If you or a loved one are diagnosed with prostate cancer, please research all of your options AFTER the urologist gives you his (or her’s). There are many alternatives out there including:
- Ultrasound HIFU (Ablatherm, Sonablate)
- MRI guided HIFU (Insightec)
- FLA (Visualase, CLS, Elasta)
- Gold Nanoparticle therapy (Aurolase)
- Photodynamic therapy
- Transurethral US guided ablation (TULSA)
- Proton beam therapy
- ….and others
If you are interested in FLA, please acquaint yourself with the procedure using the information on this web site or reach out to us by email contact or phone. To see if you are a candidate is easy and free– send your MRI using the portal on the website front page labeled “upload MRI” and email us any biopsy results and clinic notes from your urologist. Dr. Walser personally reviews these materials and then will schedule a videoconference with you, your spouse, significant other and even your physician! Everyone can be at a different location for these conferences–just need a laptop or smartphone and an email account! We can get you a review within 72 hours of receiving your information.
In the next few months, a manuscript titled “Focal laser ablation for prostate cancer: results in 120 patients” will be published in the Journal of Interventional Radiology. In a nutshell, these patients experienced no sexual or urinary side effects, returned to work 3 days after the procedure and had a 15% need for retreatment (only 2 had surgery or radiation after FLA).
I will post a link to the article as soon as it is available!
I met with several italian scientists last month!
Drs Giovanni Mauri and Gianluigi Patelli at the Congress of the Interventional Radiology Society in Europe (CIRSE). Their new laser was approved by FDA recently and we anticipate participating as a providing site in the US. The procedure is transperineal but uses small (21g) needles. Only local anesthesia and an outpatient procedure.
They published a small series of patients with good results.
About 70 patients. The mean prostate volume changed from 74 ml to 49 ml; mean post voiding volume from 151 to 30ml; mean IPSS score from 22,3 to 7,7 ; mean Qol score from 4,4 to 0,8.
The follow up range was 3-39 months (mean 14 months).
No major complications occurred.
There are a narrow set of patients who are good candidates for Focal Laser Ablation. When properly selected, Focal Laser Ablation produces the results that patients want without the side effects of surgery and radiation.
Take a look at this list – do you share any of these characteristics? You don’t need to share all of them to be a good candidate.
- Age: You are older than 65
- Family History: You have no family history of prostate cancer (your father and brothers have not died from the prostate cancer)
- Race: You are not African American
- Gleason Score: Your score is low at 3+3, 3+4, 4+3.
- Tumor Location: Your tumor is confined to the prostate gland (meaning it has not metastasized). There is no seminal vesical involvement.
- Tumor Size: Your tumor is no larger than 2cm
- PSA Levels: Your most recent Prostate Specific Antigen test results are between 4 and 10
- Symptoms: Sudden urge to urinate, waking up to urinate, weak stream
- Recovery Time: You want to return to work within the week.
- Risk Tolerance: You have a low risk tolerance for side effects and do not want urinary or sexual function impacted
If you think you might be eligible for focal therapies, please reach out and ask.
For the appropriate candidates, focal therapies can provide the right balance between mitigating symptoms and monitoring the any progression of cancer.
- Side effects are less severe: The risk of erectile dysfunction, incontinence and other side effects are almost zero.
- Recovery is shorter. As an outpatient procedure, you’re only given a light anesthetic and you can go home the same day. You can return to work within 3 days, without the catheter.
- Second line treatment options are still available: If focal therapy fails (meaning the cancer continues to grow), you can still undergo surgery or radiation therapy or a repeated focal therapy. On the other hand, if surgery fails (the cancer returns or metastasizes), you can only resort to radiation. If you have radiation and the cancer recurs, you can no longer have surgery and you are usually treated with chemical castration. When surgery or radiation fails, some patients may have focal therapies if scans show a small area of recurrence.