Posted , 38 users are following.
Very promising new treatment for BPH now in clinical trials (Water Study):
PROCEPT’s AquaBeam combines image guidance and robotics to deliver Aquablation, a waterjet ablation therapy that enables targeted, controlled, and heat-free removal of tissue for the treatment of lower urinary tract symptoms as a result of benign prostatic hyperplasia (BPH).
2 likes, 366 replies
We want the community to be a useful resource for our users but it is important to remember that the community are not moderated or reviewed by doctors and so you should not rely on opinions or advice given by other users in respect of any healthcare matters. Always speak to your doctor before acting and in cases of emergency seek appropriate medical assistance immediately. Use of the community is subject to our Terms of Use and Privacy Policy and steps will be taken to remove posts identified as being in breach of those terms.
nealpros tom86211
Posted
Neal
tom86211 nealpros
Posted
I believe that what's different about this is that the surgery is done with imaging and robotics so only the tissue that's causing issues is ablated. Also, the lack of heat adds to the precision since adjacent tissue isn't effected.
It reminds me of focal therapy for prostate cancer - using imaging to precisely kill the cancer cells and spare healthy tissue. Also, using robotics to treat either cancer or BPH seems to me to be a big plus - the future of many surgical procedures.
Tom
carolyn96211 tom86211
Posted
my husband is having HIFU have you heard of this.. Procedure is going t be done 27th June.
it stands for high intensity Focused ultrasound .
nealpros tom86211
Posted
Thanks for your thoughtful reply. As you may have seen in a post of mine the day before yesterday, I am a great proponent of image guided biopsies. The same logic should hold for BPH treatment of any sort. I guess the question boils down to which treatment causes the least collateral damage. For example, does this water spray treatment damage tissue behind the part being removed. I, of course, don't know and,as usual, it probably depends on the skill of the person doing it. Let's hope more of these are done, and follow the results.
Thanks,
Neal
tom86211 carolyn96211
Posted
I corresponded with you on your HIFU thread. I am a fan of HIFU, and believe it to be an effective treatment for localized cancer, but any treatment should only be done IF it is really necessary - and the reason is that all treatments for prostate cancer or BPH have side effects - some serious and life changing. And, there are also the issues of cost, travel, time off from work, time to recover, etc. I decided NOT to have HIFU because it was not covered by my insurance, I would have to travel to Canada for treatment, and my cancer was in several locations in the prostate.
Same issues with treatment of BPH - you want the most effective result with the least downside.
My best,
Tom
nealpros carolyn96211
Posted
Neal
carolyn96211 tom86211
Posted
my husbands cancer is localised and very low grade...we are very lucky in the UK as our National Health Service now cover this and it's being done at our local hospital which has being doing HIFU for the last 20mths .. Our Surgeon does 4 HIFU'S every last Monday of the month... To me the only down side of the procedure is a catheter afterwards but that is a small price to pay and psa every 3 months then 4 months and then 6 months then yearly..we know we will never be free of the urology department... We are very lucky that this can be done and no cost involved.
My husband does not need BHP not even sure what it is....have just been reading my husbands notes he has a Gleason level 3+3 =6 stage T2b MRI visible focus of 7mm in the sector 5p area adjacent to another 2mm lesion of Gleason 6...his prostate volume is 37cc..this is localised in the right half of the prostate which they say is low grade..But due to the size of the lesion of 7mm they recommended to treat this so we went for the HIFU seemed the best..for us..my husband has been waiting since Feburary to have this done unfortunately this has been delayed as when he was having scans they found a blood clot in his lower lung PE...so he has been on Antigoagulant for 4 months now and out of danger for General Anesthetic ..also Uroligist also put him on Biculmamide 50mg to put the cancer to sleep to not a good year for us think I've mentioned this in previous posts ...so at last 27th it is...and have seen Uroligist today to sign consent forms...so finally light at the end of the tunnel for us..also coz he has been on this cancer drug his psa is very low .37 his base line is only 1.8 anyway ..so after prodecure Uroligist said it will go up but that will be normal...
i hope I haven't bombarded you with science coz these facts and figures freek me out 🤔😬😊
Regards
tom86211 carolyn96211
Posted
BPH refers to Benign Prostate Hyperplasia - or, prostate enlargement without cancer. This is extremely common and is a major topic here. When the prostate enlarges, it restricts urine flow, and this causes infections, pain, and frequent trips to the bathroom, including many trips at night, interrupting sleep.
Back to your husbands situation. If I were in your position (I was, actually), I would ask the urologist if I could order genetic testing on the cancerous tissue. Don't know if this would be covered under your insurance, or if you would have to pay out of pocket.
The suggestion that a Gleason 6 tumor of the amount and size you are describing needs to be treated at this point is controversial. I understand that people would rather be "safe than sorry", but there are side effects to any treatment. It's possible that what your husband has might not need any treatment for a very long time. To treat or not to treat is a debatable topic. As I have mentioned before, once a man has a diagnosis of prostate cancer, they think they have to have it taken care of as fast as possible. However, it all depends on the Gleason grade and the extent and location of the tumors.
If you have absolutely decided to have the HIFU at least you will know that it is, in my opinion, the best current form of treatment for localized, early stage prostate cancer, with no radiation. The catheter is not a big deal.
If I had it all to do over again, and if the genetic testing were available at that time, I would have absolutely gone forward with the testing. That way, I would have known if the cancer was aggressive or not.
Based on the information you have provided, there is an extremely high probability that your husband will have a very favorable outcome.
By the way, 37cc prostate size if fairly normal. If, in the future, it continues to enlarge after the HIFU, then you may be looking into the various treatment options for BPH. My prostate size at the time of treatment was 56cc and was, and still is, causing issues. The HIFU should reduce prostate size somewhat - a good side effect.
Tom
derek76 carolyn96211
Posted
derek76 tom86211
Posted
http://prostatecanceruk.org/prostate-information/our-publications/publications/hifu
http://prostatecanceruk.org/prostate-information/our-publications/publications/localised-prostate-cancer
kenneth1955 carolyn96211
Posted
surfman012 tom86211
Posted
james-98 tom86211
Posted
"The Aquabeam System was shown to have a 100 percent technical success rate, and IPSS scores that improved from 23.1 at baseline to 8.6 at six months in an earlier clinical trial in New Zealand, one of several Phase 1 and Phase 2 studies into its use. Mean prostate size at six months also reduced by 31 percent from baseline, according to study results. Adverse events were described as minimal and transient, and there were no reports of incontinence, or loss of erectile function. The mean procedural time was 48 minutes, with an Ablation treatment time of eight minutes; in a larger trial in Australia and New Zealand, it was reported to be 38 and five minutes, respectively. TURP, in contrast, usually takes between 60 and 90 minutes.
Aquablation is a minimally invasive technique that results in efficient and precise resection of prostate tissue and may lessen the risks and discomfort associated with prostate surgical procedures,” said Dr. Peter Gilling, the trial’s principal co-investigator...."
The countries conducting Phase 3 investigations into Aquablation versus TURP as part of the WATER study are the U.S., Germany, Switzerland, and the United Kingdom in Europe, and Australia and New Zealand.
nealpros james-98
Posted
Neal
US-based medical device firm Procept BioRobotics has started treating patients in its global Phase III clinical trial (WATER study) of the AquaBeam system to treat lower urinary tract symptoms caused by benign prostatic hyperplasia (BPH).
The trial is designed to evaluate the safety and effectiveness of the AquaBeam system compared to the current standard of care, transurethral resection of the prostate (TURP).
The first patient in the trial was treated at Urology Bay of Plenty in Tauranga, New Zealand. The system combines image guidance and robotics to deliver Aquablation, a waterjet ablation therapy that allows targeted, controlled and heat-free removal of tissue to treat lower urinary tract symptoms.
BPH is a common prostate problem that affects more than 50% of men over the age of 50.
Waterjet Ablation Therapy for Endoscopic Resection (WATER) of prostate tissue is a prospective randomised US investigational device exemption (IDE) clinical trial for male patients between the age of 45 and 80 who have urinary symptoms due to BPH.
Tauranga Hospital surgery associate professor Peter Gilling said: "Despite the advances with laser technology, TURP is still the most common procedure worldwide for the treatment of lower urinary tract symptoms.
"The early clinical experience with Aquablation has demonstrated much promise and has evolved into a treatment scalable to hospitals worldwide."
"While it has demonstrated durable results, it does come with certain risks affecting sexual function, ejaculation and incontinence problems.
"The AquaBeam system utilises a heat-free approach and along with the combination of image guidance and robotics has the potential to standardise BPH surgery, reduce the level of complexity required to deliver safe and effective therapy and ultimately improve the quality of life for men suffering from BPH.
"This trial has been designed to evaluate these measures."
Approximately 200 patients in up to 20 global sites, including 12 sites in the US will be enrolled in the trial.
Procept Biorobotics co-founder Nikolai Aljuri said: "The early clinical experience with Aquablation has demonstrated much promise and has evolved into a treatment scalable to hospitals worldwide.
"The initiation of the WATER study is an important step to achieve our goal of providing men suffering from BPH a minimally invasive solution that offers both a sustainable and significant improvement to quality of life and a reduced risk of sexual side effects."
Procept BioRobotics develops new minimally invasive technology to surgically treat prostate disease. The first product developed is the AquaBeam system that allows surgical planning and mapping.
tom86211 james-98
Posted
Thank you for posting this. In my investigation of this technique I found it to be a very promising alternative to TURP or other currently available procedures. It appears to be right up at the top of my maximum effect/minimum downside list.
Tom