Prostate Cancer Treatment

Advantages Over Surgery
(Radical Prostatectomy)

  • Minimally invasive
  • Outpatient procedure
  • No general anesthesia
  • Rapid recovery
  • Low risk of erectile dysfunction
  • Low risk of urinary incontinence
  • Repeatable (if necessary)

3T multiparametric MRI offers unparalleled visualization of prostate cancer, allowing us to precisely target the cancer with a laser system measuring just 1.85 mm in diameter. We measure the temperature with MRI thermometry, giving real time heating information to allow Dr. Karamanian to protect vital structures. Studies have shown that our laser is extremely precise, down to 1 mm, which is very important when considering that the neurovascular bundle responsible for erections runs within a 2-4 millimeters of the edge of the prostate.

The cancer is ablated (destroyed with heat), without undergoing radical surgery and minimizing damage to the neurovascular bundle and urethra. The patient goes back to their hotel about an hour after the procedure. Many of our patients have told us that just two days after the procedure, they were back to normal. We perform our ablations under conscious sedation (carefully monitored, powerful intravenous pain and anxiety medications) to minimize pain and anxiety.

Our Workup, Treatment, and Follow-up Protocol

  1. We look at your entire prostate health picture including your PSA, pathology results, MRI, and your personal treatment goals and desires.
  2. Based on the MRI, we create a prostate map, outline where the cancer is located, whether or not it appears confined to the prostate, and its proximity to vital structures. Putting all the pieces together, we give a recommendation regarding whether or not you are a good candidate for focal laser ablation (FLA). The good news is that about 4 out of 5 new diagnoses of prostate cancer are in the local stage, usually amenable to focal treatment.
  3. If you are a good candidate for FLA and choose to proceed, we perform the procedure in our 3T MRI location in Houston, Texas. Please look at our What To Expect page for more information about what to expect on the day before, day of, and day after the procedure.
  4. We provide you with a detailed and personalized follow-up plan. 

Prostate mpMRI and Guided Focal Laser Ablation for Prostate Cancer

This video begins by describing the diagnosis of prostate cancer starting with a TRUS biopsy vs MRI.  It then describes the advantages and disadvantages of different treatment approaches and provides examples of images from focal laser ablation cases.

Example Images:


Cancer in the left peripheral zone


Focal tissue destruction

6 Months Later

Cancer no longer seen

Neurovascular bundle = Blue Arrow
Cancer = Red Arrow

CureTalks, a social initiative which interviews top experts in their respective fields, interviews Dr. Karamanian about MRI-guided focal laser ablation for prostate cancer.  Having knowledgable contrarians on the panel to challenge this treatment option creates an engaging dynamic.