Author: emwalser

Why have I never heard of Focal Laser Ablation? Why does my urologist tell me to avoid focal therapies?

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Focal therapy for the prostate began in the late 1990s; however, there is a very limited number of providers who are trained and skilled enough to perform this procedure. These 5 doctors have the most experience and have performed over 100 Focal Laser Ablation procedures:

Wavelength Medical has 1-2 years of data on the recurrence rate of cancer after focal therapies and needs an additional 3-5 years to obtain approval from insurance companies to pay for the procedure.

As most urologists do not perform and are not familiar with this procedure, they do not recommend it. Typically trained as surgeons, their preferred therapies for prostate cancer are watchful waiting or removal/ radical surgery. Focal therapy is an option in between those extremes; you might be a candidate. Check this out to learn more to see if you qualify.

Of the focal therapies, which is the safest?

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There aren’t any research studies that provide a definitive answer. We think it is the Focal Laser Ablation procedure. During the FLA, we constantly monitor all of the sensitive structures (nearby areas that can be damaged with slight changes in temperature), including:

  • Temperature of the prostate
  • Temperature the nerve bundles
  • Temperature of the urethra
  • Temperature of the rectum

This ensures that the tumor is precisely ablated without damage to the other sensitive structures. As a side note: FLA was initially invented to treat small brain tumors because of its precision and safety.

Cryotherapy is also safe and effective but less precise which makes it ideal for larger tumors. It has been around the longest and, fortunately, the risk of recurrent cancer after cryotherapy is similar to that of surgery. While Wavelength Medical focuses on FLA, we are also experts in cryo-therapies within the MRI environment. Reach out to us and we can find the right treatment for your tumor. Cryotherapy requires an overnight stay in the hospital while FLA is done as an outpatient.

What is the risk of side effects in the FLA? What about infection?

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Dr. Walser actively conducts research and monitors his patients for years after the procedure. If you choose to work with Wavelength Medical, we will also monitor you so that the outcomes of your procedure can help improve the care for other men. Dr. Walser has documented his findings and submitted articles for peer-review journals outlining all these data. Those articles will be made available soon. Since 2011, the Wavelength Medical team has performed over 300 procedures and we have been closely tracking the outcomes and recovery (at least 1 year post-treatment) for about 200 patients. The major side effects and their risks are:

  • Infection: 1-2%
  • Erectile Dysfunction: <5%
  • Urinary Incontinence: essentially 0%
  • Recurrence: 10-15% of patients undergo a second FLA procedure 1-2 years after the initial procedure. Fewer than 5% of patients choose to return for a third ablation procedure

Notes: Similar rates of re-treatment are seen in prostatectomy (prostate surgery) patients. And we are actively working to decrease those rates of retreatment. Data reflects patients treated from 2011 through 2017.