HoLEP Affect on Pca

[Bourbon2024]

as posted earlier, I have both BPH (80 cc) and localized prostate cancer. Clear PSMA. I’m having HoLEP surgery. Wonder how this will impact the cancer. How will PSA respond? What happens if HoLEP actually removed the cancer?

[Tall_Allen]

TURP takes tissue away from an area that is usually not responsible for most of the cancer.

[Bourbon2024 in reply to Tall_Allen]

isn’t TURP different procedure than HoLEP? HoLEP could remove around 80% prostate within capsule.

[Tall_Allen in reply to Bourbon2024]

The cancer is usually not at the center. HoLEP is a kind of TURP done with a laser instead of a scalpel.

[lpol83712]

Holep before radiation is what I had done. It reduces the size of the prostate so PSA will fall. It removes the center of the prostate and most cancers are in the peripheral area. Some of the cancer maybe resected. I had 1 percent of the specimen with Gleason 7 noted in it. It is unlikely to resect a cancer fully and it would not be easy to tell as the tissue comes out in fragments so you would not know the margins. The best analogy of Holep Vs Turp is using an orange. If it was Holep you would have a small incision and then through that remove all the orange pulp leaving the peel intact. With TURP you are just essentially cutting slices of peel and pulp together guessing how much of the orange to slice away rather than using a tissue plane and removing the majority of the orange pulp. This is likely the reason for a much lower redo in Holep compared to TURP. It isn't a treatment for the cancer. I had it done in July and SBRT in September 2023 and my ultra sensitive PSA in December (on ADT as well) was undetectable less than 0.01 so far so good.

[Bourbon2024 in reply to lpol83712]

Thank you for reply. What you had done is exactly what I’m looking to do. Not expecting ADT according to doctor. Best of health!

[lpol83712 in reply to Bourbon2024]

That was my best guess.