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I've read on here several people suggesting TULSA PRO. I did a deep dive on the procedure and there are certainly aspects of it that are more appealing that RALP or radiation.

In the course of learning about TULSA PRO, I came across a few articles that were quite critical of the process for a variety of reasons, one of which was the heat aspect of it and the impact it has on nearby tissue and other organs. In each of these articles they recommend IRE as a superior method of treatment - if you qualify for it.

Does anyone have experience with irreversible electroporation (IRE) that can speak to the results, recovery, side effect and such?

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Replies to "I've read on here several people suggesting TULSA PRO. I did a deep dive on the..."

I personally know several associates here in Canada who have had IRE - the NanoKnife procedure , All were very successful . An approximately 1-2 hour treatment , and home the same day . Minimaal to zero side effects .
See Professor Dr. Emerton , Kings College Hospital in London, England , video on NanoKnife . Multiple locations in Canada are performing this procedure -- many are in Toronto . One of my associates went to a clinic in Germany where they have performed thousands of NanoKnife procedures .
It is a growing treatment worldwidee -- slower in the USA for some unexplained reason . It's currently far outpacing TULSA-PRO.

I just saw this summary article on UroToday, which was recommended to me by @kujhawk1978 if I remember correctly. Often the articles here relate more to advanced treatments, but this was a "state of the profession" summary of focal therapies, which include IRE, TulsaPro, and a variety of others. Here is the link--I'm not sure if it works for anyone, but if it doesn't you might need to sign up or something. https://www.urotoday.com/conference-highlights/2024-south-central-section/155939-scs-aua-2024-focal-therapy-in-prostate-cancer.html
Here is the closing summary:
Dr. Meng concluded his presentation by discussing focal therapy in prostate cancer with the following take-home points:
-Focal therapy is an important tool in our armamentarium for treating prostate cancer
-There are multiple energy sources available, but overall oncologic outcomes are similar
-Focal therapy allows good preservation of continence and decent preservation of potency
-There is significant patient interest in focal therapy options, but patient selection is critical

Statistically, the statement was made: "Among patients with mostly intermediate risk disease, at 1 year 80% of patients have no significant disease, however, at 5 years 21% of patients may have to undergo an additional intervention for prostate cancer." This is a little weird, since the time frames are different but the percentages are almost symmetrical, but anyway, I get the drift. It puts off more radical treatment for most of the people for a meaningful amount of time.

The summary also makes the point that it is attractive because it provides an intermediate path between active surveillance and radical treatment, whether by radiation or surgery or both. I think that has been amply reflected in these forums over the few years I've been following them.

I think it relates to this discussion as it also helps to see how the specific pattern of identified cancer in the prostate contributes to the informed selection of which focal therapy (i.e., selective ablation or killing of cells) fits what is known about a particular presentation of cancer in the individual.

Good luck to you! One of the reasons my doctor recommended IRE was based on the location of my tumors.

Where were they located?
How many mm were they?
Thank you for providing your experience.

Great to hear all is going well. I too wanted to do IRE and had a virtual with Dr Powsang of Moffitt. My condition and results were the same as yours. PSA 4.5, MRI guided biopsy found area of concern, 1 core of 12 found 3+4=7 in area of concern, PSMA PET and CT showed confined to one area of the Prostate. Seemed like I was a perfect condiate for focal IRE. Only difference was my area of concern is 2 cm which Dr Powsang said was too large to do focal due to desire to treat a halo around lesion. I was disappointed to hear focal wasn’t an option but glad I met with him and he gave me the truth. Looking at other options now like MRI Guided SBRT if I can find a location in Florida that does it. I don’t think Moffitt does.

Gleason 4+3 contained within prostate. Was supposed to get cryo, but surgeon made an audible call a to IRE.
IRE failed for me. But neither did a prostatectomy (Gleason 9) and salvage radiation afterwards. Cannot stop wondering if Cryo would have done better instead of the IRE.. Or if surgery would have succeeded if done first at the lower Gleason.