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@wwsmith
Not all focals look the same. Tulsa Pro has similar cancer recurrence rates at 3 years as Surgery or Radiation. If you are the right candidate, it has great promise. I knew the risks trying a new technology and was perfectly fine with just "kicking it down the road" if that is what it ends up doing. However, the ease of the procedure and much lower risk of side effects was appealing to me. If I need radiation down the road, I have also delayed those potential side effects. It was a win-win for me. PSA was reduced by over 90% and has held steady for 1 1/2 years. No evidence of disease at this point.
Replies to "@wwsmith Not all focals look the same. Tulsa Pro has similar cancer recurrence rates at 3..."
@jcf58 A three year time frame review of Tulsa Pro is very short as a critique on recurrence issues with it. What I think really put me off on focal treatments was the quote posted below by @Jeff Marchi from this thread https://connect.mayoclinic.org/discussion/cryotherapy/
As you know, cryotherapy is focal therapy. Here’s an opinion by one well respected physician.
At the 11/1/2025 PCRI conference the following was said by Matthew R. Cooperberg, MD, MPH
What about focal therapy?
* The energy modality matters much less than the accuracy of the imaging - which is not there yet.
* Overall focal therapy is associated with minor side effects, but high rates of recurrence both in- and out-of-field.
* Focal therapy is not really a replacement for surgery or radiation; it is better considered an adjunct to active surveillance
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@jcf58 Your comments make so much sense. If a ‘one step at a time’ approach is not harmful or dangerous why not do less, rather than more?
Unfortunately, there are docs out there who fall in love with their trusted procedure and will recommend it above all others and the same goes for focal ablation.
As you point out, the right candidate is the most important part of any treatment!
Phil