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Going for Tulsa Pro Jan. 7th
I've posted here a few times over the last year and have read most of the posts from others. I was diagnosed in January 2024 through an ultrasound biopsy (it should have been MRI guided), followed by a PSA test CT scan, MRI, and Decipher test. My cancer is not aggressive, but there are three growths in my prostate. My doctors recommended a full ablation, and I’ve decided to go with the Tulsa Procedure at UCLA with Dr. Steven Raman.
I’ve waited until now because I believe Medicare will begin covering the procedure on the 1st. of 2025. Earlier this year, I switched from a Medicare HMO plan (Blue Shield) to Original Medicare with a supplemental plan, where Medicare covers 80% and the supplemental plan pays the remaining 20%. It’s been incredibly difficult to determine whether Medicare will actually cover the procedure, as I’ve received conflicting information. However, I think they will.
I considered going back to an HMO with United Health Plans, which includes UCLA physicians as in-network, but no one could guarantee that they’d cover the procedure either.
Anyway, I thought I’d document this journey. It begins on January 5th, when I’ll check into an Airbnb hotel near the procedure location. This is two days before the procedure. I’ll have to fast those 2 days and completely empty my stomach (I’ll spare you the details). In the best-case scenario, I’ll wake up with a catheter and a “burned out” prostate. I’ll need to wear the catheter for at least two weeks. Hopefully, they'll get it all 🙂
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About 3 hours. That included adding contrast after the procedure to ensure coverage. Doctor's Note: "Post ablation contrast imaging demonstrated appropriate ablation zone encompassing the prostate cancer."
If one goes for a consult to do Tulsa on your specific case, you have to ask what the proposed ablation fraction (how much they take out inside prostate) and also how much BPH you have. If you have a lot of BPH and the ablation fraction in high, and the most recent kinds of Tulsa they like to take temperature up long enough to really kill, it takes time. A lot of time.
What size were your lisons and what size was your prostate .?
Yes in my consult with Dr. Klotz , who as I inducated was on thhe original research team at Sunnybrook with Dr. Chopra , I will address your proposed questions .
Dr. Klotz is currently conducting another TULSA - PRO Trial at Sunnybrook . At my age I would not qualify . The cost in Toronto is $ 30,000 Can. dollars $ 20,000 USD
I had several tiny lesions, but my prostate size was over 100cc. Originally they aimed at about 2/3 of prostate for ablation fraction but it was higher maybe 75% on MRI post procedure image report they gave me. Dr Klotz is about the best, that sounds like a really good person to go to. Don't worry about these trials, that is about papers, the studies done for papers always have limits, go because you really want it for your case. For papers they propose so many x cases all y gleason, basically to make paper publishing less time consuming. I did some papers (completely unrelated and in research) it can take several years to get a paper published and they put all these limits so the paper publishing will be less basically. Keep in mind several years ago they didn't take the temperature up for long during Tulsa, now they take it up for so many minutes while watching the MRI all to be sure they kill what they see.
THANKS FOR YOUR TIMELY REPLY. I have one liason - my prostate is 80 cc.
In addition to discussing TULSA PRO with Dr Klotz , I plan to broach the subject of Active Surveillance as he has also published extensive research addressing this matter . I am currently on AS
My doctor (Dr. Steven Raman, UCLA) is also very knowledgeable about active surveillance and would probably advise that if it weren't for the Urologist and radiologist that he works with, both suggesting full prostate ablation. So, I'm getting it over with. I've waited a year. It would suck to have it spread knowing I had a chance to catch it before it did.
I am considering NanoKnife , TULSA PRO or Mono SBRT ( 5 TREATMENTS )
I was under about 4 hours with my TULSA PRO.
How was your outcome and recovery?
Are you inferring that with Gleason 6 in 4 cores and Gleason 3 + 4 = 7 in 2 cores , that Dr. Raman would suggest AS ?