I was recently made aware of this treatment by Leal Health. It popped up as a clinical trial in Los Angeles at USC.
Here's the short explanation:
Water vapor ablation therapy for localized prostate cancer, also known as Rezūm therapy, utilizes transurethral delivery of controlled doses of sterile water vapor (steam) directly into the prostate tissue. The thermal energy from the water vapor induces cellular apoptosis and tissue necrosis, leading to a reduction in prostate volume and alleviation of obstructive urinary symptoms.
Has anyone here had this treatment or planning to enroll in a clinical trial?
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Thanks.We do have a number of clinical trials already that used a variety of thermal ablation techniques (HIFU, cryo, FLA, PDT and IRE) and they all perform poorly even when the whole gland is ablated:
Both of these articles are quite outdated at this point. There are some thoughtful responses that question some of your assertions. I'd be very interested to know what the results look like at this point.
In other news, it appears I may be excluded from the trial for two reasons:
1. My prostate is too small: min size must be > 20cc. Mine is 14cc on last measurement.
2. Use of alpha 5 reductase medications excluded: I've been on finasteride (1mg) for nearly 30 years, which is why PCa was easily discovered in my case.
The words "frequently updated" means that it's frequently updated. Medical science is progressive.
And if whole gland MRI-targeted HIFU doesn't work even with the best technology available in 2021, what makes you think it would work in 2024?
There may be some new form of thermal ablation that will work someday in the future, but since they have no idea why it works so poorly now, they have zero chance of fixing it.
Perhaps you don't understand what REZUM is. It is another try at THERMAL ABLATION of prostate cancer. It doesn't matter if the heat is carried by steam, ultrasound, or lasers - it is still THERMAL ABLATION and there have not been any kinds (and many kinds have been tried) of thermal ablation that has worked. If it is true that significant amounts of cancer survive even when the entire gland has been burnt out, why would REZUM be any different?
So, understand that this is just a new try at thermal ablation that does not solve any of the issues raised in the "unresolved issues" article. The topic is thermal ablation, not just the mode du jour.
I understand EXACTLY what REZUM is. I understand it's another try at thermal ablation. I'm also aware that it's not a new technology and has been used for enlarged prostates. I've read WHY they have hopes this one will be better. I've asked you several times if you've researched THIS particular treatment, which is what my post is asking, and you keep bringing up other treatments I'm not interested in.
If you're not going to stay on topic, please stop replying. I'd like to find out if anyone has specifically researched THIS treatment or is planning on entering the clinical trial. There are many all over the US.
You are avoiding the topic - explain why this attempt is different. If you can't think of a reason why it should be different from every other attempt at thermal ablation, your question is answered.
You, sir, are avoiding the topic. Are you aware of THIS SPECIFIC treatment??? Have you gone to the link I posted to read about and see WHY it may or may not be different? Why do you think they would try yet ANOTHER treatment if they know it's not going to work?
Until you spend a little time researching, you don't know what you're talking about.
Now, if you have researched THIS EXACT new treatment and you have an opinion, please post it. Otherwise, please stay silent because you're not helping here.
I'm not going to keep going around in circles with you. Either read about it and give an opinion, or move on.
Why would the results for REZUM be different than any other form of thermal ablation?
...is that it is not different - it is just another kind of thermal ablation, and I expect the same dismal results that all the other kinds of thermal ablation provide.
You asked for a reaction and that is my reaction. Why do you believe it is different?
Well, if you're so knowledgeable, why don't you go over to USC where the clinical trial is being held and tell them not to do it? How am I supposed to know if it's the same as the other types of ablation. That's why I'm asking.
The bigger question is why do you persist in going around in circles here? At this point, I feel like you're harassing me and I'm going to lodge a complaint.
"How am I supposed to know if it's the same as the other types of ablation. That's why I'm asking."
Yes. And that's why I answered: "And my answer to the question...is that it is not different - it is just another kind of thermal ablation, and I expect the same dismal results that all the other kinds of thermal ablation provide."
So you asked a legitimate question and I gave you a legitimate answer. What's the problem? If you don't want a reply, why are you posting a question?
I have, in the past, talked to Ahmed (UK) and Ehdaie (MSKCC) recommending changes to clinical trials they are doing on thermal ablation. I am concerned that patients in such trials are not being fully informed.
Sir, right off the bat, you started on your own tirade and got off-topic. Here was my ONE question:
"Has anyone here had this treatment or planning to enroll in a clinical trial?"
That's all I asked. You then replied with something completely irrelevant: "It is approved for BPH, not prostate cancer." (I already knew this.)
Then you proceeded to ask ME questions off-topic: "Why would REZUM work any better?" (Again, this had nothing to do with my question.)
I don't know what your problem is, but I am no longer responding to you. You have some type of agenda that hijacks genuine posts. You've done this to me on more than one occasion.
"....and there have not been any kinds (and many kinds have been tried) of thermal ablation that has worked. " There you go again with your obnoxious and cocksure statements about a treatment modality for which you have no personal experience. I had HIFU full gland ablation surgery a few months short of eight years ago and I am doing just fine. It worked wonders for me. No QOL side effects lasting more than two weeks. Stop pretending that you are the ultimate authority on such matters.
my urologist also told me Rezum doesn’t work for PC, which I accept. What I’ve wondered lately is whether it would exacerbate my prostate cancer to use resume for the purpose of decreasing the size of the prostate. I am on active surveillance since 2018.
I'm very curious to know how these clinical trials go. They must have made some advancements in order to try to make it work for PCa.
I'm ruled out, however, because my prostate is too small (14cc) and because I've been on finasteride for nearly 30 years (1mg for hair loss). I was diagnosed in 2017 and have been on AS since. I'd prefer to stay on AS, however, if a promising minimally invasive low/no side effect treatment emerges, I may get it done.
Taking very low-dose finasteride for all those years is the reason cancer was found in me at such an early stage. My PSA is 0.7. My uro told me it's likely it wouldn't have been found for another 20 years had my prostate increased in size "normally".
I have been on AS since 2009, with no progression of my Gleason 6 pathology. But, my prostate median lobe blocked my urine flow in 2022, creating great pain and need to be catherized. I spoke with several urologists and researched about seven or eight BPH treatments before choosing aquablation, which fixed all my urinary problems.
During those consultations about treatment, none of the urologists had any hesitation about doing BPH procedures on a low risk prostate cancer patient. So, I hope this answers your question.
I’m sorry you’re not getting anywhere with convincing one member of this forum to see your point of view. Maybe you should just entertain other responses, if any.
However,on this subject I encourage you to open your mind to the apparent reality that for now, ice is ice. There is no colder ice.
First of all, I'm not trying to convince anybody of anything. I was simply asking if anyone knew about this trial and/or was planning to give it a shot. I'm not married to some outcome for this trial. As it turns out, I'm not eligible anyway as I've just learned.
Second of all, I'm not sure what reality you're speaking of. Is it that you think this water vapor ablation is a waste of time? (Maybe it is.) Or is it that you think I'm trying to convince Tall of something? (I'm not - I couldn't care less.)
There's no way for me or Tall to know if this trial will be more successful or not... that's why it's a new trial. He's asking me as if I would know.
I don’t think it’s a waste of time. It doesn’t work, shows no indication of working anytime soon and you know it. Yet you pursue it as if new studies of the same type will change that. Thus the colder ice metaphor. That study quickly became of far less interest to you than arguing for its consideration.
I have no idea what you're talking about. You just said you DON'T think ablation is a waste of time, but then that it doesn't work and won't anytime soon. Also, how can you possibly say that I know it won't work?? I don't know that. I'm not sure how you would know that.
That study did not quickly become of less interest to me. Tall wouldn't answer my question of whether he researched the clinical trial or not until very far down on the thread.
What you're talking about and accusing me of is baffling to me.
You asked if I thought it was a waste of time. I don’t think that. It simply has no value for our disease in its present state of development. I do think you know this, but took it up as a cause because of someone’s response to your touting that trial as offering something new-with every bit the rudeness you accuse.
Hopefully you’re done with that for now. Clearly you have a few supporters in your corner. I wish you the best as well.
My understanding about it from watching their videos is that it is less invasive and has less side effects than HIFU. Instead of heat generated from ultrasound, it uses steam. Apparently, the water vapor can more easily make contact with the cancer cells and stay within the bounds of the prostate.
Tall Allen loves to belittle men on this platform, it’s his MO. He projects his opinion on everything and turns people’s questions into his soapbox. People don’t like to be attacked by him so they are less likely to comment. The moderator of this platform needs to shut him down when he does this, but for some reason they allow him to argue and cause discord among members. It’s ridiculous.
I think blanket statements such as "it doesn't work" are not productive. Are focal treatments 100% successful? No, but most treatments have some failure. Some have better success rates than others. Everyone's situation is unique, so what's best for one person may not be best for another. Research and consult with an experienced doctor to make an informed decision.
For your information, Tall Allen's coments, insight, etc. have been priceless for me and many others. Most all of us understand his insight and help. He is very knowledgeable and anyone doesnt understand the way he talks, its your loss, you should not even argue or reply. Please stop arguing. Thanks and Peace.
First off Focal ablation laser can be successful,for early stage PCa. 10-21 . GLEASON 3-4 , 5% PSA , 4.7. After treatment. No major election issues long term, no need for tadalafil, PSA steadily declined. Recent MRI clear 3-24. and my ejaculate ducts were saved as well. PSA 0.4. So so far so good. Get an 2nd advise Dr Eric Walser. UTMB. HOUSTON, I believe then may be an abscopal effect. This forum. keeps Focal Ablation advances down. Cowtows to UCLA , SBRT as preferred treatment. Won't give Dr. Eric Walser a forum. Won't give Dr Thomas Seyfried a forum and won't create awareness. Jane McClelland nutrition and repurposed drug usage. How to starve cancer.
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