The prostate is a ping-pong ball-sized gland nestled in the groin, between the base of the penis and the rectum. Its main function is to provide the body with seminal fluid, a substance that helps sperm not only travel but also survive. The word “prostate” itself comes from the Greek word “prostates,” which means guardian or protector in a nod to the prostate’s location in front of the bladder.
About 1 in 9 men will be diagnosed with prostate cancer at some point during his lifetime. And the disease has several risk factors which could increase your likelihood of developing it. These include race/ethnicity, age, geography, and genetic changes.
A presentation at the 2019 RSNA conference this past December in Chicago showed encouraging progress in the world of prostate cancer treatment. Researchers praised the efficacy of a new MRI-guided prostate cancer treatment that doesn’t even involve the making of any incisions; the technique may also be used to combat benign prostatic enlargement.
The process, called MRI-guided transurethral ultrasound ablation (TULSA), is an outpatient procedure that functions by honing in its sound waves solely to diseased prostate tissue while leaving nearby healthy nerve tissue alone. The researchers at RSNA 2019 presented results from a 12-month trial, called the TULSA-PRO Ablation Clinical Trial; they reported major success in reducing and sometimes even eliminating prostate cancer with minimal side effects in recipients of the treatment. Profound Medical, which is the company responsible for marketing the TULSA-PRO system, was recently granted US FDA 510(k) clearance for prostate tissue ablation; the company also received approval for clinical use in Europe.
The TULSA-PRO Ablation Clinical Trial involved 115 men with a median age of 65 and an overall age range of 59 to 69. They all had what was considered median PSA levels. The subjects’ prostate cancer was either low- or intermediate risk, meaning that it was always confined to their prostates. Clinicians delivered the treatment to entire prostates over an average duration of 51 minutes per individual. When assessed one year later, each individual’s prostate volume had decreased, on average, from 39 cubic centimeters to about 3.8 cubic centimeters. What’s more is that 80% of patients saw an elimination in clinically significant cancer, and 65% of these individuals showed no signs of cancer at all when a prostate biopsy was performed a year later. Finally, the men’s PSA levels dropped by a median of 95% at their one-year followup appointment, no bowel side effects whatsoever and a low rate of severe toxicity.
“There are two very unique things about this system,” said co-author Dr. Steven Raman, professor of radiology and urology at UCLA. “First, you can control with much more finesse where you’re going to treat, preserving continence and sexual function. Second, you can do this for both diffuse and localized prostate cancer and benign diseases, including benign hyperplasia.”
The study also showed that MRI is a very useful and accurate tool in monitoring patients who undergo TULSA.
The Ezra approach to prostate cancer screening also involves harnessing the power of MRI. You may learn more about how our prostate cancer screening method stacks up against other approaches here.