TULSA PRO Results at 3 plus years - Treated for High Grade Gleason 8

Hi russm. Lovely post!

My husband just had Tulsa Pro on Wednesday. At this time two days ago, he was in pre-op. Great to know that three years after your procedure there's been no recurrence. Encouraging too given that you had one 4+3 and two Gleason 8s. While I've heard about Gleason 8s getting Tulsa Pro, you're the first reporting "live", so to speak.

You wrote "In my opinion, patients should not be restricted to low grade or intermediate grade" Low grade, if I remember correctly, is defined as Gleason 6 and are usually the Active Surveillance group. Intermediate, Gleason 7s are regarded as a "sweet spot" for Tulsa Pro.

But, I know that Gleason 8s have been treated --ie: they refuse prostatectomy and radiation. Age can be a factor too. For example, my husband (78 and 3+4=7) scored "High Risk" on both PROSTOX SBRT and IMRT tests. So radiation was out. And no way prostatectomy. He was ready to just go on watchful-waiting rather than those options.

So yeah... Two days out from Tulsa Pro and his biggest "side effect" so far is, this morning, I didn't close the Righty-Tighty, Lefty-Loosey on his leg catheter firmly enough.

It's great to meet my first Tulsa Pro "unicorn". Cheers and all the very best!

@russm
Thanks for the video. For me, if had a biological re-occurrence, 6 months of data would not be enough for me to say, lets do it. I thought it was positive that NCCN has included tulsa pro in their 2025 guidelines but to me, I read the discussions as more data by the end of the year would shed additional light on both its effectiveness, it being more likely to be recommended by doctors and increased acceptance by insurance companies and investors. I think it is a great step in the right direction as a viable option.

My husband inquired about TULSA but was not a good candidate since lesion was too far away from urethra - so TULSA is not adequate procedure for all patients !

Also, his biopsy showed 4+3 unfavorable but after RARP it was upgraded to 9 and small EPE was discovered, so neither biopsy nor PSMA or MRI tell it all.

My husband is happy that he had RARP and he recovered in record time BTW. I am saying this just in case somebody is considering RARP and is imagining it to be some horrible procedure. For most patients it is not.

@bobgolf I felt removal was easy. The problem was something got left behind and the radiation truly sucked. Life altering suckage 14 months later.

@surftohealth88 Agreed…and a new member just yesterday stated that he had Tulsa for a single lesion - not high grade - and had a fairly rapid BCR and is now on ADT.
So what went wrong there??!! Poor surgical technique? Lack of experience? Some unknown factor we might never know?
Unfortunately, even with the best research we, as patients, can do, settling on a treatment plan is like picking out wallpaper: it looks great in the sample book, but after it’s hung you realize you might have made a mistake.
Sometimes our decisions pan out but it’s never a guarantee…
Phil

Great report. Thanks for posting. My brother is at a decision point and I was already steering him toward TULSA. Printed off this thread and handed it to him 5 minutes ago. I did radiation, and reading this makes me wish I had had better counseling and done TULSA myself. Best to you, and thanks again.

I live your story and 100% agree. I too did Hemi gland Tulsa Pro like you where they ablated the front half of my prostate where the localized tumor was located. G3+4=7, 13 core biopsy had one core a 7 with less then 10% 4. I went to mayo Jax in Dec and had my procedure and wow what a change. I urinate stronger then before, was having erections 3 weeks later, and my PSA dropped from 4.5 to 0.5 at 3 mos post. I also think Tulsa Pro is the next great precedure for localized prostate cancer. Spread the word to all! Oh one other thing, mine was 100% paid for by BCBS because I met my max out of pocket for the year.

@russm Your account is very helpful as I am in the decision-making mode and considering TULSA. See my profile for details, but I have a 4+3 and a 3+3, negative PSMA-PET and a very large prostate. I've been in touch with the Scionti Center and will forward my test results and let Dr S advise about whether I can do TULSA. If I'm an "acceptable" candidate, it has a lot to recommend it for me. Good luck and keep those good numbers coming.

@tdgillett I wish you good health going forward. My prostate was 57cc prior to TULSA. I know some people who have a much larger prostate than I had. Dr. Scionti may want to check for calcification's within your prostate and perhaps send out your biopsy for genomic testing to Decipher. A calcification in the wrong place can deflect the the energy causing issues that might result in a return of the cancer. It is my understanding that most TULSA failures occurred in patients who have a calcification. Sometimes that can be worked around if it is small or not where the cancer is located.

@ucfron I did not have Hemi ablation. I had whole gland ablation. I had cancer on both sides/lobes and as mentioned I had 5 positive cores with 2 aggressive Gleason 8's, a bit more aggressive intermediate grade (4+3) 7, a (3+4) 7 and a Gleason 6. So, whole gland treatment was critical. The more aggressive cancer was on the left and that area was covered by TULSA swipes several times since my procedure was before they had the "boost" algorithm in the software . They did leave some prostate tissue around one of the nerve bundles and the urethral sphincter. Pre TULSA my prostate was 57cc and it is now 22cc. Per the MRI's there is still some BPH tissue and scar tissue. Despite the whole gland treatment, I was surprised to learn I still have a 22cc prostate. But, that is what it measures out to with every MRI.

I have the scans showing my whole gland treatment that includes pre-treatment, during treatment (including the heat mapping) and post treatment. It is pretty interesting to see how they attacked it including notes for the area that was attacked more than once. My procedure took longer than normal due to the additional "Swipes" of the cancer zones.

It is nice to some TULSA procedures now being covered. I paid out of pocket three years ago. But, it was worth it.