the Tulsa Pro procedure
Tulsa Pro is an advanced, minimally invasive prostate cancer treatment that has gained attention for its use of transurethral ultrasound to ablate prostate tissue. By utilizing real-time MRI guidance, it offers precise control over the treatment area, minimizing damage to surrounding healthy tissues. The procedure is designed to reduce the side effects commonly associated with traditional treatments like surgery or radiation.
How Does Tulsa Pro Work?
Tulsa Pro works by inserting a transurethral ultrasound device through the urethra, which emits thermal energy to target and destroy cancerous tissue. The entire procedure is monitored using MRI imaging, allowing for real-time adjustments and enhanced accuracy. This method minimizes the need for external incisions, reducing recovery time and improving the patient experience.
Tulsa Pro Compared to Traditional Treatments
Compared to traditional treatments such as surgery (prostatectomy) or radiation therapy, Tulsa Pro offers several advantages:
- Reduced Side Effects: Patients treated with Tulsa Pro typically experience fewer side effects, such as incontinence or erectile dysfunction, compared to those who undergo surgery or radiation therapy.
- Minimally Invasive: No incisions are required, which reduces recovery time and the risk of complications.
- Precision: Real-time MRI guidance helps ensure that only cancerous tissue is targeted, sparing healthy surrounding tissue.
Tulsa Pro vs. Sonablate HIFU (High Intensity Frequency Ultrasound)
Tulsa Pro and Sonablate HIFU (High-Intensity Focused Ultrasound) both use ultrasound to treat prostate cancer, but their delivery methods differ significantly:
- Delivery Method: Tulsa Pro uses transurethral ultrasound, delivered from within the body, while Sonablate HIFU delivers focused ultrasound externally through the rectal wall.
- Imaging: Tulsa Pro benefits from continuous MRI guidance, offering real-time feedback to ensure accuracy. HIFU does not use MRI, relying on ultrasound imaging alone, which may limit its precision.
- Patient Experience: Both treatments aim to reduce side effects, though the real-time control offered by Tulsa Pro may offer a greater degree of safety when working near sensitive structures like nerves and blood vessels.
Side Effects and Disadvantages of the Tulsa Procedure
While Tulsa Pro offers a minimally invasive treatment option, it does come with certain limitations and potential drawbacks. The transurethral approach, where the device is inserted through the urethra, can make it difficult to reach cancer located in the outer zones of the prostate. This restricted access can lead to incomplete treatment in more complex cases where tumors are positioned near the periphery of the gland.
Additionally, Tulsa Pro relies on thermal energy to destroy cancer cells, which introduces the risk of thermal damage to surrounding tissues. This can potentially affect critical structures such as nerves and blood vessels, increasing the chances of side effects like urinary incontinence and erectile dysfunction.
Another limitation of Tulsa Pro is its reduced potential for triggering abscopal effects—where treatment in one area can stimulate an immune response to cancer cells in other parts of the body. Because the procedure uses heat, it denatures proteins in the treated tissue, reducing the likelihood of an immune reaction. This limits Tulsa’s effectiveness in combination with immunotherapy, as it may not provoke a strong enough systemic immune response to target metastatic or residual cancer cells.
Tulsa Pro vs. Other minimally invasive focal therapies
Tulsa Pro is often compared to other minimally invasive focal therapies for prostate cancer, many of which have been available for some time. Procedures like cryoablation, which uses extreme cold to destroy cancer cells, and high-intensity focused ultrasound (HIFU), which uses focused sound waves, offer similar benefits in terms of targeting prostate cancer without requiring major surgery. Cryoablation, in particular, has shown success in selectively freezing and killing cancerous tissue, while preserving healthy surrounding structures. Electroporation-based methods, such as Irreversible Electroporation (IRE), go a step further by using electrical pulses to destroy cancer cells without relying on thermal energy, minimizing collateral damage even more effectively than cryoablation or HIFU. When considering these established focal therapies, Tulsa Pro appears comparable in its minimally invasive nature, but other options like IRE may provide enhanced safety and precision in certain cases, especially near sensitive structures.
Why Vitus Privatklinik Does Not Offer Tulsa Pro
At Vitus Privatklinik, we pride ourselves on being early adopters of cutting-edge technologies that we believe can benefit our patients. We offer a wide range of innovative treatments, including irreversible electroporation, electrochemotherapy, and immunotherapy. Our goal is always to stay at the forefront of medical advancements, ensuring that our patients have access to the best possible care.
However, despite its technological appeal, we have made the decision not to include Tulsa Pro in our treatment options. While we regularly embrace new technologies, such as electroporation-based therapies, we see Tulsa Pro as a step in the wrong direction. Tulsa Pro’s reliance on thermal energy presents risks that can be avoided with non-thermal options like IRE, which offer greater precision and fewer side effects. Additionally, while Tulsa Pro has certain advantages over traditional treatments, the fact that superior alternatives like IRE already exist makes us question its long-term value in prostate cancer treatment.
Some of the technologies we use and when we adopted them:
- Irreversible Electroporation: adopted very early and in exchange with the inventor of the method
- Electrochemotherapy (ECT): a well-established technology that we’ve uniquely innovated for prostate cancer treatment, offered exclusively at our clinic
- Immunotherapy: as soon as Pembrolizumab was approved we saw its potential and began using it to improve our patient’s outlook. Additionally, we keep experimenting with different combinations of immunotherapy, optimizing for faster and stronger responses in our patients
Our Approach to Innovation
We are committed to adopting the best, most effective treatments for our patients. Technologies like Nanoknife (Irreversible Electroporation or IRE) have already proven to be superior for many reasons, including greater precision and fewer side effects. While Tulsa Pro offers improvements over older treatments, it still relies on thermal energy, which can have unintended consequences, especially in sensitive areas of the body.
A Step Backward?
The question arises: why was Tulsa Pro developed when non-thermal methods like IRE already exist and are arguably more effective? The answer may lie in the complexities of the medical industry.
One possibility is financial motivation. Patents and proprietary technologies are valuable assets in the medical field. Tulsa Pro, developed by a different group of companies than those behind IRE, represents a new, patentable technology that can be marketed and monetized. It’s not uncommon for new treatments to emerge even when superior alternatives already exist, driven by business interests rather than purely medical advancements.
Additionally, Tulsa Pro may have been developed to cater to a specific segment of the medical market that prefers thermal ablation techniques. However, from a clinical standpoint, non-thermal methods like IRE are often safer and more versatile, especially for tumors located near critical structures such as nerves and blood vessels.
Why Electroporation-Based Therapies Like IRE Nanoknife Are Superior to Tulsa
While Tulsa Pro offers some advantages, electroporation-based therapies like IRE (Nanoknife) are often the better choice for many patients. Here’s why:
Non-Thermal Precision: IRE does not rely on thermal energy, making it ideal for treating tumors in sensitive areas. The electrical pulses used in IRE create tiny pores in the cancer cell membranes, leading to cell death without causing heat-related damage to surrounding tissues.
Minimal Side Effects: Because IRE is non-thermal, it significantly reduces the risk of damaging nearby nerves, blood vessels, and other critical structures. This means fewer complications such as incontinence and erectile dysfunction, which are common concerns for men undergoing prostate cancer treatment.
Repeatability: Unlike thermal methods, IRE can be safely repeated if necessary. This makes it a more flexible option for patients with recurrent prostate cancer or tumors located in difficult-to-reach areas.
Greater Versatility: IRE is especially effective in treating prostate cancer that has spread to sensitive areas. Its non-thermal nature allows for precise targeting, minimizing the risk of collateral damage.
Which prostate cancer treatment should i choose?
At Vitus Privatklinik, we believe deeply in the effectiveness of the treatments we offer and the impact we’re making on patients’ lives. We’re proud to be at the forefront of medical innovation, providing cutting-edge therapies. If your choice is between a traditional treatment like surgery or radiation and Tulsa Pro, we would recommend Tulsa for its minimally invasive approach and reduced side effects. However, if you’re choosing between Tulsa and an electroporation-based method, such as IRE, the answer is clear: electroporation offers a more refined, precise, and proven approach. Our electroporation techniques have been developed and improved over years, and they’re particularly suited for complex and advanced cases. With the expertise and tools unique to our clinic, we provide treatments unmatched elsewhere.