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References

Patient Stories

W. from Hanover

“Look at the guidelines.” Those were the words of my then urologist when I asked him about alternatives to prostatectomy, which he recommended as virtually no alternative after he diagnosed me, at age 49, with a prostate tumor (Gleason score 7a at PSA 3.86; 2 of his 12 punctures positive) in June 2016.

However, I was very afraid of the possible side effects (NW) such as possible incontinence, erectile dysfunction in at least 60% of all patients even years after the operation, as well as the complete loss of ejaculation – i.e. a future only so-called “dry orgasm”. As I had a “dry orgasm” in the future – and in the guidelines as alternatives to the complete ectomy only the active monitoring (I was too young for that) as well as the radiation therapy (8 weeks treatment with strict diet as well as mostly NW on the rectum otherwise likewise the NW as with the ectomy) are indicated, I began to investigate myself after other remedial methods. As a result, IRE treatment seemed to me the most promising and by far the least NW.

Biopsy at the Prostate Center then revealed a single positive specimen (Gleason 7a) from 50 punctures. The former urologist had apparently shot the same nest twice during his punctures.

Then, at the end of October 2016, the IRE surgery by Dr. Zapf and Dr. El Idrissi, which was completely painless and then accommodation for the following night in the clinic. In the afternoon, Dr. El Idrissi made a visit – everything was ok; only the unavoidable bladder catheter, which was inserted during the operation, pressed a little on the bladder floor. 30 hours after the IRE surgery, I was already on the train on the way back (3h) home. The bladder catheter was removed after 11 days by my new urologist (changed my urologist before the IRE surgery), and with the removal of the catheter also abruptly disappeared the slightly uncomfortable feeling when sitting or walking, which one feels when the catheter balloon presses lightly on the bladder floor. But it is bearable.

I did not experience any incontinence problems at all. Already 5 weeks after the surgery I managed to get an erection again. After about two to three months, the ejaculate was also completely free of old blood, which came from the wound in the prostate. Likewise, after three months, completely normal and satisfying sex was possible again, even if the ejaculate now consists mainly of prostate secretion, and the sperm density for childbearing may no longer be sufficient – you just can’t have everything.

Conclusion: After now one year after the IRE treatment, all urological functions (urination, erection, ejaculation with the above mentioned) work completely without any problems, my PSA level is 1.0 and all post-op MRIs did not show any pathological changes. So everything top! My express thanks here to Dr. Zapf and Dr. El Idrissi for the very successful treatment and the aftercare consultations with e.g. dietary recommendations, sports recommendations etc. In addition, I am of course very grateful to Prof. Dr. Stehling and again to Dr. Zapf for their pioneering work in the field of IRE in general.

The only downer of the entire treatment is the fact that my private health insurance company (DKV), pointing out that IRE treatment was not in the guidelines, did not reimburse a single cent of all IRE costs (for the IRE treatment itself as well as 3D biopsy and all pre- and post-op MRIs), and I had to bear all treatment costs myself.

In addition to sufficient medical indications, it is therefore urgently recommended to have something on the side for IRE treatment, because for financial policy reasons alone, it will probably be several years before IRE is included in the guidelines.

Michael

Last week was November 2, 2017, All Souls’ Day!

Exactly 5 years before, on that very day, I received the diagnosis “prostate cancer” in Vienna, and also the urgent admonition of my urologist to take the “royal road”! What was meant was to have the prostate radical removed, just to avoid the “high risk of metastases due to my youth” (46 at the time)……

It’s funny how you remember some dates, but the diagnosis of cancer hit me deep in the core!

Unfortunately, people only really appreciate many things when they have lost them or when the loss is imminent.

I have appreciated countless times over the past 5 years that I can exercise without having droplets in my pants, that I don’t have to wear “inserts”, drink a few beers without having to run to the bathroom right away, pee standing up and stop the stream as it suits me!

Yes, and I have “appreciated” uncounted orgasms and ejaculations, more appreciated than in all the many years before!!!

Forgive me for the blunt and prosaic language, I enjoy it all now, before it was just taken for granted.

My PSA value is stable at around 1.25. When I go for a screening today, the doctors don’t even realize that I had cancer. I admit that it amuses me when they want to do a palpation exam.

I still visit the urologist from back then occasionally, not because I expect anything from him, but just to demonstrate to him that IRE is a real and successful gentle treatment. He had strongly advised me against it 5 years ago!

That IRE that got me back from a cancer diagnosis on March 26, 2013. This date is also deeply etched in my memory, almost like my birthday. It was and still is a miracle for me!

To this day, I am grateful to Professor Stehling and his great team every time I live and act as a man as a matter of course – as stated above….

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A patient from Berlin

In mid-2016, I was successfully treated for a prostate carcinoma at the Prostate Center Offenbach / Main, using IRE, without any side effects.

I had decided on this new treatment method after my previous urologist in Berlin had advised me to have my prostate radically removed, but I was not particularly happy with this “solution”.

From the very first personal contacts with PC staff, I felt a firm confidence in the treatment path proposed to me.

The entire team of Prof. Dr. Stehling is characterized, in addition to the highest professional competence, above all by a high readiness to provide information on all questions, the consideration of personal appointments and, in particular, a respectful, always friendly and courteous treatment, combined with close medical support, of the patient.

A preliminary 3-D biopsy, which I was strongly advised to perform by the treating urologist, Dr. El Idrissi, then revealed further areas of treatment for complete tumor destruction.

All medical treatments and radiological follow-up examinations carried out on me at the Institute for Imaging Diagnostics so far have been optimized in their implementation to a particularly low personal stress potential, perfectly and reliably organized in terms of scheduling (also with service providers and medical contract partners) and always gave me the feeling of being in “good hands”.

I would like to take this opportunity to thank the entire team at the Offenbach Prostate Center at the Institute for Imaging Diagnostics for the successful therapy I received and the resulting gain in quality of life, and I would also like to recommend it to others.

Michael Kirchsteiger

Quote: “…In the first period after the procedure (meaning the radical removal of the prostate) you will not miss the potency at all, because you will have enough to do with incontinence…” With this explanation, which I received verbatim, my urologist in Vienna tried to allay my concerns about the recommended “royal road”, which obviously, and from today’s perspective thank God, did not succeed. This was on November 2, 2012, All Souls’ Day in Catholic Austria, how appropriate for the diagnosis of prostate cancer.

This was preceded by two years of PSA checks, the value was constant around 4.5, and a “classic biopsy” that indicated prostate carcinoma on 3 of 10 samples with Gleason score 3+3.

So, at 47, I had the choice to continue living as an incontinent monk, or to die in a few years covered with metastases. This was the unanimous opinion of alternatively consulted physicians and the self-help group for prostate cancer patients in Vienna.

All the medicine available in Vienna – which likes to classify itself as world-class, albeit expensive – had no answer to the question of whether there might not be a more gentle, i.e. organ-preserving, method. Because of my “young” age and the expected rapid cell growth, I was told that rapid radical removal was absolutely advisable. All gentle methods would have dramatic side effects, however, only radiation and chemotherapy, were known.

After I myself had come across the Prostate Center via the Internet, and I had read as much as possible about the offered IRE method, a little hope awoke in me again for the first time. In the meantime, Christmas 2012 had arrived. Instead of the already assigned radical removal, I decided to have the initial examination performed at Prof. Stehling’s institute.

The result is that today, after 3D biopsy and IRE performed in March 2013, I am writing this review with a PSA of 1.29 with no significant side effects, a whole man, and no urological system limitations.

Overall, I can only say that from the first telephone inquiry at the Prostate Center, through all examinations and treatment steps, to the follow-up, every step was well explained, the care was extraordinarily professional and at the same time humanly very empathetic. After all, this disease is psychologically difficult for a man to cope with.

The public health insurance company refuses to reimburse the costs, arguing that an equivalent(!) therapy is available in Austria for the diagnosis of prostate carcinoma with radical removal. My arguments that radical removal with surgery, the likelihood of complications, hospitalization, and rehab would result in more costs and loss of contributions were not accepted. The reference to the EU Patient Directive, according to which the patient can choose the doctor within the EU, was also ignored. Currently, my supplemental insurance is reviewing the case. I may take further legal action to get the costs reimbursed. My impression was and is that in Austria only the existing instruments and methods are to be utilized to capacity, and not the interest of the patient is the focus.

Of course, I am aware that IRE is currently still considered an “experimental method”, but so were all modern, now established therapies at the beginning, even with radical removal there is a high residual risk and dramatic side effects.

I am confident that the next PSA test will confirm the success of the IRE. At least I have gained time for the time being!

Finally, another quote from my urologist after I showed him my PSA result AFTER the IRE “…this method (meaning IRE) is unknown in Austria, probably for good reason….” ?

For me, what remains is a great relief to have saved the prostate for the time being, an equally great gratitude for the team at the Prostate Center for the professional and humanly empathetic treatment and care, the hope that the success will continue as it currently looks, and a slight distress at the quality and ignorance of Austrian medicine and social insurance.