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Tulsa Pro - my initial treatment experience

Prostate Cancer | Last Active: 16 hours ago | Replies (115)

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@wdqlei

I am new to the group and am considering Tulsa Treatment. I have intermediate risk cancer that is located on the right side of my prostate. I have a 100C size prostate and am being told that at the York Pa. facility that does the procedure they can only treat up to 85c. Has anyone here had a large prostate treated with Tulsa and where did you have it done?

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Replies to "I am new to the group and am considering Tulsa Treatment. I have intermediate risk cancer..."

There are all kinds of limits places put on it. Dr Scionti will do yours most likely, but he goes from urethra to edge has to be less than 30 mm, ideally 25 or less. If it is 30 he might do some shrinking on yours first.

Some places doing studies limit to 3+4, though they don't look at volume of 4 so kind of contradictory. Mayo limits it to that I think and size too I think but they didn't have the machine when I was there so I am not 100% sure. Other places are giving a size limitation up to some number, but better places using distance from urethra to edge. The reason they want size limits (or distance from urethra to edge) is they need to take the temperature up for so many minutes as monitored while in MRI using the latest MRI thermometry techniques, but you should still qualify most places. The bigger the size the harder to take temperature up to full kill temps. You will have to call around, but you should qualify for Dr Scionti and others I am sure.
https://tulsaprocedure.com/find-a-tulsa-pro-center/
I will add, some places might be from urethra to furthest edge of lesion in the prostate instead of edge of prostate.

I'm not sure about the size issue, but you should check with Busch Center in Alpharetta, GA (Atlanta suburb). Joe Busch is one of the most experienced with Tulsa treatment.

In October of this year I had the TULSA-PRO procedure done at Mayo Rochester by Dr. David Woodrum. My prostate was approximately 100cc. Dr. Woodrum wasn't certain due to the size of my prostate and the location of my lesion (anterior transition zone) whether the probe could reach it effectively. Seems it has a 6mm maximum distance it can transmit the HIFU signal. My outer distance was 5.9mm. But he said the probe tended to tilt in my favor once inserted and in place. He said in real time if he could not use HIFU he would switch to cryotherapy to freeze the lesion. Both procedures would be MRI guided, in-bore in real time, which to my way of understanding provides a degree of precision most ultrasound guided focal therapy treatment modes do not provide. So I was OK with his assessment. Either TULSA-PRO or cryo were fine by me. To my good fortune he was able to use TULSA-PRO. There is one other step in this process I wasn't aware of until the day before my procedure when Dr. Woodrum ordered a CT Scan of my pelvic region. Its purpose was to determine if there calcium deposits inside my prostate. Calcium deposits deflect the HIFU waveforms and make treatment with this technology problematic and its use not possible, as areas of the lesion cannot be properly heated as a result. Again to my good fortune, I had one small deposit but located far away from the region of interest. I also talked with Dr. Woodrum about doing something about the size of my prostate. As we both know 100cc is a large prostate, especially for me as I'm a small framed man. As part of this procedure he took very wide margins and ablated approximately 60cc of my prostate. So my hope is after all the healing is complete, I'll have a functioning prostate that is about 40cc, the appropriate size for a man my age, 77. I'm one month into the healing. I had a fair amount of edema in my pubic region and scrotum for the first couple of weeks, which has now subsided. My urine stream is reasonably good. My only real symptom at this time is frequency of urination is higher than normal, amount urinated is lower than normal, and urge to urinate when my body says so is pretty strong. Hopefully that will correct itself in the coming months. Hope this is helpful to you.

Here is a link from someone who had Tulsa Pro for 100 cc prostate done at Mayo Clinic in Rochester:
https://connect.mayoclinic.org/discussion/tulsa-pro-experience-mayo-clinic-mn-july-2024/?pg=4#parent-comment-1113832-72db5c