When Gunnison resident Les Lisowski learned he had prostate cancer, his doctor gave him five options for treatment. He and his wife, Sharie, started making a pros and cons list.

Lisowski, 56 at the time of diagnosis, was pretty lucky. His cancer had been discovered early thanks to a blood draw that showed high Prostate-Specific Antigen numbers (PSA), often an early indicator of prostate cancer.

While his first tests showed no cancer, his PSA numbers continued to rise and, eventually, the prostate cancer surfaced after a biopsy.

Lisowski's cancer was highly survivable, but many of the treatments had long recoveries with a risk of impotence.

His urologist, Dr. Craig Peterson, presented him with choices: observe the cancer until it worsens, radiation treatment, surgery to remove the prostate, cryotherapy or something new.

Peterson and his partner at San Juan Urology in Montrose, Dr. Jordan Luskin, were the first urologists in Colorado to try High-Intensity Focused Ultrasound (HIFU) treatment, which localized the treatment to the area of the prostate affected by the cancer. Les' cancer was on the front of his prostate.

The procedure was much quicker than any of the others and had a quick recovery time, which appealed to Les.

"I was very interested in HIFU because it was the least invasive and we knew recovery time would be minimal," Les said.

After much discussion, questions and looking at some Facebook support groups, Les opted for the HIFU. He had his procedure in July 2017 and was one of Peterson's first HIFU patients.

Since Peterson had only performed a few procedures, Les would have to travel to Florida for his treatment.

Sharie remembers that they flew down on a Thursday, Les had the HIFU procedure Friday, which took a couple of hours, and they went home Saturday. Les had to wear a catheter until the next Wednesday.

Now, Peterson said, he can perform the procedure at Montrose Memorial Hospital. He has access to a HIFU machine when needed and said the hospital is looking into buying one. So far, he's had patients come from around the state and even New Mexico and Arizona for HIFU treatment.

Peterson said he was immediately interested when he heard about HIFU at a convention a few years back.

"It's nice that you can treat part of the prostate," he said. "There's no other procedure like that."

HIFU was approved by the Food and Drug Administration in 2016, but European doctors have used it widely for some time.

The benefits, Peterson said, are the recovery time and, since it doesn't include cutting out any part of the prostate, the reduced risk of impotence or erectile dysfunction.

The procedure is not for everyone, as Peterson said the prostate can't be too large and is best-suited for certain prostate cancers.

HIFU sends focused ultrasound waves that destroy the targeted tissue.

"Focused treatment is very likely to be the future," Peterson said. "We started looking at this and wanted to bring it to the community."

Now, Les is free of cancer and had his blood drawn four times the first year after the procedure to check his PSA levels. He's having it drawn twice a year this year and will move to once a year if everything looks good.

Les is happy with his decision, even if it was an expensive one. Though HIFU is FDA-approved, his insurance did not cover the procedure.

Les and Sharie took out a loan of $25,000 to cover the costs.

Peterson said the hospital is now reimbursed by Medicare for the treatment, but the doctors are not.

Sharie said the procedure was worth the money as it ensured that Les would be able to maintain his active lifestyle with no side effects.

"We're really lucky," she said.

CHICAGO — Move more, sit less and get kids active as young as age 3, say new federal guidelines that stress that any amount and any type of exercise helps health.

The advice is the first update since the government's physical activity guidelines came out a decade ago.

Since then, the list of benefits of exercise has grown, and there's more evidence to back things that were of unknown value before, such as short, high-intense workouts and taking the stairs instead of an elevator.

"Doing something is better than doing nothing, and doing more is better than doing something," said Dr. Donald Lloyd-Jones, a preventive medicine expert at Northwestern University in Chicago.

Only 20 percent of Americans get enough exercise now, and the childhood obesity problem has prompted the push to aim younger to prevent poor health later in life.

Highlights of the advice were released last week at an American Heart Association conference in Chicago and published in the Journal of the American Medical Association:

CHILDREN AND TEENS

The biggest change: Start young. Guidelines used to begin at age 6, but the new ones say preschoolers ages 3 through 5 should be encouraged to take part in active play throughout the day.

They don't call for a certain amount but say a reasonable target may be three hours of various intensities. That's consistent with guidelines in many other countries and is the average amount of activity observed in kids this age.

From ages 6 through 17, at least an hour of moderate-to-vigorous activity throughout the day is recommended.

Most of it should be aerobic, the kind that gets the heart rate up such as brisk walking, biking or running. At least three times a week, exercise should be vigorous and include muscle- and bone-strengthening activities like climbing on playground equipment or playing sports.

ADULTS

Duration stays the same — at least 2½ to 5 hours of moderate-intensity or 1¼ to 2½ hours of vigorous activity a week, plus at least two days that include muscle-strengthening exercise like pushups or lifting weights.

One key change: It used to be thought that aerobic activity had to be done for at least 10 minutes. Now even short times are known to help.

Even a single episode of activity gives short-term benefits such as lowering blood pressure, reducing anxiety and improving sleep.

Sitting a lot is especially harmful.

The advice is similar for older adults, but activities should include things that promote balance to help avoid falls.

BROUGHT TO YOU

BY THE LETTER E

Targeting young children is the goal of a project that Dr. Valentin Fuster, a cardiologist at New York's Mount Sinai Hospital, has worked on for years with the Heart Association and Sesame Workshop, producers of television's "Sesame Street."

At the heart conference, he gave results of an intensive four-month program to improve knowledge and attitudes about exercise and health among 562 kids ages 3 to 5 in Head Start preschools in Harlem.

"It was really successful," Fuster said. "Once they understand how the body works, they begin to understand physical activity" and its importance.

When brains are young, "it's the best opportunity" to set health habits that last, he said.