Anyone tried aquablation after a PC diagnosis?

Posted by johnpca @johnpca, Mar 14, 2024

I saw some vague statement about how aquablation isn’t indicated for men with prostate cancer but I don’t see why not. Seems less impactful than a traditional TURP and my little walnut is going to be stressed enough as it is from whatever we do with the cancer.

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

Look into TULSA procedure and see if it might be a choice

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Hi @johnpca, while not specific to men with prostate cancer, you might find this discussion in the Men's Health support group useful:
- Aquablation: Post-surgery expectations
https://connect.mayoclinic.org/discussion/aquablation/
Sounds like this might be a question for your urologist. Am I understanding that you have not yet started treatment for prostate cancer?

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Thanks! And yes, that's correct, and it may be a while as I am hoping to stay with AS for as long as I can. It would be good to get some BPH symptoms addressed in the meantime, and as I am leaning toward radiation if things go badly on AS I think you have to do whatever you are going to do for BPH before RT. The reason I asked is that I saw a comment somewhere that aquabaltion may not be indicated for patients with PC, but I don't see why not. I am going to bring it up with my Uro, but wanted to know what others had heard from their providers as well.

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@johnpca

Thanks! And yes, that's correct, and it may be a while as I am hoping to stay with AS for as long as I can. It would be good to get some BPH symptoms addressed in the meantime, and as I am leaning toward radiation if things go badly on AS I think you have to do whatever you are going to do for BPH before RT. The reason I asked is that I saw a comment somewhere that aquabaltion may not be indicated for patients with PC, but I don't see why not. I am going to bring it up with my Uro, but wanted to know what others had heard from their providers as well.

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I had the same question. Why not aquablation for Gleason 7 at least? Maybe not 8 and 9. I will explain. Apparently aquablation leaves some margin tissue behind. This makes it better for incontinence, it spares the involuntary bladder sphincter at the neck of the prostate, and for ED, it spares the nerve area. But at the same time, that unremoved tissue could grow back cancer. Also, there is some questions as to whether the treatment causes cancer cells to escape into the blood stream. Full RALP is better at this because it doesn't ablate the tissue and leave small bits to escape as it captures the whole organ and puts it in a bag and removes it. I think that's the purpose of the bag process. Simple removal and dragging the resected organ through the abdomen would leave some tissue behind. Procept, the maker of the aquablation equipment, is running studies throughout the US at different hospitals, using their machine to treat prostate cancer. I think some of those results are out but they are small studies and conclude no significantly greater long term cancer cell clusters remain days/months after aquablation treatment. But they funded those studies so its not clear how unbiased they are. Also, existing studies are considered significant if they have 10,15,20 year results such as the studies comparing radiation to RALP. So, Gleason 8 and up cancers are too risky to try a new treatment on . I think this is a viable alternative to RALP as is HOLEP for less aggressive cancers. Decipher score also important to note. More to come with time.

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