Connect
← Return to Half of Prostate Cancer Focal Therapy Cases Were Inappropriate
Discussion
Half of Prostate Cancer Focal Therapy Cases Were Inappropriate
Prostate Cancer | Last Active: Aug 22 2:07pm | Replies (29)Comment receiving replies
@jim18 I definitely know folks that have done, and will do this. They are usually the ones with the most experience.
Dr. Scholz was correct in stating that the trials on whether this had better or worse long-term recurrence are not mature yet. So, we really don't know either way. But the chances of side effects are definitely lower.
One reason is that is done live, in-bore with a perimetric MRI. So the doc is viewing exactly what is happening live and the AI programs delineate the borders everywhere. Not perfect but any movement happens live where as most radiation, e.g., is done with static CT scans taken earlier. Truebore, Cyberkife and other brands have mechanisms to deal with those movements with the main one being the use of fiducials. Not a fan of the side effects with those either but the machine developed and trialed at UCLA gets around that with better technology (they claim) with 4 shots per second as the doc also sees live what is happening and any movement stops the machine instantly.
Most of side effect information for radiation are based on older technology but again we don't have mature data on the newer machines or many of the full ablation approaches to know with certainty.
I will trade a shorter life with less toxicities if that is the choice I get to make. The beauty of having options. No one size fits all. Tradeoffs. Always tradeoffs. Do your research with as little bias as possible and pick your poison.
Replies to "@jim18 I definitely know folks that have done, and will do this. They are usually the..."
@marko49 You are right. I was diagnosed with Gleason 6 about 3 years ago. I felt like I had to do something. I researched Tulsa Pro alot. I even went so far as to have the CT scan done to make sure I did not have any crystals or substances that would interfere. One doctor in Florida and one here in Phoenix were all ready to ablate both sides since my cancer is on both sides. I've had 3 MRI's that have not shown any lesions, Pirads 2 and Pirads 1. I guess if you have no lesions, they would need to ablate both sides. As time went on I became more comfortable with just living with cancer in my prostate. I ended up not having the Tusla Pro and am on Active Surveillance with the Mayo Clinic here in Phoenix. At 72 I am hopeful and pray that my Gleason 6 does not turn into 7, if it can do that, or if because of the 6 I am more susceptible to getting 7 or higher does not happen. I also have learned we rarely really, really know what is going on in our prostate.
Connect
@marko49 I am a big proponent of focal therapy. Looked at IRE, Laser, and Tulsa Pro. Was not a good candidate for any of these a couple of years ago. What I noticed in the study was that most of the inappropriate use was for Gleason 6. Percentage of Gleason 8 & 9 with focal therapy had large decreases. If someone with a 6 cannot take the thought of active surveillance any focal therapy is better than RT or RP. It is bad enough that most insurance will not cover these treatments.