WEBVTT

NOTE duration: "00:04:08.405"


NOTE Confidence: 0.9297241

00:00:04.640 --> 00:00:06.960
So ablation is using energy

NOTE Confidence: 0.9297241

00:00:06.960 --> 00:00:08.420
of some form to destroy

NOTE Confidence: 0.95168734

00:00:08.880 --> 00:00:10.639
tissue. In this case, we're

NOTE Confidence: 0.95168734

00:00:10.639 --> 00:00:12.400
talking about prostate ablation, so

NOTE Confidence: 0.95168734

00:00:12.400 --> 00:00:14.080
we use different types of

NOTE Confidence: 0.95168734

00:00:14.080 --> 00:00:16.195
energy. Could be heat, cold.

NOTE Confidence: 0.95168734

00:00:16.195 --> 00:00:17.795
We actually use electricity as

NOTE Confidence: 0.95168734

00:00:17.795 --> 00:00:19.895
well to destroy prostate tissue,

NOTE Confidence: 0.95168734

00:00:19.954 --> 00:00:21.575
usually prostate cancer.

NOTE Confidence: 0.9911133

00:00:21.954 --> 00:00:24.295
Because we use imaging guidance,

NOTE Confidence: 0.9836426

00:00:24.595 --> 00:00:25.954
we're able to place the

NOTE Confidence: 0.9836426

00:00:25.954 --> 00:00:27.570
probes or target the tissue

NOTE Confidence: 0.9845378

00:00:28.130 --> 00:00:29.810
in a very precise manner

NOTE Confidence: 0.9845378

00:00:29.810 --> 00:00:30.310
and

NOTE Confidence: 0.9691162

00:00:30.610 --> 00:00:32.450
destroy only the tumor and

NOTE Confidence: 0.9691162

00:00:32.450 --> 00:00:33.829
the surrounding tissue,

NOTE Confidence: 0.99912107

00:00:34.130 --> 00:00:35.670
but we're able to spare

NOTE Confidence: 0.99957275

00:00:35.970 --> 00:00:37.729
other structures that we don't

NOTE Confidence: 0.99957275

00:00:37.729 --> 00:00:38.629
want to damage.

NOTE Confidence: 0.96990603

00:00:39.170 --> 00:00:41.170
This is in contrast to

NOTE Confidence: 0.96990603

00:00:41.170 --> 00:00:43.475
whole prostate therapies like prostatectomy

NOTE Confidence: 0.96990603

00:00:43.695 --> 00:00:44.735
or surgery where we are

NOTE Confidence: 0.96990603

00:00:44.735 --> 00:00:46.895
removing the entire prostate or

NOTE Confidence: 0.96990603

00:00:46.895 --> 00:00:48.735
radiation therapy which is traditionally

NOTE Confidence: 0.96990603

00:00:48.735 --> 00:00:50.175
done to the entire prostate

NOTE Confidence: 0.96990603

00:00:50.175 --> 00:00:51.375
with a margin of treatment

NOTE Confidence: 0.96990603

00:00:51.375 --> 00:00:52.915
even outside the prostate.

NOTE Confidence: 0.95564777

00:00:53.855 --> 00:00:55.615
So doing a subtotal treatment

NOTE Confidence: 0.95564777

00:00:55.615 --> 00:00:56.575
where we are able to

NOTE Confidence: 0.95564777

00:00:56.575 --> 00:00:57.715
target the

NOTE Confidence: 0.984375

00:00:58.095 --> 00:01:00.079
prostate cancer primarily

NOTE Confidence: 0.9506836

00:01:00.460 --> 00:01:02.059
with a safety margin around

NOTE Confidence: 0.9506836

00:01:02.059 --> 00:01:02.559
that

NOTE Confidence: 0.9576518

00:01:03.020 --> 00:01:05.180
really allows for preservation of

NOTE Confidence: 0.9576518

00:01:05.180 --> 00:01:07.259
function or the least possible

NOTE Confidence: 0.9576518

00:01:07.259 --> 00:01:09.500
damage to a man's urinary

NOTE Confidence: 0.9576518

00:01:09.500 --> 00:01:11.659
function, sexual function, bowel function

NOTE Confidence: 0.9576518

00:01:11.659 --> 00:01:13.155
that we can achieve,

NOTE Confidence: 0.9970703

00:01:13.935 --> 00:01:15.395
with a prostate cancer treatment.

NOTE Confidence: 0.95125324

00:01:19.215 --> 00:01:21.454
The three different technologies that

NOTE Confidence: 0.95125324

00:01:21.454 --> 00:01:23.075
we have currently at Yale

NOTE Confidence: 0.95125324

00:01:23.295 --> 00:01:24.354
are Tulsa,

NOTE Confidence: 0.9995117

00:01:24.655 --> 00:01:25.475
which uses

NOTE Confidence: 0.99794924

00:01:25.935 --> 00:01:28.390
high intensity ultrasound waves. We're

NOTE Confidence: 0.99794924

00:01:28.390 --> 00:01:29.750
able to heat the prostate

NOTE Confidence: 0.99794924

00:01:29.750 --> 00:01:31.770
tissue from the inside out.

NOTE Confidence: 0.9838867

00:01:32.310 --> 00:01:32.810
Cryoablation

NOTE Confidence: 0.9835069

00:01:33.110 --> 00:01:34.149
is sort of the opposite.

NOTE Confidence: 0.9835069

00:01:34.149 --> 00:01:35.770
It uses cold energy

NOTE Confidence: 0.97075194

00:01:36.069 --> 00:01:37.850
to similarly destroy the cells.

NOTE Confidence: 0.9214003

00:01:38.390 --> 00:01:40.805
And then IRE or Irreversible

NOTE Confidence: 0.9214003

00:01:40.865 --> 00:01:41.365
Electroporation

NOTE Confidence: 0.929362

00:01:41.825 --> 00:01:43.905
uses electricity, and it actually

NOTE Confidence: 0.929362

00:01:43.905 --> 00:01:45.825
passes electricity between a couple

NOTE Confidence: 0.929362

00:01:45.825 --> 00:01:46.645
small needles,

NOTE Confidence: 0.99853516

00:01:46.944 --> 00:01:47.685
and that

NOTE Confidence: 0.9779297

00:01:48.065 --> 00:01:49.825
results in cell lysis or

NOTE Confidence: 0.9779297

00:01:49.825 --> 00:01:51.205
the death of the cells.

NOTE Confidence: 0.9386719

00:01:52.385 --> 00:01:54.225
There are highlights to each

NOTE Confidence: 0.9386719

00:01:54.225 --> 00:01:55.550
of these. These. Right? Tulsa

NOTE Confidence: 0.9320183

00:01:56.250 --> 00:01:58.430
probably of any ablation technology

NOTE Confidence: 0.9320183

00:01:58.490 --> 00:02:00.010
out there currently has the

NOTE Confidence: 0.9320183

00:02:00.010 --> 00:02:02.810
best treatment planning, treatment monitoring

NOTE Confidence: 0.9320183

00:02:02.810 --> 00:02:04.350
in real time and ability.

NOTE Confidence: 0.9320183

00:02:04.410 --> 00:02:06.010
To target certain areas of

NOTE Confidence: 0.9320183

00:02:06.010 --> 00:02:07.930
the prostate avoiding damage to

NOTE Confidence: 0.9320183

00:02:07.930 --> 00:02:08.794
other areas,

NOTE Confidence: 0.9980469

00:02:09.255 --> 00:02:11.115
and effectively treat cancer.

NOTE Confidence: 0.9123047

00:02:11.974 --> 00:02:12.474
Cryoablation,

NOTE Confidence: 0.91484374

00:02:12.775 --> 00:02:14.474
we know, is very effective,

NOTE Confidence: 0.99209255

00:02:14.775 --> 00:02:16.294
and it can be used

NOTE Confidence: 0.99209255

00:02:16.294 --> 00:02:18.215
in certain anatomical locations more

NOTE Confidence: 0.99209255

00:02:18.215 --> 00:02:19.735
easily than others and can

NOTE Confidence: 0.99209255

00:02:19.735 --> 00:02:20.555
be done quickly.

NOTE Confidence: 0.9431966

00:02:20.935 --> 00:02:21.780
And then IRE

NOTE Confidence: 0.9945623

00:02:22.580 --> 00:02:23.620
for people that are very

NOTE Confidence: 0.9945623

00:02:23.620 --> 00:02:25.800
concerned about preserving their erectile

NOTE Confidence: 0.9945623

00:02:25.860 --> 00:02:26.360
function,

NOTE Confidence: 0.9990777

00:02:27.060 --> 00:02:28.260
it seems to have the

NOTE Confidence: 0.9990777

00:02:28.260 --> 00:02:29.720
least impact on that.

NOTE Confidence: 0.9969554

00:02:30.100 --> 00:02:30.980
So those are kind of

NOTE Confidence: 0.9969554

00:02:30.980 --> 00:02:33.139
the highlights that allow us

NOTE Confidence: 0.9969554

00:02:33.139 --> 00:02:35.060
to really provide the top

NOTE Confidence: 0.9969554

00:02:35.060 --> 00:02:35.865
level care.

NOTE Confidence: 0.9943305

00:02:37.385 --> 00:02:39.485
At Yale, we understand that

NOTE Confidence: 0.9943305

00:02:39.705 --> 00:02:41.645
prostate cancer treatment options

NOTE Confidence: 0.99943036

00:02:42.025 --> 00:02:43.465
should be individualized to a

NOTE Confidence: 0.99943036

00:02:43.465 --> 00:02:43.965
patient.

NOTE Confidence: 0.9994507

00:02:44.745 --> 00:02:46.585
It's always really important to

NOTE Confidence: 0.9994507

00:02:46.585 --> 00:02:47.645
take into consideration

NOTE Confidence: 0.9891036

00:02:48.500 --> 00:02:49.700
factors that contribute to a

NOTE Confidence: 0.9891036

00:02:49.700 --> 00:02:51.959
patient's prostate cancer risk. But

NOTE Confidence: 0.9891036

00:02:52.180 --> 00:02:53.780
it's also really important to

NOTE Confidence: 0.9891036

00:02:53.780 --> 00:02:55.639
take into account their

NOTE Confidence: 0.994751

00:02:55.940 --> 00:02:56.919
personal preferences,

NOTE Confidence: 0.9427083

00:02:57.380 --> 00:02:58.760
their individual anatomy,

NOTE Confidence: 0.9965123

00:02:59.459 --> 00:03:00.915
and being able to offer

NOTE Confidence: 0.9965123

00:03:01.155 --> 00:03:01.894
this treatment,

NOTE Confidence: 0.99083114

00:03:02.754 --> 00:03:04.775
to patients who have intermediate

NOTE Confidence: 0.99083114

00:03:04.915 --> 00:03:07.094
risk prostate cancer and

NOTE Confidence: 0.9796875

00:03:07.555 --> 00:03:09.555
wish to avoid surgery or

NOTE Confidence: 0.9796875

00:03:09.555 --> 00:03:11.655
radiation, but also are uncomfortable

NOTE Confidence: 1

00:03:12.114 --> 00:03:12.614
with

NOTE Confidence: 0.9626872

00:03:12.915 --> 00:03:14.694
just being on active surveillance

NOTE Confidence: 0.9626872

00:03:14.915 --> 00:03:15.415
alone.

NOTE Confidence: 0.99350876

00:03:15.730 --> 00:03:17.170
This is an important treatment

NOTE Confidence: 0.99350876

00:03:17.170 --> 00:03:18.950
option that fills a gap.

NOTE Confidence: 0.99350876

00:03:19.010 --> 00:03:20.290
We know that ablation therapies

NOTE Confidence: 0.99350876

00:03:20.290 --> 00:03:20.950
are safe.

NOTE Confidence: 0.9932129

00:03:21.970 --> 00:03:23.350
They are not without risks,

NOTE Confidence: 0.9223966

00:03:23.730 --> 00:03:24.930
but they are safe, and

NOTE Confidence: 0.9223966

00:03:24.930 --> 00:03:26.930
on average have fewer side

NOTE Confidence: 0.9223966

00:03:26.930 --> 00:03:27.430
effects

NOTE Confidence: 0.9969799

00:03:27.970 --> 00:03:28.930
than we would see with

NOTE Confidence: 0.9969799

00:03:28.930 --> 00:03:30.390
surgery or see with radiation.

NOTE Confidence: 0.9969799

00:03:30.514 --> 00:03:31.474
We know from a couple

NOTE Confidence: 0.9969799

00:03:31.474 --> 00:03:33.474
of trials that we actually

NOTE Confidence: 0.9969799

00:03:33.474 --> 00:03:34.834
have been involved in here

NOTE Confidence: 0.9969799

00:03:34.834 --> 00:03:35.495
at Yale

NOTE Confidence: 0.90631974

00:03:35.795 --> 00:03:37.474
that this treatment is in

NOTE Confidence: 0.90631974

00:03:37.474 --> 00:03:38.614
fact effective

NOTE Confidence: 0.9938534

00:03:38.915 --> 00:03:40.995
at cancer control and also

NOTE Confidence: 0.9938534

00:03:40.995 --> 00:03:42.930
effective at avoiding or lowering

NOTE Confidence: 0.9938534

00:03:42.930 --> 00:03:44.530
risk of urinary and sexual

NOTE Confidence: 0.9938534

00:03:44.530 --> 00:03:45.270
side effects.

NOTE Confidence: 0.9973958

00:03:45.730 --> 00:03:47.190
I think it provides patients

NOTE Confidence: 0.9973958

00:03:47.330 --> 00:03:47.830
who

NOTE Confidence: 0.9995117

00:03:48.930 --> 00:03:49.830
are motivated

NOTE Confidence: 0.95292157

00:03:50.450 --> 00:03:52.050
to maintain their quality of

NOTE Confidence: 0.95292157

00:03:52.050 --> 00:03:52.550
life,

NOTE Confidence: 0.9877116

00:03:53.489 --> 00:03:55.410
an opportunity to pursue therapies

NOTE Confidence: 0.9877116

00:03:55.410 --> 00:03:56.550
that are not as damaging

NOTE Confidence: 0.9877116

00:03:56.849 --> 00:03:57.975
to their,

NOTE Confidence: 0.9733538

00:03:58.695 --> 00:04:00.215
way of life and often

NOTE Confidence: 0.9733538

00:04:00.215 --> 00:04:01.115
their psychological

NOTE Confidence: 0.99934894

00:04:01.655 --> 00:04:02.555
sense of self.