markolcott in reply to Tall_Allen

Thank you very much for taking the time to respond and recommend.

I have met with Cyberknife and with low dose radiation providers, inc Mayo and UCLA. The need to shrink my prostate by means of hormone treatment over many months encouraged me to at least look at other solutions. In regards to Focal Laser Ablation and HALO Dx, I think the lack of insurance coverage may be related to the fact that the treatment is too new to have enough time and patient outcomes to validate its efficacy.

I think that my attraction or interest in it is related to the idea that the adverse attendant outcomes sometimes resulting from the radiation treatments are theoretically reduced. Their findings seem to support this idea. Also, as a percentage, the number of patients who have had a recurrence of cancer seem to be no greater as a percentage than patients who had various forms of radiation therapy. Thing is, the numbers of patients are very low at this point, and I don't know if the data is apples to apples, ages, stages, etc.

It looks good on a blackboard to me. The consultations have been informative. I read a chinese study based on thousands of cases who did not dispute the potential of FLT but concluded that Radiation is still the best option until many more numbers come in.

I have scheduling another MpRI and MRI Biopsy and will send the results to places like the Cleveland Clinic and others for second opinions and recommendations.

I appreciate your input.

Thanks Again.

I still hope to hear from anyone who has been a patient of HALO Dx.

Tall_Allen in reply to markolcott

There is a sure way to avert ALL side effects of treatment -- don't get treated. There is no point in undertaking any therapy that doesn't do job #1 - cure the cancer.

You are quite incorrect when you write: "Also, as a percentage, the number of patients who have had a recurrence of cancer seem to be no greater as a percentage than patients who had various forms of radiation therapy. " The biochemical recurrence rate for, say, SBRT for favorable intermediate risk patients is 3%, not 40%.

John Fuller's 10 year FLA trial is the longest-running one. As you see, the results are pretty poor.

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Tall_Allen in reply to Tall_Allen

In case it's not clear, John Feller is the Chief Medical Officer of HALO Dx, and the 10-yr trial of FLA with the poor results (41% recurrence) are his.

auajournals.org/doi/pdf/10....

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calavo in reply to markolcott

If you do a search at Inspire.com in prostate cancer forum you'll encounter posts from a couple of men who've been treated at HALO in Indian Wells and many more who've been treated by Dr. Karamanian at Prostate Laser Center in Houston, which is now part of HALO. HALO in Indian Wells used to be called Desert Medical Imaging.

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markolcott in reply to Bigm789

Thanks so very much. I will contact Dr. Walser.

calavo in reply to Bigm789

Thanks, this is first I've heard of Candel 2409. The current Phase III study seems to test it as a less toxic replacement to ADT in combination with RT.

Monotherapy is mentioned in press release but not discussed.

"Because of its versatility, CAN-2409 has the potential to treat a broad range of solid tumors. Monotherapy activity as well as combination activity with standard of care radiotherapy, surgery, chemotherapy, and immune checkpoint inhibitors have previously been shown in several preclinical and clinical settings."

globenewswire.com/news-rele...

calavo in reply to Bigm789

Interesting information from Candel Therapeutics regarding Candel 2409. A clinical trial is underway for AS patients:

Randomized controlled phase 2 clinical trial of CAN-2409 followed by valacyclovir for patients undergoing active surveillance for localized prostate cancer: the ULYSSES trial (PrTK04)

More than 50% of patients with prostate cancer are diagnosed at early stages of disease with low grade, low volume, asymptomatic disease. Active Surveillance (AS) is an approach to manage patients with regular Prostate-Specific Antigen (PSA) and biopsy-based monitoring of disease status. This approach is aimed at deferring radical treatment, however, within 10 years of diagnosis, between 21 and 38% of men will have developed progressive cancer and require invasive treatments. Oncolytic viral immunotherapy using CAN-2409 may provide these patients with a low-risk local intervention and the opportunity to delay or prevent disease progression without the need for surgery or radiation.

Primary outcome measure: Disease-free survival

We have completed enrolling a 187-patient phase 2 study in localized prostate cancer patients choosing active surveillance – we call this course of action “Proactive Surveillance.”

candeltx.com/patients/

markolcott in reply to Alexandr1

Thanks v much! I appreciate both your respect for Tall Allen and also your different perspective on why you chose Tulsa Pro

markolcott in reply to Tony666

Thanks Tony, I am told I'm a good candidate for the different types of radiation therapies but must use hormones/ finasteride, for a few months prior.

markolcott in reply to j-o-h-n

Age: 73, Married, Active. Golf, Hike, Bike (not since diagnosis).

Diagnosed with moderate risk prostate cancer in May 2021.

Needle Biopsy April 26, 2021. Dr Bernard Bhuerk. 2 cores with cancer, Adenocarcinoma, Gleason Score 7 (3+4) Left Base/ 6 (3+3) Right Mid

PTEN Moderate risk Category

PSA has been elevated with wide swings since 2003. Ignorance of how having sex the night before a test can impact PSA scores may have had something to do with these scores.

In 2003 following a 9.7 PSA score and an MRI, had a biopsy that was negative.

PSA from 2004 to 2010, 4.9 to 7.

PSA from 2011 to 2020, 4.9 to 8.7. Most recent 6.7 July 7, 2021.

In late 2020 had a high score 10.15 went back to low 6 in Jan 2021)

The high score led to other tests and MRI

4K Score: 15% Nov 2021, My PSA on that score was 10.15, PSA, free 1.88, 18% risk range

3t MRI Dec 10 2020

FINDINGS: The prostate gland measures approximately 6.6 x 5.7 x 6.6 cm for an estimated volume of 130 cc. There are changes of BPH in the transition zone. No suspicious lesions. The peripheral zone is diffusely heterogeneous. There is a IO x 7 mm focal T2 hypointense lesion in the left posterior medial peripheral zone at the mid gland which is low in signal on ADC but isointense to slightly hyperintense on diffusion and does not demonstrate focal early enhancement. It is considered a PI RADS 3 lesion. No significant capsular bulging. Seminal vesicles are not well distended but are grossly intact. No pelvic lymphadenopathy.

Bladder demonstrates a diffusely thickened wall likely related to chronic outflow obstruction. Visualized bowel is normal in caliber. No significant free fluid in the pelvis. No suspicious osseous abnormality.

IMPRESSION:

Enlarged prostate with BPH. PI RADS 3 lesion in the left peripheral zone at the mid gland.

PIRADSTM v2 Assessment Categories

PIRADS I - Very low (clinically significant cancer is highly unlikely to be present) PIRADS 2 - Low (clinically significant cancer is unlikely to be present)

PIRADS 3 - Intermediate (the presence of clinically significant cancer is equivocal) PIRADS 4 - High (clinically significant cancer is likely to be present)

PIRADS 5 - Very high (clinically significant cancer is highly likely to be present)

April 26, 2021 Biopsy, needle, 12 core samples

2 cores with cancer, Adenocarcinoma, Gleason Score 7 (3+4) Left Base/ 6 (3+3) Right Mid

PTEN Moderate risk Category

Infection followed, urination burn, Subsequent Test June 14th/ PSA 11.2/ PSA Total+ % free test / free 2.27/ % 18%

Followed up in July, PSA 6.7

August Scans body and lower body, no sign of cancer outside prostate.

markolcott in reply to Bigm789

Thank you very much for the link. At the risk of taking your time without benefit to you, I'd like to share my situation and see if you have more info or opinion you'd like to share. It goes without saying, I would share any of my learnings.

After lots of reading and engagement with others, I learned a few weeks ago, via MassiveBio, that there is a FLT trial now at Mayo Rochester.

I'm inclined to believe that there must be logic and data and the potential for good health outcomes and potential commercial benefits that led Mayo to create their trial.

I recently had a second MRI and subsequent MRI guided biopsy. This was with the intention of scheduling FLT at HaloDX soon.

The recent MRI(March 2022) looked different than the one I had 16 months ago (it was less predictably problematic). Additionally, the recent MRI guided biopsy, which focused on the 2 zones previously diagnosed as having cancer, had the samples designated as benign by the pathologist.

I recognize that the odds are very great that I still have cancer and that somehow, the latest biopsy (which seemed expert, diligent and organized) just got samples in the same zones that were free of cancer.

I have decided to have both sets of slides/blocks sent somewhere and get a second opinion on both. I may try to get second opinions that include a review my MRI's and Slides/Blocks.

Given the original pathology report rated my samples as 3+3, 3+4, I've felt I have time to monitor and seek out all my options. However, my prostate is very very large (140) and I'd like to shrink it without using hormones. If it was not s large, I might consider waiting and having another MRI in 6 months.

There are a number of places that provide second opinions. I've taken a quick look at Johns Hopkins and Stanford Medical group. I plan on choosing someone by next week.

I would appreciate any input and of course would be happy to share my experience over the past year after learning I had prostate cancer.

Cheers

Mark

calavo in reply to markolcott

miR Scientific has made commercially available in the last 3 weeks a liquid biopsy test they claim 90 percent accuracy in identifying low, intermediate and high risk prostate cancer. I haven't heard from anyone who has taken it. It costs around 1200 dollars. There are positive reports regarding the test from researchers and Doctors in PCa field.

mirscientific.com/

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calavo in reply to markolcott

I too follow HALO and found the latest patient testimonial marketing video interesting. The patient says he was a radiation oncologist specializing in prostate cancer and loved his job at an important institution in southern California. My question is why didn't he treat his own cancer with his own treatment? I found his email and wrote him a letter but he didn't respond. So it will remain a mystery for now.

halodx.com/blog/focal-laser...

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