not perform the TULSA treatment on me for fear of causing incontinence. So I am back to looking for other "focal" therapy options. The two leading the race currently are IRE/H-FIRE and Proton Therapy. Unfortunately, IRE/H-FIRE is rather experimental at this point, but would be a much cheaper option than Proton Therapy. I understand Proton Therapy would be difficult to get it approved by insurance due to the high cost. Does anyone have experience with IRE/H-FIRE or Proton Therapy?