Prostate cancer treatment traditionally involves radiation or surgery, both carrying risks of adverse effects like urinary incontinence and erectile dysfunction. However, new research unveils a durable alternative using MRI-guided transurethral ultrasound ablation (TULSA), allowing whole-gland treatment without excluding future options for surgery or radiation.

Lead author Steven S. Raman, M.D., FASR, FSIR, professor of radiology, urology, and surgery at the David Geffen School of Medicine at UCLA, expresses optimism: "The success of TULSA represents a revolution in whole-gland treatment for prostate cancer. If validated, TULSA has the potential to change the standard of care for thousands of men."

During the TULSA procedure, a specialized device is inserted through the urethra into the prostate. MRI guides precise positioning of therapeutic ultrasound elements, heating prostate tissue while protecting surrounding nerves. This outpatient procedure, lasting two to three hours, offers targeted cancer cell destruction while minimizing collateral damage.

Dr. Raman emphasizes, "This image-guided therapy maximizes our ability to kill cancer cells while preserving urinary continence and potency, crucial factors in prostate cancer treatment."

The prospective observational study demonstrates remarkable outcomes: 76% of participants showed undetectable cancer on follow-up biopsy one year after TULSA, with median prostate volume decreasing by 92% within a year and prostate-specific antigen levels decreasing significantly.

Compared to alternative therapies, TULSA exhibits a favorable side-effect profile, with 92% of patients regaining continence and 87% preserving erectile function by five years. The study, conducted across 13 sites in 5 countries, highlights the critical role of interventional radiologists in prostate cancer care, leveraging their expertise in imaging and image-guided procedures.

Ongoing research includes the CAPTAIN trial, a randomized control trial comparing TULSA with radical prostatectomy, promising further insights into TULSA's efficacy.