5 ms·

As someone whose family member recently just received a test showing elevated PSA levels (Prostate Cancer indicator); this article is a very real blessing. # B

As someone whose family member recently just received a test showing elevated PSA levels (Prostate Cancer indicator); this article is a very real blessing. # Baseline issues with prostate cancer that suck. 1. Don't treat a benign version and possibly live with trouble urinating and follow on problems from that. 2. Don't treat a malignant version and die 3. Treat it and potentially be impotent 4. Treat it and end up with bowel dysfunction 5. Treat it and rehab through surgical scars looking like an upside down T from following from belly-button to waistline or a U shape around the rectum. 6. Of course there is some tail risk of much much worse situations; and while it's worth remembering, it's not worth enumerating. # TULSA method So while this method is not different - it includes things that suck... if you read further upstream of the newatlas article to RSNA primary source [1] you will find that not only do they insert a spinning ultrasound device up the urethra - but it also includes a simultaneous insertion of an endorectal cooling device(ECD)[2]. Given all that: the parts that suck about this method pale in comparison to the traditional list of 6 above. # Conclusion There is much to be squeamish about with this method, as with any prostate remediation methodology; but if applied under careful care of patient and doctor - this looks like a very promising prostate treatment. And as a family friend once put it to me: "Welcome to the world of cancers; where pretty much everything sucks." [1]: https://press.rsna.org/timssnet/media/pressreleases/14_pr_target.cfm?id=2129 https://press.rsna.org/timssnet/media/pressreleases/14_pr_ta... [2]: https://press.rsna.org/pressrelease/2019_resources/2129/fig_1.jpg https://press.rsna.org/pressrelease/2019_resources/2129/fig_... (edited for formatting)

hristov 7y ago
By the way, your family member is probably aware of this but there is another ultrasound treatment option for prostate cancer that is completely non-invasive. It is called hifu. https://www.hifu-prostate.com/ https://www.hifu-prostate.com/ Hifu sends ultrasound from a curved emitter from outside the body in such a manner that the ultrasound ray will be focused on the treatment area. Thus, while you have ultrasound going through your body, only in the treatment area does it become high intensity enough to actually destroy tissue. This way they can burn off cancerous parts without damaging other parts of the prostate and the rest of the sensitive parts around there. I am not sure why the new atlas did not mention HIFU, it also uses MRI. HIFU is already cleared by the FDA, and it will become approved by medicare very soon (this coming January, I believe), so it will be paid by medicare and probably most insurance plans (as they tend to follow medicare).
- mooreed 7y ago
  @hristov I am incredibly moved by your wonderfully thoughtful reply; we are just getting up to speed so had not heard about this at all. From the bottom of my heart, thanks for sending this. Merry Christmas!
- chollida1 7y ago
  Can confirm and sing the praises of HiFu. Went to China so my spouse could have a procedure done in 2014. HiFu took 1-2 hours and my wife walked away from the procedure. She was hiking the next day. Tumor was shrinking almost immediately. The alternatives we had were surgery that would have removed part of her abs or weekly treatments of https://en.wikipedia.org/wiki/Tamoxifen https://en.wikipedia.org/wiki/Tamoxifen Neither of which was great. Now we had to pay for the HiFu but it was soooo worth it. I think it was about $25,000 USD so very reasonable and affordable for us.
  - dorfsmay 7y ago
    For which cancers does this procedure work (assuming your wife didn't have prostate cancer)? I understand 25 k USD feels reasonable if it saves your life without surgery and it's complications, but it steep for "just ultrasound". Do you know why it was that expensive?
    - killjoywashere 7y ago
      MRI is probably the major technical cost. It's fairly high touch and the magnets wear out, so the capital cost of each test is fairly real. That and the professional component. Interventional radiologists are very much in the consultant/handyman/engineer business of "Treatment: $1; knowing where to put it: $9999"
      - comfrey11 7y ago
        In Japan an you can get an MRI for $160 US I hear
3JPLW 7y ago
My very naive understanding of ultrasound techniques is that they can work very well, but in cases where they don't work they end up creating a mess of things (scar tissue, etc) that make subsequent removal pretty much impossible as the surgeon can no longer see clear boundaries. That info is several years out of date and second-hand, so perhaps by guiding the process a little better as TFA suggests they can avoid making any subsequent surgery impossible.
pmiller2 7y ago
If elevated PSA is the only real sign of cancer, then, depending on his age, it's entirely possible your family member could die _with_ prostate cancer rather than _of_ prostate cancer. According to https://www.webmd.com/prostate-cancer/prostate-cancer-survival-rates-what-they-mean https://www.webmd.com/prostate-cancer/prostate-cancer-surviv..., 2/3 of "very elderly" men who died of things other than prostate cancer had undiagnosed prostate cancer on autopsy. And, if the cancer is localized, the 5 year survival rate is nearly 100% (same link).
- deleted 7y ago
  [deleted]
- jonstewart 7y ago
  My dad got a regular PSA test from his old doctor. But that doctor retired, he got a new doctor, moved, got a new doctor again, and the guidance changed, recommending against annual PSA tests. Then my dad developed some back pain. Took it easy, went to the doc, did physical therapy, etc., but it just got worse. Turns out, he had (has) stage IV prostate cancer, with several tumors along his spine and was on the precipice of MSSC before he received a correct diagnosis at age 66. His PSA was north of 80. The good news is that treatment has shrunk the tumors dramatically and he's mostly back to normal. The bad news is that he still has stage IV prostate cancer. It'd have been great to have had it caught earlier.
shard 7y ago
I skimmed all the comments, and am surprised that nobody mentioned the recent advances in radiation treatments. The cancer is modeled with MRI images, dots are tattooed on the patient's body and used to line up the patient with projected laser dots to ensure that body is in exactly the right position, and three trackers are placed into the prostate (Calypso) which allow real time tracking of prostate position. Radiation beams are targeted directly at the cancer, causing minimum damage to the surrounding tissue. The treatment takes about 15 minutes once a day for 30 days. The doctors say it has few side effects and is vastly preferable to surgery. The nurse said this procedure has been available for about 5 years.
- erichocean 7y ago
  My step dad designed the hardware that does the tracking. Had to do some pretty cool stuff to treat the microprocessors because of all the radiation ...

hristov 7y ago

By the way, your family member is probably aware of this but there is another ultrasound treatment option for prostate cancer that is completely non-invasive. It is called hifu. https://www.hifu-prostate.com/ https://www.hifu-prostate.com/ Hifu sends ultrasound from a curved emitter from outside the body in such a manner that the ultrasound ray will be focused on the treatment area. Thus, while you have ultrasound going through your body, only in the treatment area does it become high intensity enough to actually destroy tissue. This way they can burn off cancerous parts without damaging other parts of the prostate and the rest of the sensitive parts around there. I am not sure why the new atlas did not mention HIFU, it also uses MRI. HIFU is already cleared by the FDA, and it will become approved by medicare very soon (this coming January, I believe), so it will be paid by medicare and probably most insurance plans (as they tend to follow medicare).

mooreed 7y ago
@hristov I am incredibly moved by your wonderfully thoughtful reply; we are just getting up to speed so had not heard about this at all. From the bottom of my heart, thanks for sending this. Merry Christmas!
chollida1 7y ago
Can confirm and sing the praises of HiFu. Went to China so my spouse could have a procedure done in 2014. HiFu took 1-2 hours and my wife walked away from the procedure. She was hiking the next day. Tumor was shrinking almost immediately. The alternatives we had were surgery that would have removed part of her abs or weekly treatments of https://en.wikipedia.org/wiki/Tamoxifen https://en.wikipedia.org/wiki/Tamoxifen Neither of which was great. Now we had to pay for the HiFu but it was soooo worth it. I think it was about $25,000 USD so very reasonable and affordable for us.
- dorfsmay 7y ago
  For which cancers does this procedure work (assuming your wife didn't have prostate cancer)? I understand 25 k USD feels reasonable if it saves your life without surgery and it's complications, but it steep for "just ultrasound". Do you know why it was that expensive?
  - killjoywashere 7y ago
    MRI is probably the major technical cost. It's fairly high touch and the magnets wear out, so the capital cost of each test is fairly real. That and the professional component. Interventional radiologists are very much in the consultant/handyman/engineer business of "Treatment: $1; knowing where to put it: $9999"
    - comfrey11 7y ago
      In Japan an you can get an MRI for $160 US I hear

3JPLW 7y ago

My very naive understanding of ultrasound techniques is that they can work very well, but in cases where they don't work they end up creating a mess of things (scar tissue, etc) that make subsequent removal pretty much impossible as the surgeon can no longer see clear boundaries. That info is several years out of date and second-hand, so perhaps by guiding the process a little better as TFA suggests they can avoid making any subsequent surgery impossible.

pmiller2 7y ago

If elevated PSA is the only real sign of cancer, then, depending on his age, it's entirely possible your family member could die _with_ prostate cancer rather than _of_ prostate cancer. According to https://www.webmd.com/prostate-cancer/prostate-cancer-survival-rates-what-they-mean https://www.webmd.com/prostate-cancer/prostate-cancer-surviv..., 2/3 of "very elderly" men who died of things other than prostate cancer had undiagnosed prostate cancer on autopsy. And, if the cancer is localized, the 5 year survival rate is nearly 100% (same link).

deleted 7y ago
[deleted]
jonstewart 7y ago
My dad got a regular PSA test from his old doctor. But that doctor retired, he got a new doctor, moved, got a new doctor again, and the guidance changed, recommending against annual PSA tests. Then my dad developed some back pain. Took it easy, went to the doc, did physical therapy, etc., but it just got worse. Turns out, he had (has) stage IV prostate cancer, with several tumors along his spine and was on the precipice of MSSC before he received a correct diagnosis at age 66. His PSA was north of 80. The good news is that treatment has shrunk the tumors dramatically and he's mostly back to normal. The bad news is that he still has stage IV prostate cancer. It'd have been great to have had it caught earlier.

shard 7y ago

I skimmed all the comments, and am surprised that nobody mentioned the recent advances in radiation treatments. The cancer is modeled with MRI images, dots are tattooed on the patient's body and used to line up the patient with projected laser dots to ensure that body is in exactly the right position, and three trackers are placed into the prostate (Calypso) which allow real time tracking of prostate position. Radiation beams are targeted directly at the cancer, causing minimum damage to the surrounding tissue. The treatment takes about 15 minutes once a day for 30 days. The doctors say it has few side effects and is vastly preferable to surgery. The nurse said this procedure has been available for about 5 years.

erichocean 7y ago
My step dad designed the hardware that does the tracking. Had to do some pretty cool stuff to treat the microprocessors because of all the radiation ...