Sperling Prostate Center

Promising News About TULSA Treatment for Prostate Cancer

Question: What do you get when you cross prostate cancer doctors (urologists) with cancer doctors (oncologists)?

Answer: You get the Society of Urologic Oncology (SUO). Its organization and bylaws had been established in May, 1984 but the founding officers who were elected did not begin their terms until 1985. As described in its history, some of the new organization’s objectives included bringing together “like-minded urologists with special interest in oncology, to fulfill an educational mission in this area, to identify opportunities to participate in research protocols…”

As with all medical societies, annual meetings bring opportunities to present the latest research to peers such as clinical urologists, radiation and medical oncologists, surgeons and fellow scientists. The SUO’s 24th Annual Meeting (Washington, D.C., Nov. 28 – Dec. 1) featured an important paper on Transurethral Ultrasound Ablation of the Prostate (TULSA-PRO), a customizable treatment for localized prostate cancer that does not involve incisions or radiation. Because the ultrasound tissue destruction is delivered via the urethra (urination passage from the bladder through the prostate to the penis) it’s often called an inside-out ablation method. When the treatment is planned, guided, monitored, and confirmed by real time 3T MRI, as we offer at the Sperling Prostate Center, it is highly precise.

The mutli-center study presented at the SUO meeting brought good news about TULSA. It reported the results to date of a study called TACT (Pivotal Study of MRI-guided Transurethral Ultrasound Ablation in Patients With Localized Prostate Cancer), which had enrolled 115 patients at 13 international centers.[i] At baseline, the average enrollee PSA was 6.3 ng/mL, and 72 had greater than or equal to Grade Group (GG) 2 disease.


All patients received whole gland (not focal) ablation, and underwent MRI and 10-core biopsy at 1 year following treatment. Patients were followed for up to 5 years. At 1 year, 85% of patients were free of ≥GG2 disease. At 5 years, 21.7% underwent salvage treatment for recurrence without unexpected complications. (It was noted that treatment failure was linked with 1-year MRI showing visible lesion and/or high PSA. The investigators postulated that treatment failure was caused by undertreatment due to patient selection or targeting error.)

The study concluded, “Effective disease control is durable to 5 years after a single TULSA procedure, with a favorable safety profile. Favorable preservation of genitourinary quality of life is also durable to 5 years.” Of particular interest, the study pointed out that during the study period, the procedure itself has improved. More recent protocols include better screening for prostate calcifications that can interfere with treatment effectiveness, better device positioning strategies, and the ability to increase target temperatures for lesions visible on MRI during the procedure.

Are you a candidate for TULSA-PRO?

Request your free consultation with Dr. Sperling and we’ll review your unique circumstances together to see if TULSA-PRO Ablation is right for you.

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NOTE: This content is solely for purposes of information and does not substitute for diagnostic or medical advice. Talk to your doctor if you are experiencing pelvic pain, or have any other health concerns or questions of a personal medical nature.

[i] Pivotal study of MRI-guided transurethral ultrasound ablation (TULSA) of localized prostate cancer: 5-year follow up. Poster #197 presented Dec. 1 by Scott Eggener, MD at the 24th annual SUO meeting (Washington, DC Nov. 28-Dec. 1). https://suo-abstracts.secure-platform.com/a/gallery/rounds/18/details/3269


About Dr. Dan Sperling

Dan Sperling, MD, DABR, is a board certified radiologist who is globally recognized as a leader in multiparametric MRI for the detection and diagnosis of a range of disease conditions. As Medical Director of the Sperling Prostate Center, Sperling Medical Group and Sperling Neurosurgery Associates, he and his team are on the leading edge of significant change in medical practice. He is the co-author of the new patient book Redefining Prostate Cancer, and is a contributing author on over 25 published studies. For more information, contact the Sperling Prostate Center.

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