John Morgan is a partner in an investment company. He and his wife, who have four grown sons, two dogs and a flock of chickens, love to travel. Morgan, who was a professional ski racer in his 20s, lifts weights, rides a bike, and skis.
In late 2018, the 66-year-old Maryland man was diagnosed with prostate cancer.
He was determined to find a treatment that allowed him to continue to live a full, busy life. He had heard about a groundbreaking new treatment called TULSA-PRO and considered traveling to a Mayo Clinic site in Florida or even to Germany to receive it, but then discovered it was available less than 2 hours away from his home at WellSpan York Hospital.
At the end of April, Morgan became one of the first WellSpan patients to receive the TULSA-PRO treatment, performed by Dr. Edward Steiner, an interventional radiologist who used a robotic-guided instrument to obliterate Morgan’s tumor and cancer-damaged prostate, using MRI imaging.
About two weeks later, Morgan attended his youngest son’s college graduation. After a month, he was back riding his bike and lifting weights. Next year, he’s signed up to compete in the world’s longest amateur downhill ski race, The Inferno, a 9.25-mile contest held in Switzerland.
Dr. Steiner said TULSA-PRO is a milestone.
“This is going to be a mainstay option in the treatment of prostate cancer,” Dr. Steiner said. “Surgery, radiation and TULSA-PRO – those are going to be the big three. Everything out there confirms that is the direction we are heading in. There are very few procedures where you can prove your effectiveness. At the end of this procedure, we can confirm that the entire gland is now completely ablated or without any blood supply.”
“I’m tremendously excited. I think this is one of the most significant innovations in the care for prostate cancer in the last 30 years.”
What is TULSA-PRO?
TULSA-PRO (short for transurethral ultrasound ablation of the prostate) is a minimally invasive procedure, performed under anesthesia, which uses ultrasound to produce very high temperatures to precisely ablate or destroy cancerous prostate tissue.
The procedure is approved for use in men with prostate cancer of a certain size and that has not spread beyond the prostate. WellSpan York Hospital is just one of nine sites in the country where the procedure is currently performed, with Dr. Steiner joining peers at Stanford and Yale, among others. He is assisted in performing the procedure by certified registered nurse practitioner Gena Paul, whom he calls “my right hand.”
One of the major advantages of TULSA-PRO, Dr. Steiner said, is that it has fewer side effects and complications than other prostate cancer treatments such as surgery or radiation. This includes erectile dysfunction (with TULSA-PRO, this side effect much less common, is often temporary, and can be solved with medication) and incontinence (just 2.6 percent of TULSA-PRO patients experience it). After an overnight stay, patients go home with a catheter for two weeks but can return to work in several days.
TULSA is covered by Medicare and many third-party insurers.
Why TULSA-PRO is important
Prostate cancer is the most common cancer in American men, except for skin cancers, according to the American Cancer Society. The chance of getting prostate cancer increases as a man gets older. Most prostate cancers are found in men over the age of 65. Black men are more likely to develop prostate cancer than men of other races.
Prostate cancer ultimately is the number-two cancer killer of men, following lung cancer.
TULSA-PRO is one of the few procedures that can treat recurrent prostate cancers where surgery and radiation may not be possible. These “salvage” procedures can be lifesaving.
How TULSA-PRO became possible
Dr. Steiner said medicine requires a continuum of cutting-edge innovations and services to be able to offer aggressive, ground-breaking procedures such as TULSA-PRO. For prostate cancer, the continuum includes advanced imaging, something Dr. Steiner calls “man-o-grams” for men.
Dr. Steiner and his team have also introduced MRIs paired with ultrasound, a “fusion biopsy” method that leads to a very precise, three-dimensional view of the prostate, followed by a targeted biopsy. Patients can benefit from this because WellSpan has the latest and most advanced magnets in its MRI suites, the artificial intelligence that is required for the fusion method, and the trained teams to perform the tests. And the tests are fast. A man can undergo a scan in 25 minutes and a follow-up biopsy in just about 45 minutes.
“We can see better, and find the cancer, and then accurately and precisely biopsy the lesions under anesthesia,” Dr. Steiner said.
The impact of TULSA-PRO on men’s lives
Avoiding prostate cancer treatment side effects was one of Morgan’s goals.
“When my urologist said I had two options, surgery or radiation, I said what’s behind door number three?” Morgan said. “I didn’t want the collateral damage that comes from either of those options.”
Morgan first tried immunotherapy, which was unsuccessful. Then he heard that TULSA-PRO was approved as a treatment in the United States by the Food and Drug Administration, and available at WellSpan York Hospital. He had a consultation with Dr. Steiner and decided it was his best option. In several months, he will undergo testing to see if the treatment was effective. He’s very hopeful that he won’t have to worry about prostate cancer again and very grateful that he’s back to his active life.
“I had some blunt conversations with my urologist, as you can imagine,” he said. “One possible outcome involved wearing a diaper for the rest of my life. I really didn’t want to live with that or any other collateral damage, so I asked what else can we do?
“I think TULSA-PRO is a game changer. Having prostate cancer is not a death sentence and it’s not the death sentence of life as you know it. If you qualify for this, you can deal with it.”
