Posted on 06/20/2022 9:17:18 AM PDT by ConservativeMind
In recent years, a new treatment strategy known as focal therapy (partial gland ablation) has emerged for prostate cancer considered to be "intermediate risk"—mostly, small tumors confined to one area of the prostate. Researchers have been working closely with an advanced focal therapy approach known as high-intensity focused ultrasound (HIFU), guided by magnetic resonance imaging (MRI).
Now a landmark clinical trial has demonstrated this less-invasive method works well for many patients. The phase 2 trial, led by MSK urologic cancer surgeon Behfar Ehdaie, looked at a particular type of HIFU treatment, also called MR-guided focused ultrasound (MRgFUS), in men with intermediate-risk cancer. The novel approach effectively controlled the disease in patients and greatly reduced adverse side effects of treatment. This suggests many men with intermediate-risk prostate cancer can avoid surgery, chemotherapy, and radiation.
When the cancer is confined to the prostate gland, the main treatment options have traditionally included active surveillance (close monitoring), surgery, and radiation. But men who needed surgery or radiation often had persistent side effects, such as urinary and sexual problems, that could reduce quality of life.
The MR-guided focused ultrasound (MRgFUS) is an outpatient treatment that takes about two hours.
Dr. Ehdaie says that using MRgFUS for intermediate-risk cancers became possible due to two important developments over the past 15 years. First, there was an acceptance by experts of using active surveillance for low-grade tumors. The second advance was new imaging technology that enabled MRIs to be incorporated into ultrasound treatment.
"Probably most important was the lack of side effects," Dr. Ehdaie says. "Nobody in the study reported urinary incontinence or experienced bowel problems. Most men were able to achieve erections."
Based on this data, the FDA in December 2021 granted approval for the technology, called Exablate Prostate, to treat prostate tissue.
(Excerpt) Read more at medicalxpress.com ...
They use this type of ultrasound in cosmetic medicine to tighten skin.
I had TULSA (Trans Urethral Ultrasound Ablation) of my Gleason 7/Stage I prostate cancer in Aug. of 2020, just FDA approved in Dec. ‘19. Out-patient....3 hour procedure.
Totally successful, not only no side effects - no pain or discomfort. PSA now .227. Computer-mapped & doc-controlled procedure in MRI to see results as they happen. You leave pain-free/discomfort free with catheter for 2 - 3 weeks.
Cannot recommend more highly.
Dr. Stephen Scionti one of first in nation to do it, now most experienced. Cannot recommend him & staff more highly. No - not paid for this.
https://tulsaprocedure.com/scionti-prostate-center/
PM me with any questions - happy to help.
Amazing!
don’t want to control cancer by watching it grow; better to get rid of it period. One aspect of medicine’s attitude toward prostate cancer is to be too benign toward it. It’s generally said that it’s so slow growing that a man is virtually guaranteed five years of life after its discovery. And this is the basis of “active surveillance.” The problem with the approach is that the man continues aging toward that time when he’ll be told that he’s just too old for the surgery. Foolish to settle for the “five years” while it progresses to that stage that guarantees a horrible and painful death.
“don’t want to control cancer by watching it grow; better to get rid of it period. One aspect of medicine’s attitude toward prostate cancer is to be too benign toward it. It’s generally said that it’s so slow growing that a man is virtually guaranteed five years of life after its discovery. And this is the basis of “active surveillance.” The problem with the approach is that the man continues aging toward that time when he’ll be told that he’s just too old for the surgery. Foolish to settle for the “five years” while it progresses to that stage that guarantees a horrible and painful death.”
You need to do some homework ...
I am still under active surveillance but my doctor now performs the US treatment.
I clicked both the top and bottom Medical Express links and they both delivered that same article about LIVER cells. Please post the correct link. The man I love is about to have prostate surgery for grade 2 and 3 malignant cells, and we need to have information about whether this other approach would be better.
This is the proper link:
https://medicalxpress.com/news/2022-06-high-intensity-focused-ultrasound-hifu-prostate.html
I recently (3 months ago) went from ‘Active Surveillance’ to MRI guided focal treatment. My focal specialist chose cryogenics instead of the ultra-sound, though he did both. He said I was an ideal candidate for the cryogenics. My PSA has dropped from a high of nearly 10 at one point, down to 2 now, the same as it was nearly 40 years ago. I switched from AS to the treatment after a change in PSA and MRI last fall.
I had focused radiation treatment last fall. PSA was over12. Radiation and hormone treatment PSA now at .06 . so far so good. One more 6 month hormone shot to go.
Thanks, I have now read the article, and it seems to have been used for men who had cancer in only part of the prostate. On the other hand it does speak of follow up where they found no cancer left in the tissues that had been targeted. Thus it appears that the tissue surrounding the cancer cells was still there. Therefore, would it be possible to target one area, later another, and still more at appropriate intervals to get rid of all cancer cells throughout the prostate.
I ask this because my guy’s PSA was around 20, and when they biopsied 12 locations in the prostate all 12 had a score of 2 or 3 on a 5 point severity scale. He is now comtemplating total removal. The good news is his soft tissues and bone were tested and show no metasteses. My late father had prostate cancer which was treated by implanting radioactive seeds in the prostate (at least I think that was what he told my son, the implanted part). How does that work? Are they removed when the PSA goes down? How do they know it has worked if they don’t do more biopsies? My father’s PSA returned to normal and he died 3 years later at 90 of a stroke while standing in a long grocery line. He did not say he had any bad effects from the seed treatment.
Any thoughts and advice from people whith experience and knowledge will be greatly appreciated. He is the love of my life. I am already giving him a number of supplements which I hope will help, but information or ideas on that topic would also be appreciated. My brother is recovering very well from colon cancer surgery and taking a number of supplements I sent him.
Bkmk
Bkmk
Bkmk
I am 75 and under surveillance for about six years.
I had a office biopsy taken with PSA about 5. Later I had an MRI with a saturation biopsy in the hospital based on that MRI. My PSA dropped maybe because the target biopsy got some of it. Since then I get MRI’s about once a year and a PSA stable at about 2. I think I have three locations all at the lowest “cancer” level.
My urologist keeps treatment as an option and till my last visit had recommended the 40-day radiation treatment. Now he says US is recommended for meif I want treatment.
or if my PSA or MRI show worse indications.
This US is done in conjunction with the MRI to target locations and strength of treatment.
The seed treatment places tiny radioactive particles near the cancers. As I have never considered this option nor has my urologist recommended it, that is about the extent of my knowledge.
“I ask this because my guy’s PSA was around 20, and when they biopsied 12 locations in the prostate all 12 had a score of 2 or 3 on a 5 point severity scale”
Are you referring to the Grade Group or Gleason? Gleason adds two so 2+2 is very low. I suspect you were referring to Grade Group 2 which would be a Gleason 3+4 or 4+3.
A PSA of 20 is high due to the number of locations and sizes? What does his urologist recommend?
Article was NOT about TULSA, which can treat whole prostate.
We elected to ablate (burn up) about 90% of mine even tho my cancer was still very small at the time.
Check with Dr. Scionti’s office ......
TULSA and HIFU are different. HIFU goes in through rectum, cannot touch opposite side of urethra. TULSA, being in urethra, can do 360 deg.
I would never let them subject me to a prostate biopsy or even digital exam so I guess I’ll never know what killed me.
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