Laser Ablation

[MD1010]

Is laser ablation a viable option for two localized Gleason 3+4 leasons, in 47 cm prostate with .14 density? What are pros/cons vs RT or RP? Thanks

[Tall_Allen]

(1) FLA is not a good idea in my opinion. The best, longest follow-up MRI-guided FLA study still had a 41% recurrence rate among men who had a follow-up prostate biopsy 6 months after FLA. In more than half of those men, the cancer was significant:

prostatecancer.news/2021/03...

Similarly poor results have been found by the latest type of MRI-guided HIFU (called TULSA-PRO):

prostatecancer.news/2021/03...

(2) Surgery and radiation for your type of PC have exactly the same long-term cure rates, although side effects are different:

prostatecancer.news/2020/02...

The way you decide is by talking to specialists in ALL of your good options before making up your mind. Specialists in one kind of therapy, say surgery, may have no idea about other kinds of therapies, say SBRT, but that may not stop them from having an opinion. Near the end of this article are some questions to ask specialists and to ask yourself:

prostatecancer.news/2017/12...

(3) Is active surveillance still a good option? Many of the top active surveillance centers are finding that patients with a small amount of GS 3+4 are still good candidates. A vital piece of information is the "% of pattern 4." Not all pathologists report it. Epstein at Johns Hopkins always does.

[cesces]

Tall Allen's advice for your situation is rock solid.

Just follow it.

[PCInPA]

Probably not, for all the reasons TA noted. I also considered FLA as many do at the start.

You can read how I went about making a decision here ...

healthunlocked.com/api/redi...