CancerCompass message board discussion started by smayuran on 2/23/2008 http://www.cancercompass.com/message-board/message/all,21238,0.htm Tue, 07 Oct 2008 00:00:00 GMT Tue, 07 Oct 2008 00:00:00 GMT http://backend.userland.com/rss RSS.NET: http://www.rssdotnet.com/ Hello,My dad was diagnosed with early stage Prostate Cancer a couple of weeks ago (Gleason score 3a+3a, PSA 11.1, size of prostate 35cc weight 37g, cancer type Adeno Carcinoma Small Acinar, age 65).I've just started my research on the subject & have reviewed options such as the Da Vinci robotic surgery, but get the impression that HIFU Ablatherm is probably the best option for treatment. I'd appreciate it if patients or anyone else could give me some better insight about the HIFU treatment. I've listed some questions below, but please do let me know about any other details you consider useful as well:1) Feedback from anyone who actually did the HIFU, any complications/issues you ran into, any positives or your experience.2) Place of treatment & costs.Has anyone done the HIFU treatment in the Philippines? What was your experience & impression of the expertise there?The URL link below states that the HIFU treatment costs about US $10,000 in Philippines & I also found that it would cost about US $25,000 in Canada.http://www.philippinecentersf.com/trade/trade_news_medservic 3) How much does experience or number of operations performed matter for HIFU? Is it a more automated procedure where experience is not a critical or important factor as it is for a surgical treatment option?4) Difference between HIFU Ablatherm & Sonablate 500 treatments.Thank you,Mayuran smayuran Sat, 23 Feb 2008 00:00:00 GMT HIFU is done all over the world, except the United States where it is done only on an investigational basis. I am familiar with the Sonablate 500, and have seen the Ablatherm in action. Both will likely give similar results. The Sonablate is more compact and more portable. The Sonablate has a color Doppler ultrasound built in so that the neurovascular bundles can be identified, and you can treat around them. Experience does count with the treatments as a large amount of the treatment time involves appropriate programming of what to treat. Being able to "read" the ultrasound image is of utmost importance, as well as positoning the prostate adequately, power setting, etc. As far as locations is concerned, I am familiar with Cancun, Puerto Vallarta and Nassau. The hospitals are clean, the water is safe, and you will have an American surgeon as well as American staff. hifudoc Sat, 23 Feb 2008 00:00:00 GMT EDAP Reports Publication of Head-to-Head Study of Ablatherm-HIFU Versus Other HIFU Technology for Prostate CancerThursday February 14, 9:00 am ET   Journal of Endourology Highlights Ablatherm's Unique Sustainable Long-Term Clinical Data Ablatherm's Superior Safety and Efficacy ConfirmedLYON, France, Feb. 14, 2008 (PRIME NEWSWIRE) -- EDAP TMS SA (NasdaqGM:EDAP - News), the global leader in therapeutic ultrasound, announced today that the Journal of Endourology published results in its February 2008 issue from a head-to-head study entitled ``Transrectal High-Intensity Focused Ultrasound Devices: A Critical Appraisal of Available Evidence.'' Based on a thorough review of the existing medical literature, the objective of the study was to evaluate clinical outcomes and unique characteristics comparing EDAP's Ablatherm(r)-HIFU versus Sonablate500(r) for the treatment of prostate cancer.The article highlights the clinical superiority of Ablatherm in terms of present and longer-term data available. For the purposes of the study, clinicians referenced six publications on Ablatherm-HIFU featuring 2,032 patients treated, compared to three publications relating to Sonablate500 with 287 patients treated. Reviewed published articles have included Ablatherm patients with up to 10 years of follow up, whereas disease-free rate cannot be reported beyond five years for the competitive technology. Clinicians note that Ablatherm has been used in a greater number of centers for a longer period of time, providing more clinical information regarding its effects. The article also demonstrates the need for additional clinical studies for the use of other HIFU devices in order to draw the same short-term treatment success results as Ablatherm.The article concludes that the availability of more short- and long-term oncologic outcomes with the Ablatherm device creates less uncertainty about the actual efficacy of the device-specific treatment.Although both HIFU devices are built on the same scientific foundation, critical differences exist. Ablatherm-HIFU is unique in offering three specific treatment protocols addressing each of the targeted types of prostate cancer patients: (i) patients diagnosed with prostate cancer who have yet to undergo any previous treatment (primary treatment), (ii) patients who failed radiotherapy and HIFU being their only available therapeutic option, and (iii) patients with recurrence of their cancer. In addition, Ablatherm's probe integrates two ultrasound transducers, one for localizing and imaging the tumor and one for HIFU treatment, thus offering the best imaging quality, while ensuring a safe and efficient treatment.John Rewcastle, medical director of EDAP, commented, ``We are pleased this review, in addition to several other positive publications, provides further validation of Ablatherm-HIFU's unique technological merits in comparison to other HIFU devices. Substantial and longer-term data following Ablatherm-HIFU is increasingly available, which allows physicians to accurately discuss outcomes as they guide patients through the treatment selection process. With over 15,000 treatments performed worldwide, we believe Ablatherm is the standard-of-care in HIFU treatment of localized prostate cancer.''Marc Oczachowski, EDAP's chief executive officer, said, ``We are delighted this review confirms both the unique expertise and experience of our Ablatherm device in treating localized prostate cancer. We are pleased this review has been published at a time when we are actively recruiting patients for our U.S. Phase II/III clinical trial of Ablatherm-HIFU. We are confident that the results of this published study could have a positive effect on the enrollment pace in our ongoing trial. We look forward to confirming Ablatherm's efficacy and safety in the U.S. market and are pleased with the progress to-date.''EDAP's Ablatherm-HIFU is not approved for the treatment of prostate cancer in the United States and currently is undergoing evaluation in a multicenter Phase II/III clinical trial under an Investigational Device Exemption granted by the FDA.About EDAP TMS SAEDAP TMS SA develops and markets Ablatherm, the most advanced and clinically proven choice for high-intensity focused ultrasound (HIFU) treatment of localized prostate cancer. HIFU treatment is shown to be a minimally invasive and effective treatment option with a low occurrence of side effects. Ablatherm-HIFU is generally recommended for patients with localized prostate cancer (stages T1-T2) who are not candidates for surgery or who prefer an alternative option, or for patients who failed radiotherapy treatment. Ablatherm-HIFU treatment is in clinical trials, but not FDA-approved or marketed in the United-States. The company also is developing this technology for the potential treatment of certain other types of tumors. EDAP TMS SA also produces and commercializes medical equipment for treatment of urinary tract stones using extra-corporeal shockwave lithotripsy (ESWL). For more information on the company, please visit http://www.edap-tms.com and http://www.hifu-planet.com or http://www.urotoday.com/HIFU. Forward-Looking StatementsIn addition to historical information, this press release contains forward-looking statements that involve risks and uncertainties. These include statements regarding the company's growth and expansion plans. Such statements are based on management's current expectations and are subject to a number of uncertainties and risks that could cause actual results to differ materially from those described in these forward-looking statements. Factors that may cause such a difference include, but are not limited to, those described in the company's filings with the Securities and Exchange Commission Contact: EDAP TMS SA Investor Relations / Legal Affairs Blandine Confort +33 4 72 15 31 72 bconfort@edap-tms.com The Ruth Group Investors: Stephanie Carrington 646-536-7017 scarrington@theruthgroup.com R.J. Pellegrino 646-536-7009 rpellegrino@theruthgroup.comSource: EDAP TMS S.A. 60year Sat, 23 Feb 2008 00:00:00 GMT  My husband is going through the process now and we have opted for the Proton beam, found at LLU (Loma LInda Medical center (loma Linda Near Riverside CA) It is covered by medicare but there is a long waiting list. I looked into the Canadian HIFU and was not impressed . Why? The side effects can be bad, you are out of the country and if complicatons occur you have to pay additional medical costs, while needing hospitalization. They want $25000+.  You can have radiation at the local hospital that is now being improved, covered by insurance and although it too has side effects, at least you are near home.  There is also hormone therapy.  I know many patients personally that did the proton beam and it is very successful and the body can deflect more of the radiation because of the way they do the beam.  MD Anderson Has a proton beam treatment and one in Indiana and one in Boston ?New yourk? Not sure.Once you have the  HIFU there is no guarantee it will not come back. One day it may be approved here but as Prostate cancer is so curable, especially early stages, there are many options. Have you check with Cancer treatment Centers of America. They have a good program. All the best MMSOn 2/23/2008 smayuran wrote:Hello,My dad was diagnosed with early stage Prostate Cancer a couple of weeks ago (Gleason score 3a+3a, PSA 11.1, size of prostate 35cc weight 37g, cancer type Adeno Carcinoma Small Acinar, age 65).I've just started my research on the subject & have reviewed options such as the Da Vinci robotic surgery, but get the impression that HIFU Ablatherm is probably the best option for treatment. I'd appreciate it if patients or anyone else could give me some better insight about the HIFU treatment. I've listed some questions below, but please do let me know about any other details you consider useful as well:1) Feedback from anyone who actually did the HIFU, any complications/issues you ran into, any positives or your experience.2) Place of treatment & costs.Has anyone done the HIFU treatment in the Philippines? What was your experience & impression of the expertise there?The URL link below states that the HIFU treatment costs about US $10,000 in Philippines & I also found that it would cost about US $25,000 in Canada.http://www.philippinecentersf.com/trade/trade_news_medservic 3) How much does experience or number of operations performed matter for HIFU? Is it a more automated procedure where experience is not a critical or important factor as it is for a surgical treatment option?4) Difference between HIFU Ablatherm & Sonablate 500 treatments.Thank you,Mayuran  mmsurvivor Sat, 23 Feb 2008 00:00:00 GMT I had a Sonablate HIFU treatment on March 29th, 2008. I am in the process of recovery now. I was originally going to have the Albatherm in Toronto, Ont. Canada. It would cost $21,930 and that included them putting you up in a hotel for two nights. What happen is that my prostate had to be shrunk to 40cc or less from 72cc. After 4.5 months on Androgen deprivation therapy it only reach 43.5cc too large for their probe. They were getting a new probe that could do larger prostates but mine was at the limit of the probe so I did not want to risk having to do it again. The Toronto Albatherm clinic has good stats with only having to repeat two treatments in over 300. So I decided to go with the Sonablate which can do prostates as large as 50cc as a new clinic open in Winnipeg only a few hours drive for home, so no plane flight. The Sonablate cost was $22,000 and I had to pay for the hotel costs.    Complications      I had my suprapubic catheter (a catheter put through the abdomen wall above the pubic bone into the bladder) plug three times which require my having to go to the emergency to get it flushed and in third time a urethral catheter was inserted (through the penis). I did have problem with bladder spasms and pain during urination. These were all controlled with an anti spasmodic drug, Detrol LA, and anti inflammatory drug to reduce the prostate size. Apparently my large prostate with the subsequent swelling from the procedure--inflammation, cause the pain during urination. I have had no continent issues right from the beginning. The only thing which is common with HIFU is that you have a strong urgency to urinate and that is right now so you need to know where a bathroom is all the time. You will also need to go frequently as you are drinking a lot of water. These two things subside over two to four weeks. I am five weeks out of the operation and I have no catheter and only have some frequency to urinate during the night but that to will subside. The frequency is decreasing.Experience    The Sonablate doctors have to go through a course and it seems that they work with another Sonablate doctor for experience, but the more experience they have the better. Don't know about the Albatherm but I suspect it is similar.Differences and similarities    Both machines include a motion detector and a rectal temperature monitor. Because the machine is taking such as small strip of tissue and heating it to 80 to 90 degrees Celius you cannot have any movement as that would cause the machine to hit the wrong target. The motion detector causes the machine to shut off thus protecting the wrong tissue from being destroyed.       Both machines have the probe covered by a condom that has degassed water pumped in to swell the condom to make a tight fit to the rectal wall. The water is cooled to keep the transducer and rectal wall cool. This avoids any heat damage that may occur  to the rectal wall.      The Sonoblate machine has its transducer ( the sound emitting device) in a cylinder attached to the end of the probe. The transducer consists of two transducers one for deeper treatment and one for shallower treatment. The transducer moves within a cylinder at the end of the probe so the probe does not move once it is positioned. Both probes can be used to for treatment or imaging. The Sonablate machine takes images after each treatment shot so the doctor has a continuous upto date image of the prostate and any changes that occur during treatment. The prostate will swell with the first shot to increase in size about 10% at least that is what happened with my prostate. As pointed out the Sonablate has a doppler imaging system to give good color and identification of the nerve and vascular (blood vessel) bundles.        The Albatherm has one transducer at the end of the probe and it is fixed. The whole probe moves back and forth in the rectum during the treatment phase. The Albatherm can take only one picture at the beginning of the procedure as it requires a different transducer to take the image. That transduce must slide out into position while to treatment transducer is retracted. The imaging system can identify the nerve and vascular bundles.        The Sonablate procedure has the man lying on his back with his legs up in stirups. You are under a spinal but can also be under a sedation to make you sleep. However, in the Sonablate procedure a patient can in fact not take the sedation and so be awake through the whole process. I was awake during my procedure.      The Albatherm procedure has the man lying on his right side on the Albatherm table and he has both the spinal and the sedation for the procedure. No option to be awake.      Both have good result with incontinuence and erectile dysfunction. The Sonablate procedure has stats of 0.6% incontinuence. The Albatherm stats shows a 5 to 6% with most of that type I or II incontinuence which means the man will get a drop or two when he exerts himself in activities like lift a weight or swinging a golf club. Their stats show that a very small number may show a more serious type of incontinuence but this is very rare. Remember that Albatherm has better stats data that Sonablate as the Albatherm has been monitoring for a long time and Sonablate systems have not. Erectile dysfunction is stated at 20% but I think this is too high as the updated technology has improved the systems and the use of Cialis after the catheter is out will help regain the erectile function. I know that Sonablate treatment includes Cialis but the Albatherm as far as I have seen does not.   The Albatherm frequently will have the patient undergo a TURP (transurethral resection of the Prostate) in order to reduce the size of the prostate and apparently this also eliminates the pain after the treatment. The Sonablate system does not use the TURP. The TURP can cause its own problems and there is a risk of damaging the sphincters that control urine flow even though this maybe a low risk      The Sonablate machine takes a treatment strip that is 1 to 2 mm by 10 to 15 mm long while the Albatherm machine takes a strip that is 1 to 2 mm by 18 to 24mm long. The Sonablate system divides the prostate into 3 zones with each zone consisting of two blocks. The Albatherm does not appear to have zones but only blocks across the entire prostate. The Sonablate with its smaller strip length can get into tighter corners of the prostate. DocTV Wed, 07 May 2008 00:00:00 GMT i can't find cost or location 1luap2 Mon, 09 Jun 2008 00:00:00 GMT