Prostate Cancer Treatment Comparison

Personalized Treatment Planning

Laser focal therapy (LFT) and transurethral ultrasound ablation (TULSA-PRO) complement each other. Both use MRI guidance. LFT uses a laser to destroy tissue, whereas TULSA-PRO uses sound waves. Laser tends to be more precise, especially near vital structures such as the neurovascular bundles (responsible for erectile function). TULSA-PRO has ten ultrasound elements which fire at the same time, allowing for wider coverage to be more easily obtained, but sound waves are not quite as precise as a laser. The physicians at Prostate Laser Center will look at each patient’s individual situation to determine the pros and cons of both approaches.

Is focal therapy right for you?

 Laser Focal TherapyTULSA®Radical ProstatectomyRadiation Therapy
Customizable treatment planningIcon CheckmarkIcon CheckmarkIcon XDepends on type
Partial gland treatmentIcon CheckmarkIcon CheckmarkIcon XSome types
Whole gland treatmentIcon XIcon CheckmarkIcon CheckmarkIcon Checkmark
Radiation freeIcon CheckmarkIcon CheckmarkIcon CheckmarkIcon X
Outpatient ProcedureIcon CheckmarkIcon CheckmarkIcon XUsually requires numerous visits
Overnight hospitalization requiredIcon XIcon XIcon CheckmarkIcon X
Requires general anesthesiaIcon XIcon CheckmarkIcon CheckmarkIcon X
Urinary Incontinence Risk<3% 17% 216%710-18%5
Erectile Dysfunction Risk<10% 125% 2Ranges widely, but approximately 50%834% – 57%6
Does not limit future treatmentIcon Checkmark3Icon Checkmark4Icon XIcon X
 Learn MoreLearn More  

Note: Percentages vary based on many factors. This is general information. Please speak with your physician prior to making any treatment decisions.

References

[1] Urology Today. (2020). Outpatient trans-rectal MR-guided laser focal therapy phase II clinical trial: 10-year interim results video. Published online April 27, 2020

[2] Profound Medical. (2019). TULSA-PRO: TACT 12-month data. Published online April 2019.

[3] Lindner, U., Lawrentschuk, N., Weersink, R.A., et al. (2010). Focal laser ablation for prostate cancer followed by radical prostatectomy: Validation of focal therapy and imaging accuracy. European Urology, 57(6), 1111-1114. doi: https://doi.org/10.1016/j.eururo.2010.03.008

[4] Nair, S.M., Stern, N., Dewar, M. et al. (2020). Salvage open radical prostatectomy for recurrent prostate cancer following MRI-guided transurethral ultrasound ablation (TULSA) of the prostate: Feasibility and efficacy. Scandinavian Journal of Urology, 54(3), 215-219. doi: 10.1080/21681805.2020.1752795

[5] Albkri, A., Girier, D., Mestre, A. et al. (2018). Urinary incontinence, patient satisfaction, and decisional regret after prostate cancer treatment: A French national study. Urologia Internationalis, 100, 50-56. doi: https://doi.org/10.1159/000484616

[6] Gaither, T.W., Awad, M.A., Osterberg, E.C. et al. (2017). The natural history of erectile dysfunction after prostatic radiotherapy: A systematic review and meta-analysis. The Journal of Sexual Medicine, 14(9), 1071-1078. doi: https://doi.org/10.1016/j.jsxm.2017.07.010

[7] Ficarra, V., Novarra, G., Rosen, R.C., et al. (2013). Systematic review and meta-analysis of studies reporting urinary continence recovery after robot-assisted radical prostatectomy. European Urology, 63(3), 365-367. doi: https://doi.org/10.1016/j.eururo.2012.05.045

[8] Emanu, J.C., Avildsen, I.K., & Nelson, C.J. (2016). Erectile dysfunction after radical prostatectomy: Prevalence, medical treatments, and psychosocial interventions. Current Opinion in Supportive and Palliative Care, 10(1), 102-107. doi: 10.1097/SPC.0000000000000195

What Others Have to Say About Focal Therapy for Prostate Cancer

Cleveland Clinic

“Focal therapy offers a middle ground therapy for men with localized prostate cancer. It uses ablation, or tissue destruction, to target the area that contains the index lesion. Men who have focal therapy will continue to be monitored after treatment.”9

Yale Medicine

“For some men with lower-risk or localized types of prostate cancer, there is a middle-of-the-road option. With an approach called focal therapy, only those parts of the prostate that are cancerous are destroyed and other tissue is left unharmed.10

Ucla Health

“Focal therapy offers advanced treatment options for prostate cancer.”11

“The widespread adoption of prostate mpMRI has led to improved disease localization, enabling the performance of focal therapy as a viable treatment strategy for men with low volume intermediate-risk prostate cancer”12

[9] Cleveland Clinic. (2021). Prostate cancer: Focal therapy. Published online January 26, 2021.

[10] Folsom, E. (2021). Are focal therapies the future of prostate cancer? Yale School of Medicine. Published online March 25, 2021. 

[11] UCLA Health. Focal therapy offers advanced treatment options for prostate cancer. Published online Summer 2018.

[12] Connor, M.J., Gorin, M.A., Ahmed, H.U. et al. (2020). Focal therapy for localized prostate cancer in the era of routine multi-parametric MRI. Prostate Cancer and Prostatic Diseases, 23, 232-243. doi: https://doi.org/10.1038/s41391-020-0206-6

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