MY latest biopsy shows a Gleason 8 (15% of one core Left Peripheral Gland - Grade 4 (1 in 4 samples) while the other core is 10% of 3+4 grade 2 (1 in 4 samples).
Latest PSA I have is from November at 3.74 (highest ever was 7)
I'm curious about TULSA. Are there any stats from someone other than TULSA providers that show it's true effectiveness especially when pitted against Brachy or SBRT?
There are no direct comparisons. But a recent study by Klotz found that a third of treated patients, who were intermediate risk, had a recurrence after treatment. And that was with whole gland treatment. Ablation does not work for many patients.
Hi Tall_AllenI hope you don't mid but i understand your treatment was SBRT. What was your gleason? did you also do ADT? What do you feel about ADT. I've only read the negative!
I thought i had everything under control before i went to my radiology appointment. New treatment from the 15% of 4+4 gleason, 35 SBRT treatments, 2 years of ADT along with HDR Brachy. WOW. i'm stunned into thinking that surgery may be the better way!
I had high volume, low risk PCa.
ADT -18 months- certainly improves the results of brachy boost therapy.
here are some studies to review re your question. Certainly if you are talking top notch urologists and radiologist, they should be able to take your diagnostics and give you some relevant studies as to what success rate you might expect with each SOC treatment.....
MRI was "clear". but my genetic test? came back as High Risk which was the reason for the latest biopsy.ADT scares me. I'm not good with odds! I'm the 1% chance of getting an infection thru biopsy. In my head cannot imagine what changes 2 years of ADT will bring me!
Don't like the idea of 2+ weeks of a catheter nor the incessant leakage but it's beginning to sound better than the other alternatives
Thank you for sending the link.
I was afraid that is what i'd be reading - experimental!
Back to reality
I think it's probably fine for someone with certain very favorable criteria, who may have opted for AS. The fact is they need to do more long term studies on it. Studies that are not financed by the people who make the equipment.
Tulsa-Pro didn’t work for my GG3 (4+3). Someone posted Partin tables the other day-check them. Consider that after you spend $30,000 on the procedure the tables show you a good chance of recurrence anyway. So you’re out that small nest egg. basically you would be putting off for a year the treatment that you need. My Mayo urologist says he considers ultrasound to be a “pretreatment “. But, I know others that it has worked for with 4+3 SO FAR. And by so far I mean 1 year. The side effects do seem to be less. If I had it to do over I wouldn’t do it. And I would be almost done with my ADT course.
Thank you for your confirmation.
you would do radiation over surgery for a do-over?
Yes, I would, because radiation can go a little farther than surgery. And being high risk, that’s an added benefit
could you explain what you meant by "radiation can go a little farther than surgery".
Had HDR all planned until my latest biopsy where 15% of one core was a 4+4 so all bets came back to me. The ADT scares me but so does the possible multiweeks of a catheter then the incontinences
I think radiation covers a larger area. Thats just my uneducated recollection. And if you check those Partin tables for high risk prostate cancer you see that there is only about a one in three chance your cancer is prostate contained. So the one that offers the most coverage seems best to me. But ask your doctor, I am just a bloviator spouting things I think I read.
Advice for my husband, looking at treatment options
newly diagnosed Gleason 7 3+4 
Here we go.......
Radiation, Focal or Removal?
SBRT in Miami
