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Prostate Cancer Treatment Pros and Cons: Treatment Comparisons
Personalized Treatment Planning
If you’ve been diagnosed with prostate cancer or are at risk for it, you’re likely wondering about treatment options.
There is no universal treatment for prostate cancer. Instead, a range of treatment options are available. Factors such as Gleason score, stage of cancer, and how much the cancer has spread within the prostate gland, among others, influence suggested treatments.
Each prostate cancer treatment has unique benefits and drawbacks. All of the treatments compared below are generally recognized as effective. However, they differ in terms of side effect risks, the nature of the procedure, limitations on future treatment, and more.
Laser focal therapy (LFT) and transurethral ultrasound ablation (TULSA-PRO) complement each other as treatment options for prostate cancer. Both use MRI guidance. Laser focal therapy / focal laser ablation (FLA) uses a laser to destroy tissue, whereas TULSA-PRO uses sound waves.
Lasers tend to be more precise, especially near vital structures such as the neurovascular bundles (responsible for erectile function). Profound Medical’s TULSA-PRO treatment has ten ultrasound elements that fire at the same time. This allows for wider coverage to be more easily obtained, but sound waves are not quite as precise as a laser.
Prostate Laser Center offers both LFT and the TULSA-PRO prostate procedures.
The physicians at Prostate Laser Center carefully review each patient’s situation. This is an important step in comparing prostate cancer treatments on the individual level. With this context, the physicians can determine the pros and cons of the different prostate cancer treatment options to make an informed recommendation for each person’s situation.
Is focal therapy right for you? Prostate cancer treatments compared
A variety of prostate cancer treatments are available, each with its own pros and cons. You can use the table below to quickly review the pros and cons of focal laser ablation for example. Or, you could compare laser prostate ablation vs. radical prostatectomy.
LFT and the Tulsa procedure for prostate cancer both have significantly lower incidences of certain post-operative side effects as compared to radiation therapy and radical prostatectomy. Specifically, those side effects are urinary incontinence and erectile dysfunction. It’s important to consider ongoing quality-of-life concerns as part of the broader comparison of treatments.
Discussing your condition and options for treating prostate cancer with a physician is crucial for making an informed decision. However, learning about the basics of common treatment options can help you better understand those conversations with your physician.
| Laser Focal Therapy | TULSA-PRO® | Radical Prostatectomy | Radiation Therapy | |
|---|---|---|---|---|
| Customizable treatment planning |  | |  | Depends on type |
| Partial gland treatment | | | | Some types |
| Whole gland treatment | | | | |
| Radiation free | | | | |
| Outpatient Procedure | | | | Usually requires numerous visits |
| Overnight hospitalization required | | | | |
| Requires general anesthesia | | | | |
| Urinary Incontinence Risk | <3% 1 | 7% 2 | 16%7 | 10-18%5 |
| Erectile Dysfunction Risk | <10% 1 | 25% 2 | Ranges widely, but approximately 50%8 | 34% – 57%6 |
| Does not limit future treatment | 3 | 4 | | |
| Learn More | Learn 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
“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
“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
“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
