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Focal Laser Ablation

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User

Posted 27 Mar 2017 at 17:58

Paco had also had done a T3 MP MRI test before biopsy. This is a pretty accurate machine, I think.

Let us know how you are doing later.

Enjoy the trip, by the way😉

Lola

User

Posted 27 Mar 2017 at 19:05

Hi Clare
All the best.

Regards
Gordon

User

Posted 28 Mar 2017 at 13:00

Thank you Lola and Gordon,

Well all done. He was under the laser for 3.5 hours in the end. The consultant kept bringing him out of the MRI and he kept thinking it was over but no just another reposition of the laser and back in.

In addition to the cancer there was a node/stricture on the neck of the bladder which he offered to treat. We said yes to this as likely to cause urine flow difficulties at same time.

Following the procedure the images were run through but today we go back for a complete 'show and tell' plus we get the CD! The catheter is not providing to be as big a problem as A thought, it should be in for 3 days. The consultant said it was a hard treatment and considers from his experience there was likely to be Gleason 7 in some of the areas that he ablated based on the tissue density experienced.

Big rest day today. Started Cialis, prednisone and contining on antibiotics this morning. List of drink/ food no nos whilst having a catheter...he is following orders and sleeping.

Thanks for the support. Monitoring in place for back in UK and the UK consultant we are going with seems genuinely interested in having the case.

Clare

User

Posted 28 Mar 2017 at 13:30

Hi, Clare.

Glad to know you've finished at least for today and can have a rest.

I'm somehow confused, maybe because of the language or because of medical words. I'm not sure about what your hub has had done. A MP MRI previous to biopsy or a biopsy targeted by multiparametral MRI by 3 TESLAS..

On the other hand you mention "laser". I can't find the connection as , as far as I know laser {we call it"green laser") is used for other prostate issues.

My husband's tumor was shown in MP MRI and then confirmed by biopsy, Gleason 4+3=7

This is not the right moment to ask questions to you. All you have to do now is resting and relaxing.

I'm also on my trip to Madrid for Paco's results from bone scan and CAT. The urologist will tell us and confirm or not on the robotic surgery he offered after biopsy and MP MRI.

Take it easy, relax and rest.

Best wishes,

Lola

User

Posted 28 Mar 2017 at 13:50

Good news Clare. Best wishes on great results

If life gives you lemons , then make lemonade

User

Posted 28 Mar 2017 at 14:23

C

Sounds like all is going to plan, the mention of treatment of the bladder neck stricture caught my attention. Is your consultant treating the stricture with the FLA or a more conventional treatment i.e. dilatation or incision into the tissue ?

Thanks Chris

User

Posted 28 Mar 2017 at 14:43

Really interesting to read your story and glad to see it is going well. I'm sure this will all help others in the future.

User

Posted 28 Mar 2017 at 15:17

Hi Lola,

I don't think your confusion is a language issue but that we have opted for a treatment that is considered 'experimental' . It is a bluelight laser that is used for cancer rather than the greenlight treatment that I know little about but I believe can be used for BPH.

The treatment A had yesterday is not available in the UK and the only part of Europe using it is Holland as far as I am aware. Even though classed as experimental the first FLA was done in the USA in 2009 and the consultant we used yesterday has treated over 1.000 men to date.

So my husband was diagnosed in December 2016 via a 1.5 tesla MpMRI scan which could clearly see the abnormalities. This was followed up with a targeted biopsy of 46 cores taken under general anaesthetic. 17 cores had Gleason 6 (3+3 ) identified and 11 / 20 segments were impacted so large but diagnosed as low risk.

The treatment my husband opted for then used the MRI 3 tesla to give the visuals in order to treat the tumour directly. So the laser is inserted and then he was put into the MRI machine to check position in real time. Once laser is in correct place the MRI slides back and the ablation is done. The laser then gets repositioned, check with MRI etc etc so he had 3.5 hours of going in and out of the MRI machine getting the tumour zapped as it were.

We decided to opt for this rather than the offered surgery or radiotherapy due to the side effects of the radical treatments. We didn't't want to over treat especially as he was diagnosed Gleason 6

Active surveillance felt like an under treatment due to the family history and large size of tumour.

The radical approaches are still available should this focal laser ablation fail or we can return for a second go but the consultants was confident he had got it yesterday..he was certainly thorough... Fingers crossed .. Clearly he will need lifetime monitoring now ( he is 54) .

I hope Madrid trip is fruitful. Thank you for your kind words Lola. I am very grateful for all support received and let us know how you get on.

Regards

Clare

User

Posted 28 Mar 2017 at 15:32

Hi Chris,

With regard to the stricture it was diagnosed and treated yesterday! Yes the consultant used the laser to sort it out and says the urine flow should be noticeably improved.

A had never said he had noticed any change in his urine flow but when it came up yesterday said that since around 2013 he had I fact not been able to urinate as quickly as he used to, he commented that it took some time for the last bits to 'dribble out' and could even say when he did the Leeds half marathon in 2014 it was strange he had to stop to pee and that it took 32 seconds off his time cos that's how long he took!!

So news to me but seems he did have symptoms in this respect and the consultant saw and pointed out the problem straight away on the 3T scan yesterday.. He said he could sort it if A wanted him to though it wasn't cancer ...

A said yes please and Consultant pointed out it was gone in the after event slide show ... However could be a map of the moon for all my knowledge! ( I can recognised the hip bones now thought!)

Weather is perfect here so a good place to recover and he's on the balcony in a chair with a big cushion being nagged to do reverse kegals.

So yes a stricture was a new diagnosis!

Hope that answers the question

Regards

Clare

User

Posted 28 Mar 2017 at 15:50

Hi, Clare.

Now it is quite clear to me. Despite reading almost every post here I wasn't aware of this subject.

That's great, not only because of the fact that the procedure has gone ok but also because in case (crossing fingers) it didn't work good enough you can come back to conventional treatment.

Really glad for you both. Thanks for sharing, as anyone can take benefit of the knowledge you provide.

The best to you.

Just arriving in Madrid.
Love

Lola

User

Posted 28 Mar 2017 at 15:50

On the balcony in nice weather with a cushion ???
As much as I love the NHS , this is sounding great Clare. I'd be nagging you for a glass of wine whatever they said !!

If life gives you lemons , then make lemonade

User

Posted 28 Mar 2017 at 16:37

Ah Chris-,alchohol is number 1 enemy to the bladder for anyone wearing a catheter according to Susie the lovely American physical therapist! Not even green tea is getting passed me ( caffeine is number 2 enemy) . He did have steak and ice cream the night before as the prostate was getting a good ablation it didn't seem an unreasonable decision, he needs to be grateful lol!

Now if we could get sunshine on the NHS that would be a vote earning policy!

User

Posted 01 Apr 2017 at 14:04

Just an update.

FLA done on Monday to ablate large left hand side Gleason 6 tumour plus 2 small Gleason 6 tumours on the right hand side.

Catheter in for Monday, Tuesday and Wednesday night. Recovering near to centre in a hotel ( the clinic has a pop in open door policy but we have only needed to go when due.

Catheter out on Thurday, water drunk, urine passed, examined and taught to self Catherise and given bag of self Cath equipment plus jug for the 48 hour urine monitor.

A woke up Thursday night needing to pee and just couldn't so had to face up to putting in a temporary catheter.. Wasn't that bad( came pre lubed in its own bag which then became the 'catch bag' as the catheter went in... He filled it and was much relieved in both senses!

Friday morning he peed normally and the pressure of flow improved all day. No problems last night ( Friday evening) slept through and peed this morning..he is feeling slightly bloated so possibly mild retention?? Uncertain so will discuss at check up later.

Still on medication so no real idea what impact that is having

Antibiotic
Prednisolone
Cialis
Tamousilin

There is definitely 'life' in the form of semi erections but given the nerve bundles were not touched that is expected.

Back to drinking his green tea.. Thinking he should cut it out ( caffeine) whilst he is healing.

No blood in urine but warned in around 3 weeks time the prostate will start showing... signs if healing via the urine in the form of blood and scabs etc... Hmmm..

User

Posted 02 Apr 2017 at 01:09

Hi Clare,

Your reports make interesting reading. Seems that blood and dead cells can be expelled in the urine in a similar way to HIFU. Some men also get retention in this procedure although I was lucky in this respect.

Barry

User

Posted 02 Apr 2017 at 07:28

Hi Clare
Thanks for sharing the journey to date. It sounds like everything is going to plan, which must be so re-assuring after such a big decision.
Best regards
Chris

User

Posted 02 Apr 2017 at 07:36

Clare, great news!

Thanks for sharing the outdate. Wish everything continues to go like this.

On my part, awaiting the 25th for Paco's operation.

Best wishes,

Lola.

User

Posted 03 Apr 2017 at 19:02

Nothing much to report except pee flow getting stronger - now doing 400 ml which we understand is as good as it gets ... Pressure still lowest in morning but improving as day goes on. Slight internal pain still from time to time and ED no changes from the semi status! ( committed to 100% disclosure so sorry if it's tmi!)

Barry - that's interesting sounds very similar post procedure to the HIFU....

Chris - hope your recovery is going well

Lola - keep enjoying the Spring and the family time

Big shop at the chemist yesterday - v much cheaper than in the UK so took opportunity to stock up on low dose aspirin, vitamin D3, turmeric and milk thistle. Ben and Jerrys next door to hotel do a almond milk diary free ice cream - I think their profits are up this week! Shame we can't take this home ...
Regards

Clare

User

Posted 18 Apr 2017 at 19:28

update at 3 weeks post FLA

3.5 hour FLA done in the USA on 27th March
5th April flew home
10th April A was back at work
18th April erection strength best since 26th March (about 80%)

Current meds:

Tamousilin 1 tab at night

All other meds stopped (cialis stopped early due to side effects)

-no incontinence
-no getting up in night to pee
-flow still not back to full strength and still doing reverse kegels whilst peeing but improvement seen
-uncertain whether he is one of 30% to lose ejaculate completely as its just like post template biopsy re orgasming blood ( only tried the once post FLA)
-pre ejaculate now back after 2 week absence
-erection strength improving (took two months after template biopsy to recover)
-too early to judge if it was succesful re his PCa of course

For info

User

Posted 19 Apr 2017 at 05:09

Thanks for the updating, Claret.

The recovery seems to be going ok, so happy for you.

Best wishes to you both,

Lola.

User

Posted 27 Apr 2017 at 13:11

Hello,

Did your husband's da Vinci procedure go ahead as planned.

If so, hope everything went well.

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