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Laser Surgery For Prostate Cancer

Different Types Of Focal Therapy

Prostate cancer laser treatment ‘truly transformative’ – BBC News
  • HIFU : HIFU focuses the energy of sound waves to create heat and destroy cancer cells. Just like a magnifying glass concentrating sun rays to burn a hole in the paper. During the procedure, an ultrasound probe is inserted into the patients rectum while the patient is asleep from anesthesia. Guided by MRI and ultrasound 3D-images, the physician finds the tumor, plus the area to be treated, and delivers the energy aimed at the diseased tissue in the prostate gland. HIFU is a noninvasive precision treatment that spares healthy tissue and lowers the chances of negative side effects associated with radical prostate surgery or radiation, such as impotence, incontinence and bowel function disturbance. UChicago Medicine is the first medical center in the Midwest to offer and perform this procedure with the newest Focal One advanced robotic HIFU technology. This fills a significant treatment void for men with localized prostate cancer who find themselves in between active surveillance and whole gland treatments such as radiation or surgery. The treatment has been used for years in both Europe and Asia.

Urologists Ariel Shalhav, MD, and Scott Eggener, MD, answer questions about new treatment options for prostate cancer, including focal therapy and HIFU, as well as specialized care programs for men diagnosed with advanced prostate cancer or at high risk for the disease.

After You Leave The Hospital

  • Follow your healthcare providers instructions for taking your antibiotics and tamsulosin .
  • Dont shower for the first 24 hours after your procedure. After 24 hours, you can go back to showering as usual. Dont take a tub bath or submerge your lower body in water for 2 weeks after your procedure.
  • Dont lift anything heavier than 20 pounds for at least 48 hours after your procedure. Your healthcare provider will tell you if you need to wait longer than 48 hours.

What To Expect After Green Laser Prostate Surgery

The GreenLight Laser is used for the treatment of Benign Prostatic Hyperplasia . This is most commonly referred to as enlargement of the Prostate. It is a therapy involving evaporation of prostatic tissue that blocks bladder outlet.

The surgery is performed under the effect of anesthesia. Surgeon will place a telescope into the urethra up and about the prostate level. A scope is used to guide laser fiber towards the prostate tissue which is quickly and smoothly vaporized. The surgery is also termed as the following:

  • Prostate photovaporization
  • Laser ablation of the prostate
  • KTP laser surgery

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How Greenlight Laser Prostatectomy Works

GreenLight laser prostatectomy is a procedure in which the excess prostate tissue is removed to relieve constriction of the urethra, allowing easy passage of urine.

The laser is used to vaporize excess prostate tissue that is limiting the flow of urine. Most patients can expect very rapid relief of their BPH symptoms, often within 24 hours of GreenLight Laser prostatectomy.

For most men, GreenLight laser prostatectomy is an outpatient procedure, allowing them to return home the same day.

What Are The Advantages Of Holmium Laser Enucleation Of The Prostate

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Use of HoLEP in many different parts of the world has shown it to be a safe and effective procedure. Although there are many types of BPH surgeries available, HoLEP offers a unique advantage in being able to remove a large amount of tissue without any incisions on the body, even in very large prostates, while decreasing the risk of bleeding and providing tissue for pathology . This decreases the need for blood transfusions during surgery, minimizes the time of stay in the hospital to one or two days, and reduces the risk of needing repeat treatment.

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Benefits Of Greenlight Laser Pvp

  • Minimal bleeding
  • Only 30% of patients need a post-op catheter
  • Discharge on the same day
  • Resume normal activities in 2 to 3 days with caution
  • Return to vigorous activity level in 4 to 6 weeks
  • Complications occur infrequently and are mild if they do
  • Post-operative impotence has not been associated with PVP
  • Erectile Dysfunction is not typical in PVP patients
  • Long-term success in improved urine flow
  • Fewer symptoms of urinary obstruction

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Laser Surgery For An Enlarged Prostate Is No More Effective Than Standard Surgery

This is a plain English summary of an original research article

Two procedures to treat men with enlarged prostates are both effective, new research has shown.

A benign enlarged prostate is not cancer and is not usually a serious threat to health. But it is common in men over 50 and some need surgery to treat troublesome urinary symptoms caused by the growing prostate. The most common procedure is transurethral resection of the prostate which is usually successful but can lead to complications such as bleeding in some men.

The UNBLOCS trial compared the effectiveness of TURP to a new laser procedure which might reduce a patients hospital stay and cause fewer side effects. The thulium laser, ThuVARP, vaporises excess prostate. Men who needed a prostate operation were asked to consent to either procedure without knowing which one they would receive.

One year later, men in both groups were satisfied with their surgery. They reported similar improvements in their urinary symptoms and quality of life. There was no difference between the two procedures in terms of hospital stay or complications. However, men in the TURP group achieved a faster urinary flow rate . TURP was also slightly more cost-effective and faster to perform than the laser procedure.

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Arrange For Someone To Take You Home

You must have a responsible care partner take you home after your procedure. A responsible care partner is someone who can help you get home safely. They should be able to contact your care team if they have any concerns. Make sure to plan this before the day of your procedure.

If you dont have a responsible care partner to take you home, call one of the agencies below. Theyll send someone to go home with you. Theres a charge for this service, and youll need to provide transportation. Its OK to use a taxi or car service, but you still need a responsible care partner with you.

Agencies in New York

Types Of Lasers Used In Cancer Treatment

What you need to know before a GreenLight Laser Prostatectomy

Three types of lasers are used to treat cancer:

  • carbon dioxide lasers
  • neodymium:yttrium-aluminum-garnet lasers

CO2 and argon lasers can cut the skins surface without going into deeper layers. So, they can be used to remove cancers on the surface of the body, such as skin cancer.

The Nd:YAG laser is more often used through an endoscope to treat internal organs, such as the uterus, esophagus, and colon.

Nd:YAG laser light can also travel through optical fibers into specific areas of the body during LITT.

Argon lasers are often used in photodynamic therapy.

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Targeted Therapy For Prostate Cancer

Targeted therapy is a type of cancer treatment that uses drugs to identify and attack cancer cells while doing little damage to normal cells. These therapies attack the cancer cells inner workings the programming that makes them different from normal, healthy cells. Each type of targeted therapy works differently, but they all change the way a cancer cell grows, divides, repairs itself, or interacts with other cells.

Greenlight Laser Treatment Of Bph

The GreenLight Laser is used in the treatment of Benign Prostatic Hyperplasia , commonly known as enlargement of the Prostate. GreenLight laser treatment is a therapy that evaporates prostatic tissue which is blocking the outlet of the bladder. It is performed under anesthesia by placing a telescope into the urethra up to the level of the prostate. The laser fiber is guided through the scope and the prostate tissue is then quickly and gently vaporized. Other names for the procedure include photovaporization of the prostate or photoselective vaporization of the prostate or laser ablation of the prostate. You may also see the GreenLight laser referred to as a KTP laser.

The University of Virginia has dedictated physicians who are trained in the use of the GreenLight laser.

How does GreenLight differ from other laser treatments of the prostate?

Several other laser therapies exist. Interstitial laser therapy is a type of thermotherapy that heats the prostate tissue, but does not vaporize or remove it. Holmium laser therapy is another high power laser that evaporates tissue in a procedure similar to the GreenLight. At the University of Virginia, we use the new GreenLight HPS system, which is a higher powered version of the original GreenLight laser made by LaserScope/AMS. The higher powered GreenLight HPS allows the surgeon to remove more of the obstructing prostate tissue in a shorter time than the older GreenLight system.

Is GreenLight treatment right for me?

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Focal Therapies Could Spare Side Effects Of Other Treatments

The research, published in the journal The Lancet Oncology, found that only six per cent of patients treated with VTP required surgery or radiotherapy compared with 29 per cent of men on active surveillance. However, a third of men in the VTP group experienced serious side effects compared to only one in ten in the active surveillance group.

In 1975 almost everyone with breast cancer was given a radical mastectomy, says Professor Mark Emberton, who led the study. But since then, treatments have steadily improved and we now rarely need to remove the whole breast. In prostate cancer we are still commonly removing or irradiating the whole prostate, so the success of this new tissue-preserving treatment is welcome news indeed.

Dr Matthew Hobbs, Deputy Director of Research at Prostate Cancer UK, said: Focal therapy treatments like this one have the potential to offer a middle-ground option for some men with cancer that has not spread outside the prostate. By treating the cancer directly, rather than the whole prostate, this type of therapy could spare some men the long-term side effects of other treatments.

What Treatments Are Used In Focal Therapy For Localized Prostate Cancer

MRI Guided Focal Laser Ablation for Prostate Cancer

Focal therapy uses ablation, which is the use of extreme temperatures to destroy tissue. In focal ablation, the area of the prostate that contains the index lesion is targeted, rather than treating the entire prostate gland. Focal ablation techniques include:

  • Cryotherapy: The use of very cold gases passed through needles to freeze and destroy cancer tissue.
  • HIFU : The use of high-frequency sound waves directed at the tumor through an ultrasound probe inserted into the rectum. The high intensity waves cause the diseased tissue to heat up and die.
  • : A drug called a photosensitizer is injected into the bloodstream. This drug then absorbs light rays directed at the tumor, and produces an active form of oxygen that destroys cancer cells.
  • Laser ablation: The use of laser radiation energy pinpointed to a very small area to burn away cancerous tissue. Some laser ablation has the advantage of being able to be performed at the same time as magnetic resonance imaging , allowing very specific targeting and also real-time views of results.

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Stop Taking Nonsteroidal Anti

Stop taking NSAIDs, such as ibuprofen and naproxen , 2 days before your procedure. NSAIDs can cause bleeding.

If your healthcare provider gives you other instructions, follow those instead.

For more information, read Common Medications Containing Aspirin, Other Nonsteroidal Anti-inflammatory Drugs , or Vitamin E.

Advantages Of Laser Focal Therapy

Minimally Invasive

A minimally invasive outpatient procedure

Relatively Rapid Recovery

Tends to have fewer disruptions to daily life compared with traditional treatment

No General Anesthesia

Uses local anesthesia and moderate, conscious sedation

LFT has a lower reported incidence of erectile dysfunction and urinary incontinence than radical prostatectomy and radiation therapy

Repeatable

If necessary, LFT is a repeatable procedure

No Limitations

If necessary, surgery and radiation are options. RP was not complicated by the FLA procedure.

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What Happens After Holmium Laser Enucleation Of The Prostate

  • Tissue removed during surgery will be tested in the laboratory for any abnormal findings.
  • The patient will be seen by the doctor following surgery to monitor recovery and to repeat tests, such as urinary flow rate, bladder scan, and symptom score. These tests gauge the effectiveness of the surgery. Typically, patients are seen at six weeks and six months after surgery.
  • The use of pelvic floor exercises as soon as possible can help improve problems with urinary incontinence.

How Long Is The Healing Process

Dan’s Journey with Laser Focal Therapy Prostate Cancer Treatment

Most patients need at least one to two weeks of rest at home before they can return to work. Some patients may require three to four weeks of recovery time before going back to work, especially if the job is physically strenuous. No heavy lifting should be attempted during the recovery period however, patients are expected to walk and do light activities.

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What Can I Expect From The Procedure

The procedure takes an average of 60 to 90 minutes under general anaesthetic. A thin laser fibre is positioned within the laserscope and is passed up through the urethra to deliver the treatment.

At BPC, we recognise that for some men, a trim TURP can be a useful procedure at the end of GreenLight laser surgery if residual prostate tissue is still present. We call this a trim TURP. By completing the procedure in this way, the normal flow of urine out of the body is restored and the likelihood of needing further surgery in the future is reduced. Having a trim TURP in additional to laser surgery does not have a significant impact upon your post-operative recovery, our experience shows. After your procedure, you will spend one night in hospital.

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Cost Of Treatment And Insurances

At New York Urology Specialists, we offer affordable treatment for men. Our prices are low for patients without insurance and for those who have high insurance copays, high deductibles, or insurance plans that do not cover treatment costs.

We accept many health insurance plans. We would be happy to verify your eligibility and benefits and provide you with detailed information on your health plans coverage. and credit options are available to help you pay for medical care.

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What Are The Risks Or Potential Complications Of Holmium Laser Enucleation Of The Prostate

  • Injury to the urethra or development of scar tissue at a later date.
  • Injury to the capsule of the prostate .
  • Injury to the bladder or ureteral orifices .
  • Infection of the bladder, testes or kidneys.
  • Return of urinary obstruction at a later date requiring another operation .
  • Need for transfusion or reoperation due to bleeding.
  • Failure to relieve all symptoms and/or need for prolonged catheterization after surgery.
  • Five to 15 percent of patients are found to have previously undiagnosed prostate cancer in their prostate specimen. Prostate cancer can be treated after HoLEP.
  • Standard risks of anesthesia including blood clots, heart attacks, etc.

How Is Bph Diagnosed And Whos A Candidate

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We typically diagnose BPH after hearing of a patients symptoms, most commonly the frequent or urgent need to urinate. We often ask patients to complete questionnaires to measure the extent to which their symptoms bother them, as well as the strength of their urine stream. Ultimately, if a man has problems urinating, we determine if its BPH by measuring the size of their prostate via an ultrasound and evaluate the appearance of their prostate with a cystoscopy, a procedure that uses a small camera to identify signs of BPH, such as the narrowing of the urethra where it passes through the prostate gland.

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What Is A Cystoscopy

A cystoscopy is a test to check the health of your urethra and bladder. You might also hear it called a cystourethroscopy or, more simply, a bladder scope.

Itâs an outpatient test, which means you can get it at your doctorâs office, a hospital, or clinic and go home the same day. The doctor inserts a tube into your urethra. If youâre a man, the opening is at the end of your . If youâre a woman, itâs just above your . The test lets your doctor check the complete length of your urethra and the bladder for polyps, narrow areas called strictures, abnormal growths, and other problems.

Follow Your Healthcare Providers Instructions For Taking Aspirin

If you take aspirin or a medication that contains aspirin, you may need to change your dose or stop taking it 7 days before your procedure. Aspirin can cause bleeding.

Follow your healthcare providers instructions. Do not stop taking aspirin unless they tell you to.

For more information, read Common Medications Containing Aspirin, Other Nonsteroidal Anti-inflammatory Drugs , or Vitamin E.

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What Are The Side Effects Of Holmium Laser Enucleation Of The Prostate

The most common side effects include:

  • Temporary burning and bleeding during urination. Some blood may be seen in the urine for weeks after surgery. This is usually not an indication of anything serious, only that the healing process is not yet finished.
  • Urinary incontinence is expected in all patients immediately after surgery and they should wear pads for the first few days/weeks. This typically improves over the course of several weeks. Performing Kegel exercises can help decrease leakage from stress maneuvers such as coughing, sneezing, or lifting. The rate of long term leakage from stress maneuvers is low. Patients may also have leakage with urgency and this may be treated with medication. The risk of urge incontinence can be dependent on several factors including age, prostate size, symptoms, and other medical problems.
  • Erectile function is generally not significantly affected. A small percentage of patients have reported improved erectile function while a small percentage have reported decreased erectile function.

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