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Anyone do Tulsa Pro, newer laser ablation procedure?

Posted by michael1952 @michael1952, Dec 16, 2021

Anyone do Tulsa Pro, relatively new laser ablation procedure for prostate

What was your experience, did you do partial or full ablation?

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poodledoc | @poodledoc | Jan 23 5:11pm
In reply to @russm "First of all, I wish you the very best with your MRI and future PSA tests...." + (show)
@russm

First of all, I wish you the very best with your MRI and future PSA tests. I hope they are perfect in your favor. If you are comfortable sharing those results, I am sure myself and others are anxious to hear them.

I am still in the "treatment" decision process and will be having a PSMA PET scan in a little over a week. At this point, I am considering pretty much every option including TULSA PRO, HIFU, radiation or surgery.

As mentioned, I had a couple of Gleason 8's (16 percent and 8 percent) in the two cores and a couple of Gleason 7's out of 12 samples. I sent my scans and reports out to several doctors and spoke with your doctor on Friday. He requested the aforementioned scan and mentioned that I may need more when and if he sees me for a TULSA or HIFU consultation.

Thank you again and best of luck moving forward.

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@russm I had a PSA done in July 2022 which read 1.1 then another one 2 yrs post HIFU on Jan 10 which read 1.3 slightly elevated but Dr says he wants to wait until April to do the follow-up MRI and a PSA repeat. My PSA nadir was 0.9 on August 2021. He also said he does not get concerned unless the PSA rises 1.2 points above the nadir which in my case would be 2.1 Although you should not get too tied up with PSA numbers as they can certainly fluctuate. Bill

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russm | @russm | Jan 21 11:52pm
In reply to @poodledoc "I have my 1 year recheck with MRI in a couple of weeks. My PSA before..." + (show)
@poodledoc

I have my 1 year recheck with MRI in a couple of weeks. My PSA before treatment was 2.6 and has remained at 1.0 on my 3 month rechecks. I had a hemi-ablation so I still have 1/2 of my prostate. No urinary or sexual side effects. Medicare did cover about $5,000 which left me paying $15,000 out of pocket. I might add this is my second HIFU, my first being with an in-experienced doctor in 2018, and the cancer came back.

Jump to this post

First of all, I wish you the very best with your MRI and future PSA tests. I hope they are perfect in your favor. If you are comfortable sharing those results, I am sure myself and others are anxious to hear them.

I am still in the "treatment" decision process and will be having a PSMA PET scan in a little over a week. At this point, I am considering pretty much every option including TULSA PRO, HIFU, radiation or surgery.

As mentioned, I had a couple of Gleason 8's (16 percent and 8 percent) in the two cores and a couple of Gleason 7's out of 12 samples. I sent my scans and reports out to several doctors and spoke with your doctor on Friday. He requested the aforementioned scan and mentioned that I may need more when and if he sees me for a TULSA or HIFU consultation.

Thank you again and best of luck moving forward.

REPLY
1 reply
poodledoc | @poodledoc | Jan 19 7:06am

Hello @russm When I was doing research a few years ago I found these 2 articles to help with my decision. These pertain to HIFU and not TULSA PRO however. I would trust the doctors at Mayo. Good luck to you. Bill
https://www.hifuprostateservices.com/do-you-qualify-for-hifu/
https://www.mayoclinic.org/medical-professionals/urology/news/high-intensity-focused-ultrasound-for-the-treatment-of-prostate-cancer/mqc-20519431

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russm | @russm | Jan 18 6:23pm
In reply to @poodledoc "Hello Russm, I have had 2 Prostate HIFUs. The first by an in-experienced urologist in Dec..." + (show)
@poodledoc

Hello Russm, I have had 2 Prostate HIFUs. The first by an in-experienced urologist in Dec 2018. Pre-op PSA was 6.9 and 6 months post-op it dropped to 1.2 Then my 2nd HIFU with Scionti was in Dec 2020, pre-op PSA 2.6 (biopsy showed relapse of Gleason 7 – 3+4) and 6 month post-op 1.0 Keep in mind the first HIFU was done on about 2/3 of the right side of my prostate (focal). My second HIFU involved the entire right side. So I still have my entire left side intact. My last PSA in July this year was 1.0 and I am due next month for my 2 year PSA. Hopefully it will remain around 1.0 I have no issues with ED or incontinence. I think the key to a successful HIFU is finding an experienced doctor. Either Mayo or Dr Scionti should be a good choice. Good luck to you, Bill

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Bill,
I thought I'd give you an update. My biopsy showed that I have prostate cancer. On the left side of my gland, I have a 3+4, a 4+3, and two 4+4 samples that showed up. I also had a small 3+3 in the right side. I was so disappointed as the biopsy report also showed my prostate density at .09 and my prostate volume at 56cc. Considering, I had free PSA ranges from 22 to 28 and not too high of a PSA…and a PSA density well under the .15 that is sometimes referenced. I did not expect to have Gleason 8 cancer. I remain hopeful that someone will accept me for HIFU or TULSA. I am concerned as the biopsy also mentioned some calculi. I read that calculi can prevent you from having the treatment. But, I also read that calculi can be removed. Thank you again for your replies. I have already sent in my biopsy reports and the MRI for review.

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fowleraacapt | @fowleraacapt | Dec 13, 2022

They say at least 8ozs a day has been shown to help. I believe it has to be pure and god quality like PomPom.

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pgcdds | @pgcdds | Dec 13, 2022
In reply to @fowleraacapt "Russ I also had 2 RAD 4 lesion show up in MRI with PSA of 5.8,..." + (show)
@fowleraacapt

Russ
I also had 2 RAD 4 lesion show up in MRI with PSA of 5.8, they did a trans-perineal biopsy guided with the MRI and ultrasound (very accurate supposedly) and thankfully all 14 samples came back negative. So keep the faith and drink lots of pomegranate juice and lots of Vit C 😀

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How many daily ounces of Pomegranate juice do you recommend drinking?

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russm | @russm | Dec 12, 2022
In reply to @fowleraacapt "Russ I also had 2 RAD 4 lesion show up in MRI with PSA of 5.8,..." + (show)
@fowleraacapt

Russ
I also had 2 RAD 4 lesion show up in MRI with PSA of 5.8, they did a trans-perineal biopsy guided with the MRI and ultrasound (very accurate supposedly) and thankfully all 14 samples came back negative. So keep the faith and drink lots of pomegranate juice and lots of Vit C 😀

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That is an incredible and positive message. Thank you so much for sharing! I am hopeful considering my Free PSA is pretty high and considering I have 57.4 volume. There are a few calculators out there that put things in my favor. With that said, I don't want to become overly optimistic. Thank you again.

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melcanada | @melcanada | Dec 11, 2022
In reply to @web265 "Won't you eventually become "castrate resistant" taking Zolodex?" + (show)
@web265

Won't you eventually become "castrate resistant" taking Zolodex?

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Yes then enzalutamide

Ideas welcome

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web265 | @web265 | Dec 11, 2022
In reply to @melcanada "Why not just get it all out and get on Zolodex that stops the testosterones that..." + (show)
@melcanada

Why not just get it all out and get on Zolodex that stops the testosterones that is the fertilizer for prostate cancer

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Won't you eventually become "castrate resistant" taking Zolodex?

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1 reply
fowleraacapt | @fowleraacapt | Dec 11, 2022
In reply to @russm "Thank you for the information on HIFU and TULSA-Pro. I had a PSA that bounced around..." + (show)
@russm

Thank you for the information on HIFU and TULSA-Pro. I had a PSA that bounced around from 4.5, 3.8, 4.3, 4.4 5.0, 5.4 over the past several years then rose to 6 this past summer. My DRE was normal. Free PSA levels have been 22 to 28 and prostate volume is 57.4. My doctor ordered an MRI and I have two Pi-RADS 4 lesions in the same lobe of the prostate peripheral zone. The lesions are 11mm and 10mm. So, about 1CM each.

I have a biopsy schedule in January. I am hopeful I don't have cancer. If it turns out to be a gleason score 7 cancer, I have been exploring HIFU and Tulsa-Pro. I have a Florida home about an hour from the Scionti and watched his videos. It is nice to see that Mayo appears to be offering TULSA-Pro also.

Was your PSA 2.6 after the cancer returned following your HIFU in 2018? Or, was that your initial PSA that motivated further exploration of the potential for prostate cancer.

I live in Indiana for a good part of the year and had a pretty serious back issue that took me to the Mayo Clinic in Rochester MN over 30 years ago. After two surgeries performed locally failed, they did a great job. So, I may also explore Mayo in Jacksonville for the TULSA-Pro option. I noticed Dr. Scionti has performed numerous procedures and watched his videos. Do you have any thoughts/updates…thank you!

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Russ
I also had 2 RAD 4 lesion show up in MRI with PSA of 5.8, they did a trans-perineal biopsy guided with the MRI and ultrasound (very accurate supposedly) and thankfully all 14 samples came back negative. So keep the faith and drink lots of pomegranate juice and lots of Vit C 😀

REPLY
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