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Prostatic artery embolization

Tech70
Posts: 69
Joined: Nov 2017

I have been on active surveilence for 4 years for Gleason 6 PCa.  All tests so far, 5 biopsys, 2 3T MRIs, 2 Oncotype DX tests and numerous PSA's all indicate that there is little chance of more serious cancer.  HOWEVER, I do suffer from fairly serious BPH symptoms which affect my quality of life.  I started a  new medication for overactive bladder, Gemtesa, which seems to work pretty well, but it's quite expensive ($488 per month).  Plus I worry about taking so many medcations.  My urologist mentioned TURP, but that seems overly aggressvie and all the other treatments like Urolift, laser ablation, etc. seem to have the potential for some nasty side effects.  Lately my research has turned up information on PAE, prostatic artery embolization which is done by in intervential radiologist as an outpatient procedure.  It works by shutting off the blood supply to the prostate causing it to shrink.  Since no tissue is being mechanically destroyed, the side effects are reported to be minimal and its effetiveness is good.  I wonder if anyone on the board has had the procedure or knows of anyone who has had it.  Since I live within an hour of major medical facilities like Johns Hopkins and Jefferson I'm confident in finding an experienced provider.

VascodaGama's picture
VascodaGama
Posts: 3393
Joined: Nov 2010

Hi Tech,

I met two guys who had the procedure done in a Lisbon hospital. Both were happy with the results. I was curious because their PSA was high but they were negative to prostate cancer.  One had the balloon type (repeated two times in 4 years by an urologist) and the other the more recent microcatheter (by a radiotherapist). 

PAE has been in practice by a urologist in Portugal since the 1990th but only got eye attention from a medical conference of 2008. Nowadays you can find several private clinics and institutions (JH) doing it,  from whereyou may obtain contacts to patients. Without blood supply  at the prostate this organ should die taking along all our problems including the bandit. Unfortunately PAE only manages to plug one of the blood vessels. In any case  it manages to cause shrinkage of the gland lowering the PSA and facilitating urine flow. In this link you can find the results from a ten year clinical study;

https://interventionalnews.com/prostate-artery-embolization-effective-decade/

Hope it resolves your BPH issue.

VG 

eonore
Posts: 110
Joined: Jun 2017

I have been reading about this procedure   A study that I read found that it was not as effective as Turp in reducing urinary symptoms, but evidently effective enough, since overall satisfaction rate was similar for both procedures.  There has been some resistance in the medical community, since the surgeons feel that the interventional radiologists are encroaching in their bailiwick.  My only question is whether the changes to your prostate caused by PAE would have some impact on the availability of subsequent cancer treatment should it become necessary.

 

Eric

JJO
Posts: 18
Joined: Sep 2017

I'm on AS and recently had Aquablation done.  It is bascially the same as TURP but has two advantages:

1. It uses high pressure water instead of a surgical tool.

2.  Once the urologist programs in how much of the prostate to remove, the rest is done by computer so it lessens the chance of error.  

I also asked, as was assured, that it would not preclude any cancer treatment options should that be necessasry.   The procedure does require full anaesthesia, but I went home at the end of the day and the recovery was very easy.  You do need a catheter overnight.  The results have been very good, so far.  

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