Less than three years ago, a multidisciplinary team of Yale urologists and radiologists joined an elite group. They became one of only a few centers in the country that offer the TULSA procedure to patients with prostate cancer. The group had been the first, nationally, to provide the service in a clinical trial and non-trial setting [in collaboration with Yale Cancer Center and Smilow Cancer Hospital].
This week, the Yale team performed its 50th case.
“We are excited to have reached this milestone,” says Preston Sprenkle, MD, associate professor of urology. “The program has been building, and we are more consistently and frequently doing cases. We’ve found it’s a good option for our patients and have had good outcomes.”
TULSA stands for transurethral ultrasound ablation of the prostate. It is a procedure performed on patients who have an intermediate risk prostate cancer.
Jessica Lee, MD, assistant professor at Yale of radiology & biomedical imaging, says the TULSA procedure is a way to treat minimally invasive cancer without incisions under real-time MRI [magnetic resonance imaging] guidance.
“We are so excited to perform our 50th case,” says Lee. “We are one of the few centers that offer this treatment, and we truly appreciate the resources and support which have enabled us to provide this service to patients.”
Those who have undergone the TULSA procedure have been carefully selected, says Sandeep Arora, MBBS, associate professor of radiology & biomedical imaging.
“We don’t do it on everyone, and we have other options for minimally invasive procedures,” says Arora. “We [Dr. Sprenkle and I] look at the MRI together and decide the best possible next steps.”
Being one of the first and most experienced medical centers performing the procedure has real-time benefits for both the patient and procedural progress. Sprenkle says the team has been making technical improvements with device manufacturers.
“We have been doing the procedure much faster as we have gained institutional experience and improved the software.”
“We have also done innovations like separation of the rectum and prostate with a spacer, and we have done a treatment with fiducial markers in place. Only two or three other sites worldwide have done that,” Arora adds.
The goal of the TULSA procedure is to allow patients to have their prostate cancer treated while avoiding some of the side effects and potential complications from more invasive treatments, says Lee.
“The procedure has the ability to get rid of all the patient’s significant prostate cancer while having the least impact on urinary function, sexual function ... In some men, it may even improve their urinary function,” says Sprenkle.