1. < Prostate Cancer

Focal Cryotherapy vs RARP

Posted by happydappy @happydappy, May 5 6:34pm

I'm diagnosed GG 2 and MRI and biopsy indicated that the cancer is located in one lesion near the prostate capsule. Being treated at a university center of excellence. SBRT may not be best for me due to non cancer related urinary issues as radiation could make it worse. Surgeon offered RARP or focal cryotherapy. He's experienced with both. He said focal therapy, while having less side effects, does not have the long term success rates as prostatectomy. What are other's experiences with making this decision or having cryotherapy?

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surftohealth88 | @surftohealth88 | May 6 10:09pm

Yes, each technique has pros and cons. Some work better for certain placement of lesion inside the prostate. Also, if lesion is close to anal opening it can be tricky to have focal radiation in that spot. They use special "spacers" in that scenario but it still can cause anal irritation and possibly long term proctitis.

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bjroc | @bjroc | May 7 6:31am
In reply to @surftohealth88 "Just wanted to say that we were informed that TULSA can be successful only if cancer..." + (show)
@surftohealth88

Just wanted to say that we were informed that TULSA can be successful only if cancer is close to urethra, not if it is on outer edges of prostate.

Also, we were informed that any localized therapy is almost never curative, it just removes cancer from that particular part of prostate gland and one has to continue with AS, inclooding having biopsy every year or two. But, it can be a valid choice if somebody knows all of the risks and details and still can not imagine doing RP or RT at this point.

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I had Tulsa, so I know the distance can be up to 3 cm, ideally less than 3 cm. But 3 cm in all directions from urethra is the distance, and of course it can't be outside the prostate. 3 cm is pretty big, so many people are handled by Tulsa, some are not. Original poster of this thread not seeking it though, as one does have to travel usually.

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1 reply
tk192 | @tk192 | May 8 10:59am
In reply to @bjroc "I had Tulsa, so I know the distance can be up to 3 cm, ideally less..." + (show)
@bjroc

I had Tulsa, so I know the distance can be up to 3 cm, ideally less than 3 cm. But 3 cm in all directions from urethra is the distance, and of course it can't be outside the prostate. 3 cm is pretty big, so many people are handled by Tulsa, some are not. Original poster of this thread not seeking it though, as one does have to travel usually.

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May I ask how was your experience with Tulsa and where did you have it done? I am Gleason 4-3 and looking for options. Tulsa looks interesting

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2 replies
bjroc | @bjroc | May 8 11:17am
In reply to @tk192 "May I ask how was your experience with Tulsa and where did you have it done?..." + (show)
@tk192

May I ask how was your experience with Tulsa and where did you have it done? I am Gleason 4-3 and looking for options. Tulsa looks interesting

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Dr Scionti in Sarasota is where I had Tulsa Pro done, one can stay in an AirBnB or similar if you go to a place like that. You can sort through this thread that I started, but it got kind of big with some side discussions that is all good of course, but you can sort through it for info:
https://connect.mayoclinic.org/discussion/tulsa-pro-initial-experience/
My recent MRI is clear of anything suspicious cancer wise, but I do still have some BPH. For BPH Tulsa sometimes helps for the short term sometimes not for the long term, but cancer is the important one and Tulsa so far so good on that.

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jcf58 | @jcf58 | May 8 2:58pm
In reply to @tk192 "May I ask how was your experience with Tulsa and where did you have it done?..." + (show)
@tk192

May I ask how was your experience with Tulsa and where did you have it done? I am Gleason 4-3 and looking for options. Tulsa looks interesting

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I was Gleason 4+3 and I did Tulsa Pro last July at Rochester Mayo. My PSA went from 8.6 to 0.68 at three months. My PSA at nine months was also .68. My MRI at six months was clear. At this point I’m very happy with my choice. The low risk of side effects and the fact that all other treatment options are still on the table if the cancer returns sold me on it. You can read all my comments and description of my experience if you click on my profile.

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1 reply
topf | @topf | May 8 4:38pm

Is cryo still used as a primary treatment in this day and age?

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1 reply
happydappy | @happydappy | May 8 7:30pm
In reply to @topf "Is cryo still used as a primary treatment in this day and age?" + (show)
@topf

Is cryo still used as a primary treatment in this day and age?

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My surgeon did cryo when at NYU because of demand but not so much now. He said the literature on it is not that convincing. I'm the one that brought up focal therapies and he said I'd be a candidate but he stressed that RP or radiation would be more effective for eradicating the cancer long term.

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happydappy | @happydappy | May 8 7:31pm
In reply to @jcf58 "I was Gleason 4+3 and I did Tulsa Pro last July at Rochester Mayo. My PSA..." + (show)
@jcf58

I was Gleason 4+3 and I did Tulsa Pro last July at Rochester Mayo. My PSA went from 8.6 to 0.68 at three months. My PSA at nine months was also .68. My MRI at six months was clear. At this point I’m very happy with my choice. The low risk of side effects and the fact that all other treatment options are still on the table if the cancer returns sold me on it. You can read all my comments and description of my experience if you click on my profile.

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So glad you're happy with your decision and may you stay cancer free!

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