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Targeted Treatment Options - Tulsa Pro and MRI-Guided SBRT Options

Posted by maverick75 @maverick75, Apr 5, 2023

Hi, I'm recently diagnosed with PC - I’m a 69 yr old male otherwise healthy and was diagnosed a few weeks ago following Prostate MRI and Biopsy at with localized Prostatic adenocarcinoma, and a Gleason score 4+3=7 (Grade Group 3) involving 66% of the tissue at the center of the 1 cm lesion. Max PSA was 3.4. Given my intermediate risk profile, I'm considering a more targeted treatment with Tulsa Pro and an MRI-Guided SBRT. Both seem like viable alternatives although long term data isn't there yet on either and Tulsa Pro not yet been approved by Medicare or most insurance companies. Anyone else in my risk profile done either of these?

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bl2023 | @bl2023 | Apr 22, 2023

Considering the above two options. I’m unfavorable intermediate risk with G7(4+3), 3 lesions rt side, 1 on the left side, Psma pt shows no spread. 63 yrs old, healthy, want to avoid SE’s. Discussed Tulsa pro with Dr. Scionti in FLA (still trying to get Kaiser to send me the disk of my mri and Psma pt scan). Sbrt with Kaiser in South SF, CA. Anyone have either one? Results? SE’s? Regrets? What was the determinative factor that made you choose one over the other? I’m concerned about the small number of men in the TACT trial and the high percentage of cancer missed. Would appreciate your input. Thanks.

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1 reply
maverick75 | @maverick75 | Apr 23, 2023
In reply to @bl2023 "Considering the above two options. I’m unfavorable intermediate risk with G7(4+3), 3 lesions rt side, 1..." + (show)
@bl2023

Considering the above two options. I’m unfavorable intermediate risk with G7(4+3), 3 lesions rt side, 1 on the left side, Psma pt shows no spread. 63 yrs old, healthy, want to avoid SE’s. Discussed Tulsa pro with Dr. Scionti in FLA (still trying to get Kaiser to send me the disk of my mri and Psma pt scan). Sbrt with Kaiser in South SF, CA. Anyone have either one? Results? SE’s? Regrets? What was the determinative factor that made you choose one over the other? I’m concerned about the small number of men in the TACT trial and the high percentage of cancer missed. Would appreciate your input. Thanks.

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I'm a 4+3, one lesion, localized as well, but older, near 70. I was initially very interested in Tulsa Pro but doctors at both Mayo and Moffitt didn't recommend any targeted therapy due to the intermediate, unfavorable risk profile. Regarding Tulsa Pro, they also cited the fairly high rate of recurrence and the need for close, long term testing including biopsies. I haven't made a final decision yet but at the moment, MRI-Guided SBRT is at the top of my list. Personally, (and I'm not an oncologist) but given your multiple MRI-visible lesions on both sides and your age, I'd be really hesitant to do anything less than whole gland treatment. In regards to SEs, if you haven't already, take a look at the just completed Mirage Clinical Trial.
https://pubmed.ncbi.nlm.nih.gov/36633877/

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1 reply
bl2023 | @bl2023 | Apr 23, 2023
In reply to @maverick75 "I'm a 4+3, one lesion, localized as well, but older, near 70. I was initially very..." + (show)
@maverick75

I'm a 4+3, one lesion, localized as well, but older, near 70. I was initially very interested in Tulsa Pro but doctors at both Mayo and Moffitt didn't recommend any targeted therapy due to the intermediate, unfavorable risk profile. Regarding Tulsa Pro, they also cited the fairly high rate of recurrence and the need for close, long term testing including biopsies. I haven't made a final decision yet but at the moment, MRI-Guided SBRT is at the top of my list. Personally, (and I'm not an oncologist) but given your multiple MRI-visible lesions on both sides and your age, I'd be really hesitant to do anything less than whole gland treatment. In regards to SEs, if you haven't already, take a look at the just completed Mirage Clinical Trial.
https://pubmed.ncbi.nlm.nih.gov/36633877/

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Thanks for the input. From the TACT trial it seems that not all the cancer is killed with Tulsa compared to Sbrt.

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danush1336 | @danush1336 | Jun 25, 2023

Did you need adt and if so how was it tolerated

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