I had Tulsa-Pro treatment in Nov 2023 and, in 3 months, my PSA went down from 6 to 0.02 which, for me, is a very good result. I would mention a whole bunch of stuff which is not discussed in this video. 1. It can be used as a salvage treatment. In my case, I had a recurrence of PC after focal radiation treatment and Tulso-Pro seemed like the best re-treatment option open to me. 2. I had a biopsy just before, which showed some Gleason 4+4, and this was considered acceptable. 3. The role of the MRI in this procedure is not what you might expect, it is to measure the temperature of the prostate during the HIFU dosing. This is to make sure that the areas under treatment hit the temperature required to ablate the tissue. 4. In order to protect the rectum and the urethra, a cooling device is inserted into the rectum and the Tulsa-Pro device, itself, cools the urethra. 5. Calcifications are the biggest impediment to successful treatment, since they block the ultrasound. I didn't have any but they are not uncommon in a prostate. 6. At my hospital, the protocol was to remove the catheter after just 24 hours. I could not imagine keeping it in for 10 days! 7. My side effects include ED, which I think may be permanent (it actually started after the radiation treatment). Also I suffer some urinary urgency, which is slowly resolving. 8. Although the procedure is quick (around 1.5 hours), there is extensive preparatory work and it involves a very large team, consequently the cost is commensurate.
So regarding item 7.. it sounds like you had radiation treatment prior which had already started you down the path of having ED. Did it get worse after tulsa pro?. Also any pain in the urethra afterwards?
I had Tulsa Pro this year, 2024, I highly recommend it if you are a candidate. Other treatment procedures will leave you with incontinence. It's been 5 weeks and I'm doing fine. PSA will be checked in April, wish me luck, thanks
Terrific information. I keep seeing the Tulsa Pro ads and reading them still left me uncertain about the procedure. Dr. Scholz gives us clear, unbiased information.
Hello Paul, is there a particular Dr you would recommend? Also curious as to an approx $Cdn charge for the procedure (will have to fly out from Vancouver as there is no facility here as yet) Much appreciated
@@PauloFrazao Thank you for your quick response Paul! This will significantly help my research and I am most grateful. Hope you are doing well yourself these days. All for now & Muito obrigato?!
Seems like a great option. I’m interested so I gave TULSA a call for more info on who is a good candidate and the one thing that may rule a person out is calcium in the prostate because it interferes with delivery of the ultrasound. I just hope this isn’t my case. This presentation like all others is very informative and helpful. Can’t thank you two enough!
fyi folks: I was told one can petition Medicare for reimbursement of cash payments for focal ,if one has referral(s) from a urologist /GP for the procedure, I plan to do this.
I’m in the VA health system. Unfortunately this procedure isn’t covered at all. Only the radical prostatectomy. To pay out of pocket for this, the doctor I consulted in Sarasota said it would be 31K. I asked the Florida VA organization to see if this can be covered. As of 1 January 2025 the Medicare system is set to cover this TULSA PRO procedure.
@@RedPillTruth2023 Had it in august 2021, have had no issues since then though I just had an MRI which showed two new lesions. I am hoping it is not recurrence. The procedure itself wsa not bad at all, pain the first night that the medicine took care of. Biggest issue was the catheter..and bladder spasms because of it, but overall, not bad at all. And I had really no side effects, I did have 1 seminal vesicle treated so I had less semen afterwards but other than that, no ED, no incontinence..like i went back to normal pretty quickly. I will be going for a biopsy in June, will keep you posted with the outcome.
Any treatment that requires an indwelling catheter for days is excluded from my consideration. That was one reason why I chose IMRT (along with its effectiveness and - in my case, anyway - negligible side effects).
A catheter for a few days is 50 times worse in your mind than it really is. Ask around and see if other men have had an indwelling catheter for any reason and their experience. That is no reason to eliminate a valid treatment option.
My Husband has on an in-dwelling cath for 7 MONTHS !! HE IS NOT ABLE TO URINATE ON HIS OWN FOR 6 MONTHS. Sorry I didn,t notice all caps was on. He has a highly aggresive cancer. He had biopsy and all his biopsy was at least 8. His Doctor has told us that without treatment he would only have 1 to 2 years to live. Prayers always asked for..... His Name is Tommy
Catheter is a minor inconvenience. Whether or not a catheter is involved is a terrible reason to choose or reject a treatment procedure when your very life is on the line.
Catheters are indeed very intrusive, I had one for only 3 days and it was very hard to live with and I believe caused some long-lasting trauma to the urethra and penis - this was with IRE, though the treatment seems to have been effective
The Tulsa Pro clinical trial was restricted to GL 3+4 or less. Some MDs are treating more advanced cases with Tulsa Pro despite a lack of clinical trials. Wearing a catheter for 12 days is not fun. I had Tulsa Pro and suffered post treatment UTI and now have chronic pain from epididymitis. 3 months after TP I did a PSMA PET and was found to have disease in the seminal vesicles and ultimately did MRIdian SBRT at UCLA and it was planned curative and was much easier. No anesthesia, no catheter. The ProtecT study shows for focal disease active surveillance, surgery or RT offer similar long term side outcomes. I’m not sure why anyone would opt for a focal treatment without evidence from controlled clinical trials.
There was mention of Brachytherapy as a focal therapy… I have never heard of this as a focal therapy?… Can a small lesion be treated vocally with brachytherapy?
I have Gleason 9 prostate cancer with regional metastasis, 3 peri rectal lymphnodes lit up on the Pmsa scan. I am on ADT and just finished brachi and 25 sessions of external beam radiation. My psa pre treatment psa went from 2.3 in 6/22 to 19 in 9/23. I am worried that because the lymphatic system is a system and has 3 to 4 times more fluid in it then our blood and therefore that I need some sort of additional systemic treatment to kill the possible microscopic cells that didn’t get hit by the localized radiation. Am i thinking sbout this right? Im 52 and in good shape. Im thinking hit it wihile its down now with chemo and go for a cure. Not save the chemo for later! Thoughts please!
i want focal.i now have 2 small adjacent nodes affected now.the tumor in the prostate is localized.can the nodes be removed in the focal treatment?ultrasound is fda approved.
😮what if tumer does not show up on mri. And a mri biopsey showes one spot out of 14 with 3+4, and will not show on mri. We picked watching But do not know how to pick treatment with 3+4, and not showing up on mri.
I contacted the actual Tulsa pro company and talked to the person in charge of training and support of the clinics and drs using the procedure .. yes!!! You need to find the right dr that has done many many of these treatment and also really takes the time to do it perfectly as possible of course .. Dr scionta from Sarasota has been given as a name to research as he has been doing HIFU and Tulsa pro as much as any single Dr.. He does every procedure himself .. not a training student.. yes $35 grand cash due to insurance not really caring if you have function after treatment .. so hopefully insurance will find the heart to allow this choice
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I had Tulsa-Pro treatment in Nov 2023 and, in 3 months, my PSA went down from 6 to 0.02 which, for me, is a very good result.
I would mention a whole bunch of stuff which is not discussed in this video.
1. It can be used as a salvage treatment. In my case, I had a recurrence of PC after focal radiation treatment and Tulso-Pro seemed like the best re-treatment option open to me.
2. I had a biopsy just before, which showed some Gleason 4+4, and this was considered acceptable.
3. The role of the MRI in this procedure is not what you might expect, it is to measure the temperature of the prostate during the HIFU dosing. This is to make sure that the areas under treatment hit the temperature required to ablate the tissue.
4. In order to protect the rectum and the urethra, a cooling device is inserted into the rectum and the Tulsa-Pro device, itself, cools the urethra.
5. Calcifications are the biggest impediment to successful treatment, since they block the ultrasound. I didn't have any but they are not uncommon in a prostate.
6. At my hospital, the protocol was to remove the catheter after just 24 hours. I could not imagine keeping it in for 10 days!
7. My side effects include ED, which I think may be permanent (it actually started after the radiation treatment). Also I suffer some urinary urgency, which is slowly resolving.
8. Although the procedure is quick (around 1.5 hours), there is extensive preparatory work and it involves a very large team, consequently the cost is commensurate.
So regarding item 7.. it sounds like you had radiation treatment prior which had already started you down the path of having ED. Did it get worse after tulsa pro?. Also any pain in the urethra afterwards?
Isn't the whole point of Tulsa Pro to avoid ED and urinary issues?
@@schmingusss my thoughts exactly
I had Tulsa Pro this year, 2024, I highly recommend it if you are a candidate. Other treatment procedures will leave you with incontinence. It's been 5 weeks and I'm doing fine. PSA will be checked in April, wish me luck, thanks
Were was you treated? And did insurence pay? Thank you. Wish you the best.
@user-oy1gk8is9o Where did you get treated?
Did you have focal or whole gland treated?
Any ED?
Insurance doesn’t pay. It’s all out of pocket…
Thank you so much for your video's. I am trying to educate myself with treatment options, etc. and your channel does a fantastic job.
Terrific information. I keep seeing the Tulsa Pro ads and reading them still left me uncertain about the procedure. Dr. Scholz gives us clear, unbiased information.
I had Tulsa performed in May 2023 at Sunnybrook Hospital in Toronto. So far so good. PSA went from 5.8 to 1 within a few months. 🤞
Hello Paul, is there a particular Dr you would recommend? Also curious as to an approx $Cdn charge for the procedure (will have to fly out from Vancouver as there is no facility here as yet) Much appreciated
@@Jack-2day Hi Jack, Dr. L. Klotz is leading the Tulsa program at Sunnybrook. Cost is 30K CAD. Feel free to reach out for any additional questions.
@@PauloFrazao Thank you for your quick response Paul! This will significantly help my research and I am most grateful. Hope you are doing well yourself these days. All for now & Muito obrigato?!
@@PauloFrazao Not covered by OHIP?
@@schmingusss unfortunately not.
Thank you for presenting this video. I wasn't aware of this treatment.
Seems like a great option. I’m interested so I gave TULSA a call for more info on who is a good candidate and the one thing that may rule a person out is calcium in the prostate because it interferes with delivery of the ultrasound. I just hope this isn’t my case. This presentation like all others is very informative and helpful. Can’t thank you two enough!
fyi folks: I was told one can petition Medicare for reimbursement of cash payments for focal ,if one has referral(s) from a urologist /GP for the procedure, I plan to do this.
I’m in the VA health system. Unfortunately this procedure isn’t covered at all. Only the radical prostatectomy. To pay out of pocket for this, the doctor I consulted in Sarasota said it would be 31K. I asked the Florida VA organization to see if this can be covered. As of 1 January 2025 the Medicare system is set to cover this TULSA PRO procedure.
Had HIFU done in Sarasota.. Dr Scionti
@@dmcarden how did it go? Can you tell me? I’m considering it strongly.
@@RedPillTruth2023 Had it in august 2021, have had no issues since then though I just had an MRI which showed two new lesions. I am hoping it is not recurrence. The procedure itself wsa not bad at all, pain the first night that the medicine took care of. Biggest issue was the catheter..and bladder spasms because of it, but overall, not bad at all. And I had really no side effects, I did have 1 seminal vesicle treated so I had less semen afterwards but other than that, no ED, no incontinence..like i went back to normal pretty quickly.
I will be going for a biopsy in June, will keep you posted with the outcome.
Excellent information and presentation as always. Thank you.
I wasted 25k+ on HIFU in 2016. Went to the "best", and it failed miserably, though I was deemed an ideal candidate.
What did you end up doing the problem at the time you did it it was so new and there was very few practitioners that had skills
@@pinotwinelover the guy I went to actually got the fda approval and had 15 years doing it out of states.
@@stevef7814 wow!!! Yeah, had mine done in 2021, but there is a chance that i'm having a recurrence now
@@stevef7814who was the doc?
@@stevef7814was it in florida?
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sperling in Florida has been doing the proceedure for some time.35K cash.
Dr Sperling also does FLA. Supposedly has done over 5K procedures. Dr Scionti in Sarasota Florida also does the tulsa pro. Same approx cost. 34K Cash
Any treatment that requires an indwelling catheter for days is excluded from my consideration. That was one reason why I chose IMRT (along with its effectiveness and - in my case, anyway - negligible side effects).
A catheter for a few days is 50 times worse in your mind than it really is. Ask around and see if other men have had an indwelling catheter for any reason and their experience.
That is no reason to eliminate a valid treatment option.
My side effects from IMRT were fairly mild.
My Husband has on an in-dwelling cath for 7 MONTHS !! HE IS NOT ABLE TO URINATE ON HIS OWN FOR 6 MONTHS. Sorry I didn,t notice all caps was on.
He has a highly aggresive cancer. He had biopsy and all his biopsy was at least 8.
His Doctor has told us that without treatment he would only have 1 to 2 years to live. Prayers always asked for..... His Name is Tommy
Catheter is a minor inconvenience. Whether or not a catheter is involved is a terrible reason to choose or reject a treatment procedure when your very life is on the line.
Catheters are indeed very intrusive, I had one for only 3 days and it was very hard to live with and I believe caused some long-lasting trauma to the urethra and penis - this was with IRE, though the treatment seems to have been effective
The Tulsa Pro clinical trial was restricted to GL 3+4 or less. Some MDs are treating more advanced cases with Tulsa Pro despite a lack of clinical trials. Wearing a catheter for 12 days is not fun. I had Tulsa Pro and suffered post treatment UTI and now have chronic pain from epididymitis. 3 months after TP I did a PSMA PET and was found to have disease in the seminal vesicles and ultimately did MRIdian SBRT at UCLA and it was planned curative and was much easier. No anesthesia, no catheter. The ProtecT study shows for focal disease active surveillance, surgery or RT offer similar long term side outcomes. I’m not sure why anyone would opt for a focal treatment without evidence from controlled clinical trials.
Hi Mike, did you experience side effects from SBRT (am assuming photon)? Any ED?
@@dmcarden No change in pre treatment symptoms. Mild ED was present before as was mild urinary urgency.
@@mperloe Been hearing good things about sbrt; how many years has it been since your sbrt treatment?
@@dmcarden I finished SBRT in October 2020. Not all SBRT is the same.
@@mperloe which one did you do?
how about a combo focal and immune therapy to subdue recurrence?
There was mention of Brachytherapy as a focal therapy… I have never heard of this as a focal therapy?… Can a small lesion be treated vocally with brachytherapy?
Do they do the TULSA PRO surgery plus MRI with or without Gadolinium contrast?
what about aoh1996 its still on trials
I wonder about that too because that will be a miracle drug if they ever comes out
Why not use this to treat the prostate even for metastatic disease? Even with chemo, ADT, etc., the in situ prostate is still cancerous, is it not?
I have Gleason 9 prostate cancer with regional metastasis, 3 peri rectal lymphnodes lit up on the Pmsa scan. I am on ADT and just finished brachi and 25 sessions of external beam radiation. My psa pre treatment psa went from 2.3 in 6/22 to 19 in 9/23. I am worried that because the lymphatic system is a system and has 3 to 4 times more fluid in it then our blood and therefore that I need some sort of additional systemic treatment to kill the possible microscopic cells that didn’t get hit by the localized radiation. Am i thinking sbout this right? Im 52 and in good shape. Im thinking hit it wihile its down now with chemo and go for a cure. Not save the chemo for later! Thoughts please!
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Please tell me what is suppose to be the PSA for a 67 year old man with a healthy prostate?
i want focal.i now have 2 small adjacent nodes affected now.the tumor in the prostate is localized.can the nodes be removed in the focal treatment?ultrasound is fda approved.
Photodynamic is best optin!
what is it?@@jaybrox1652
can you do whole gland tulsa pro with gleason 8 and still avoid the nerve bundles?
😮what if tumer does not show up on mri. And a mri biopsey showes one spot out of 14 with 3+4, and will not show on mri. We picked watching
But do not know how to pick treatment with 3+4, and not showing up on mri.
It’s got to be visible on mri for focal therapy
My cancer is localized in one of the prostates and, according to my doctor, the cancer is benign. Should I consider Tulsa-Pro?
If your 'cancer' is benign, its not cancer.
We talk about skilled doctors doing a procedure but how does somebody approach a search for such a doctor?
I contacted the actual Tulsa pro company and talked to the person in charge of training and support of the clinics and drs using the procedure .. yes!!! You need to find the right dr that has done many many of these treatment and also really takes the time to do it perfectly as possible of course ..
Dr scionta from Sarasota has been given as a name to research as he has been doing HIFU and Tulsa pro as much as any single Dr..
He does every procedure himself .. not a training student.. yes $35 grand cash due to insurance not really caring if you have function after treatment .. so hopefully insurance will find the heart to allow this choice
What about clearpoint prism, who use laser to heat the tumor
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