Going for Tulsa Pro Jan. 7th

Posted by paulcalif @paulcalif, Dec 29, 2024

I've posted here a few times over the last year and have read most of the posts from others. I was diagnosed in January 2024 through an ultrasound biopsy (it should have been MRI guided), followed by a PSA test CT scan, MRI, and Decipher test. My cancer is not aggressive, but there are three growths in my prostate. My doctors recommended a full ablation, and I’ve decided to go with the Tulsa Procedure at UCLA with Dr. Steven Raman.

I’ve waited until now because I believe Medicare will begin covering the procedure on the 1st. of 2025. Earlier this year, I switched from a Medicare HMO plan (Blue Shield) to Original Medicare with a supplemental plan, where Medicare covers 80% and the supplemental plan pays the remaining 20%. It’s been incredibly difficult to determine whether Medicare will actually cover the procedure, as I’ve received conflicting information. However, I think they will.

I considered going back to an HMO with United Health Plans, which includes UCLA physicians as in-network, but no one could guarantee that they’d cover the procedure either.

Anyway, I thought I’d document this journey. It begins on January 5th, when I’ll check into an Airbnb hotel near the procedure location. This is two days before the procedure. I’ll have to fast those 2 days and completely empty my stomach (I’ll spare you the details). In the best-case scenario, I’ll wake up with a catheter and a “burned out” prostate. I’ll need to wear the catheter for at least two weeks. Hopefully, they'll get it all 🙂

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

@jcf58

I wish I had kept notes! It was at least 2-3 months before my stream was back to pre procedure and I only had 30% ablated. I was ok with that as I still had full control and no pads. It is better than pre procedure these days (nearly 7 months).

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I wish you had kept notes too, lol. But great to know you are doing so well, gives hope to me and others who follow behind 😀

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It's been 10 months since Tulsa procedure at Mayo Jax and I feel great as an 80 year old that was almost too OLD for the procedure. As above, most all functions related are back or better than prior to Tulsa. I do have many other issues that require meds, I put the list in ChatCPT which provided a "personalized medication daily schedule", which gave potential compatibility problems and side effect warnings. For me, a tool to better track start and stop dates and which of my 6 "..ologists" prescribed them, It also helped with advice that make it easier to control supply and reorder.

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@bjroc

Well there isn't probably one cause of BPH.

I will say 5-alpha reductase inhibitors prescriptions (dutasteride and finasteride) and OTC supplements that have essentially low dose 5-alpha reductase inhibitors will work plus lower PSA, but it covers up the issue so that doesn't solve things BPH wise.

Several proposed things that cause BPH are for one a testosterone to estrogen ratio below 10 which would be a direct cause. I have posted what can be done prior if you have those tested and it isn't ten or higher. I will post it below.

Another cause of BPH is inflammatory foods or ones that are prostate inflammatory, and that is complex to tackle as it may differ by person, and some very different opinions on foods of course. But the general things are basic to more complex, the basic being avoid sugar and all fairly refined carbs (things like Ezekiel bread are believed ok), avoid all oils but Olive and some are ok with coconut others not - but unfortunately most prepared foods have all the cheap oils, avoid all dairy and milk. Then the complex and differing opinion ones are to avoid meat totally as it has these in it:
Heterocyclic amines
TMAO (Trimethylamine N-Oxide)
Heme iron
Neu5gc (N-Glycolylneuraminic acid )
AGEs (Advanced glycation end products )
See GameChangersMovie.com on that
So that means use soy instead of meat. Other websites avoid soy and go for meat/keto. I did meat and keto for years and still had BPH so I am now avoiding meat. Up to you what you try.

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Testosterone / estrogen ratios improvement protocol v004

Have a holistic doctor, naturopath, primary care, or other doctor order labs for you (testosterone, estrogen and progesterone) and hopefully have useful suggestions. A good testosterone to estrogen ratio for a male that is 40 or older should be around 10 and up, though it is much higher in younger men. That is 10 times more testosterone than estrogen or 10:1. If it is quite a bit lower there are some things you can do.

Symptoms of poor Testosterone / estrogen ratio in men include:

• BPH and sometimes prostate cancer follows
• Low libido
• Hair loss
• Weight gain & body fat
• Gynecomastia (“man-boobs”)
• Erectile dysfunction
• Muscle loss
• Fatigue

Things to do - knowing we are people with prostate problems including PCa.

• If PCa and BPH, don’t take exogenous testosterone (like injections) unless approved by physicians, so only work on natural was to raise the Testosterone portion of the ratio. That would mean exercise, controlling blood sugar, etc.
• Try things to lower estrogen. Some natural ways are cruciferous vegetables. Supplements include Sulforaphane glucosinolate (SGS) and DIM as these derive from cruciferous vegetables. Be sure the DIM and SGS work right for you, as they may not always do the job or an inadequate one. My experience is these don’t work that well.
• Avoid plastic touching food especially hot food, as it has “xenoestrogens” which to the body are just like estrogen. That means dump all plastic storage containers, especially older ones. Some filter all drinking water to get plastics out.
• Talk to your doctor about progesterone as it is a truly natural anti-estrogen but only if ratios are really bad. It is available OTC as well (Amazon search: progesterone USP micronized powder), but you need a very small amount daily with breaks from time to time (over a week breaks). Use a low dose suitable for men and doctors ordering labs to help (estrogen and testosterone), so it does require a doctors help for that. Trans-mucosal progesterone may produce best results. Progesterone Powder USP, Bioidentical Micronized Powder can be dissolved into tiny amounts with a measuring spoon. For men 1/64 tsp (need a tiny measuring spoon), dissolve in drops of Olive oil on a spoon, mix around with finger. Apply transmucosal or on gum area of mouth 30 minutes before bed. It will make you sleepy, just be aware of that.

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Excellent! Thank you so much!

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Figured I'd give an update. Tomorrow will be 6 weeks since I had the Tulsa Procedure. Since there were some unexpected equipment challenges during my procedure which required removing the original probe and inserting a alternate probe, I was concerned about my recovery. It tur b s out my concern was unfounded. Other guys that went before me wrote to tell me that things start to improve around week 5. I had a little blood in my urine and a slow stream every time until just before week 5, then like clockwork, the blood was gone and my stream was improving. I had been taking 2mg Terazosin for years prior to the procedure and and flomax post. About 5 days ago I stopped taking both. No more blood and my flow is better than it's ever been. I have had no incontinence issues and no sexual dysfunction. Physically and just important if not more so, psychologically I feel great and relieved. If you've been recently diagnosed, if you're a candidate, consider the Tulsa procedure, I'm really glad that I did. Today is March 3rd. On March 19th. I go in for an MRI to confirm that they got the targeted area. I'm optimistic that they did. I'll report back.

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Awesome. I concur with your advocacy to consider Tulsa Pro😉 as my recovery was even easier. Hope MRI results look good.

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@paulcalif

Figured I'd give an update. Tomorrow will be 6 weeks since I had the Tulsa Procedure. Since there were some unexpected equipment challenges during my procedure which required removing the original probe and inserting a alternate probe, I was concerned about my recovery. It tur b s out my concern was unfounded. Other guys that went before me wrote to tell me that things start to improve around week 5. I had a little blood in my urine and a slow stream every time until just before week 5, then like clockwork, the blood was gone and my stream was improving. I had been taking 2mg Terazosin for years prior to the procedure and and flomax post. About 5 days ago I stopped taking both. No more blood and my flow is better than it's ever been. I have had no incontinence issues and no sexual dysfunction. Physically and just important if not more so, psychologically I feel great and relieved. If you've been recently diagnosed, if you're a candidate, consider the Tulsa procedure, I'm really glad that I did. Today is March 3rd. On March 19th. I go in for an MRI to confirm that they got the targeted area. I'm optimistic that they did. I'll report back.

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So happy for you Paul.
While I just have ASAP, technically not cancer, I will go the Tulsa route if/when it results as cancer. My issue is in the right apex, peripheral zone. I’m curious where your issue was? Did you have full ablation? I’d be looking at Stanford for the procedure, closest. You or anyone know about their team?
So concerned about sexual function thereafter.

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My slow growing cancer was located in a few areas on both sides (I don't recall the proper description). My doctor required me to consult with two other doctors prior to under going Tulsa. One pushed brachytherapy the other surgery. I mention this because when I consulted again with my doctor, telling him what the other doctors had said, he seemed to agree. It wasn't until the day of the procedure that he told me I had the option of whole glad or just targeting the cancerous growths. We talked about the pros and cons of each. To be honest, I don't recall what we decided, and I don't know whether he took it all or not. I thought I asked him to only remove the growths, but in his written remarks he talked about full ablation. He may have written that prior to the procedure? I meet with him later this month and I'll be sure to ask. BUT, the bottom line is, I have NO incontinence, my urine flow is great. My erections are just as good as they were before my procedure which is not great but adequate. Most importantly, I can still reach orgasm. I do have an ejaculate that has blood in it but the blood is dissipating with session. It may be that once all the blood is gone, there won't be any ejaculate, but at 70 years old (today), does that really matter? It still feels just as good. In the final analysis, everything went perfectly and I'm better off now than before the procedure. No cancer (I hope), better flow, no side effects, and no more Terazosin.

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@kyle13

So happy for you Paul.
While I just have ASAP, technically not cancer, I will go the Tulsa route if/when it results as cancer. My issue is in the right apex, peripheral zone. I’m curious where your issue was? Did you have full ablation? I’d be looking at Stanford for the procedure, closest. You or anyone know about their team?
So concerned about sexual function thereafter.

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Kyle13: Here was my description: Prostate, Index Lesion x 5 Left ant TZ mid, needle core biopsy:
Adenocarcinoma, GRADE GROUP 3, Gleason grade 4+3 (score 7) (estimated 70 % grade 4)
4 of 5 needle cores are positive
70 % tissue involvement.

All 12 of the other cores were negative.

I had 30% my prostate ablated. I started sex 1 week after and have had no issues. I told my doctor that I actually think it’s better than before, but I think it’s just that I’m so happy that things didn’t change.😉

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I had TULSA in November and returned for follow up March 4. I had labs done at the VA two weeks ago and PSA was 0.88. OU checked my PSA on Mar. 4 and it was 0.7. Before the procedure it was around 10. Dr. Stratton was very pleased and told me it couldn't get any better. My only side effect is dry orgasm. Erection is about like it was before the procedure. Dr. wrote a prescription for Viagra. I go back in June for an MRI. I'm very happy with my decision to go with TULSA PRO.

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@bobbygene

I had TULSA in November and returned for follow up March 4. I had labs done at the VA two weeks ago and PSA was 0.88. OU checked my PSA on Mar. 4 and it was 0.7. Before the procedure it was around 10. Dr. Stratton was very pleased and told me it couldn't get any better. My only side effect is dry orgasm. Erection is about like it was before the procedure. Dr. wrote a prescription for Viagra. I go back in June for an MRI. I'm very happy with my decision to go with TULSA PRO.

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Awesome!! With results like ours I think the Tulsa Procedure will become the default choice for prostate cancer isolated to the prostate. Hoping my results turn out as good as yours.

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