If the results of your diagnostic workup reveal that you might be a good candidate for focal therapy, your doctor will order an MRI scan to determine whether or not focal laser thermo therapy (FLTT) is feasible. If you meet all of the criteria, your MRI scan will be used to make a treatment plan and you will be enrolled in the FLA clinical trial here at The Princess Margaret.
The rest of this section discusses what to expect with FLTT. If you would like to know more about what to expect with the HIFU procedure, visit www.hifu.ca.
Prior to the procedure, you will be asked to have your blood chemistry and urine documented along with your complete medical history to ensure the safety of the procedure. You will also be asked to fill out quality of life questionnaires to establish a baseline. You will also meet with an anaesthesiologist to ensure that you can undergo the general anaesthesia required for this treatment.
The evening before your procedure, you will be asked to fast after a light dinner. You will also need to perform a bowel preparation and take antibiotics.
FLTT is an outpatient procedure that lasts approximately four hours. The procedure is performed in an operating room equipped with an MRI scanner. You will be placed on the MRI bed on your back and given a general anesthetic. You will be asleep for the whole procedure.
During the procedure, the prostate is mapped using MRI and the target tumour is located. A robot is positioned and programmed to insert a tiny laser fibre (shown right) into the prostate via the perineum. Once the tip of the laser fibre is in position the laser is turned on and heat is applied to the tumour. Your surgeon monitors the temperatures within the prostate using imaging technology.
Before the procedure is over, the surgeons ensure that all of the target tissue has been heated to theraputic temperature (a temperature at which the cancer cells will be destroyed). If required, they will reposition the laser and continue the procedure.
In the afternoon following treatment, you will be discharged from the hospital with a catheter in place. Two days later, you will have the catheter removed here at the hospital. You will be scheduled for follow-up at the 1 week, 1 month and 4 month marks for a check-up, blood test and to fill out more questionnaires. At the 4 month mark, we will perform a biopsy to ensure that the treatment was effective at destroying the tumour.
If you have any additional questions, please get in touch with Michael Nesbitt 416-946-4501 ext.6897.