@n227rv Hi again. You wrote "It appears that both prostatectomy and SBRT leave the patient, that is you and me, either without a prostate or with a chunk of leather where a working gland used to be - along with collateral damage to other tissue" I would have qualified that to "potentially along with collateral damage to other tissue".

Here's the thing about Tulsa Pro you need to know. Whole gland ablation will shrink your prostate by 90% approx. We were told that my husband's 48 cc prostate (large apricot or a golf ball) would shrink to about 4-5 cc. (volume of a large grape or a single standard board game die).

Now most Tulsa Pro recurrences can go the radiation route. We can't --he scored "High Risk" on both PROSTOX tests.

So far, I know of two men who got recurrence and got it treated with a second Tulsa Pro. One had only Partial (75% approx) the first treatment. The second originally had a Whole gland procedure. But. No idea of the original size of that prostate...

Here's the point about Tulsa Pro and you nailed it. "I am fine if I buy five more years after a fairly non-invasive treatment." We would be so grateful for that happening to us.

And for the exact reason you raised "Who knows what innovations there might be in the treatment of prostate cancer in 2031?"

It's called Kicking the Can Down the Road.

We had no choice. PROSTOX slammed the door on any form of radiation. So we kicked the can down the road.

Wisest advice I ever received "Do Your Homework. Do Your Homework. Do Your Homework."

Cheers.

@n227rv As I mentioned earlier, I had Tulsa. Where the tulsa ablation was stopped, apparently because my colon comes up to the prostate, that is where I had a recurrence. At Mayo they just inject a spacer to push the colon away and they used cryoablation to finish things off (hopefully for good). So two procedure person here. That is one thing I wasn't told about in Tulsa prep that sometimes they don't want to get near things like the colon coming right up to the prostate but they did they best they could on first run with Tulsa. I got it now with cryo, despite that earlier limitation that stopped doc from doing as good a job originally. So far I am getting on 6 years into this, and hopefully don't need anything more.

I will add the reason Mayo didn't repeat Tulsa a second time for me was because they feel cryoablation when done the same way under MRI provides a little more power to the target to destroy it. So for me the second time was cryo. The procedures are nearly identical.

All is good so far now for me, one month out from second run (1 Tulsa 2 Cryo).

Good luck with the choices, it is complex.