Interview with Dr. Lumiani

How did you come to TULSA-PRO?

For our patients with prostate cancer I had been looking for a long time for a gentle therapy possibility, which would be promising in addition to the classical methods, such as surgery or radiation therapy.

For several years there have been alternative therapy methods available which are, on the one hand, not very effective and, on the other hand, have side effects for men. The art is to use a method to destroy diseased tissue while preserving healthy tissue and the important structures for male function.

Several years ago, a lecture was given at a urological congress at the University of Heidelberg, in which the experience and results of the prospective phase I study with TULSA-PRO® were reported. The advantages of the method were fascinating and understandable for me. When TULSA-PRO® was offered for routine clinical use by Profound, I quickly decided to introduce this form of therapy to our patients.

It was very advantageous for me that the planning of the therapy was based on current mpMRI images of the prostate and that the therapy was performed through the urethra. Furthermore, the therapy is both MRI-guided and MRI-controlled. With this method, any tumor localization could be reached without damaging the adjacent organs.

After three years of performing the TULSA Procedure, how has your clinical program developed since then?

Since March 2017 we have been performing the TULSA Procedure with our patients and look back on a very good acceptance by patients and a fast development of this therapy due to corresponding experiences with this method on our part.  Since then, we have successfully treated more than 300 patients with TULSA-PRO®.

The TULSA Procedure is a new method for us, which rounds off our multiparametric MRI examination, which is produced in the highest quality, and the patient-friendly MRI-controlled and targeted 3D live biopsy of the prostate, which we have developed as a form of therapy.

Patients are often free of symptoms directly, and only a few hours after the therapy. The next day our patients can already cope with everyday life without complaints. They do not need rehabilitation, as it is the case after surgery, for example. We are pleased to be able to offer our patients not only high-quality diagnostics of the prostate, including an MRI-guided prostate biopsy but also a new, innovative and effective treatment method.

Which therapies do you perform?

With TULSA-PRO® we treat malignant prostate cancers as well as benign changes of the prostate.

We primarily use TULSA-PRO® focally, i.e. specifically for ablation of the cancerous part of the prostate. Depending on the location of the cancer, we can, in most cases, spare the male functions completely.

After we found out that the TULSA-PRO® method is almost four times faster than a HIFU treatment, we have started to treat benign changes of the prostate as well.

The benign enlargement of the prostate (the so-called benign prostatic hyperplasia) often causes bladder emptying disorders, frequent urge to urinate and repeated urination at night in men.

A few weeks after the TULSA Procedure, we noticed that the men were able to empty their bladders well, the nightly urination (nocturia), and the urge to urinate improved considerably or in many men, this urge to urinate had diminished completely. The constant search for a toilet, the wearing of large pads and the daily taking of tablets were overcome after the therapy.

Through the MRI-controlled planning and the MRI-controlled TULSA Procedure, the man retains all functions such as continence and potency. The special feature is that the patient usually also keeps his normal ejaculation. This is a new quality of life for the affected men.

From the age of 50 onwards, many men suffer from prostate cancer as well as prostate enlargement (benign prostate hyperplasia). With TULSA-PRO® we can treat both malignant and benign prostate changes in one session. The patient is then free of cancer and also free of complaints due to the treated hyperplasia.

We carry out a strict selection of whether a patient is suitable for the TULSA Procedure or whether he benefits from this method compared to other forms of therapy.

After the TULSA PRO therapy, all our patients are without exception continental and potent, in many cases, with preservation of ejaculation.

What are your clinical results?

After three years, we are not yet able to establish long-term data, but we see promising results in the follow-ups. The men are living their lives to the fullest, the PSA level is within the normal range, and the mpMRT control examination of the prostate shows no cancerous tissue.

All our patients receive after the TULSA Procedure an mpMRT examination of the prostate in the highest quality, the determination of the current PSA value, and a complex urological examination with determination of the functions of the man.

The first mpMRI control examination of the prostate gland after the therapy will take place in three months. The second control in six months and thereafter regular annual checks. In our clinic, the check-ups include an MRI examination, PSA determination and a urological check-up.

Our patients can have the mpMRI control examinations of the prostate at our clinic’s different locations in Germany. A local urologist carries out the PSA level and the urological control examinations. All evident data are then transmitted to the ALTA Clinic for evaluation and reporting.

How do you find your patients?

We have been specializing in prostate diagnostics for 13 years, as one of the first clinics in Germany, and have been performing mpMRI of the prostate at a high-level right from the start.

That is why we have made a name for ourselves not only in Germany but also worldwide. Many patients come on the recommendation of friends or acquaintances or through a referral from their urologist. The internet is becoming increasingly important, especially due to our good patient evaluations. On our homepage (www.alta-klinik.de) we also try to explain the complexity of the prostate gland including its treatment to our patients in an understandable way.

That sounds like a great accomplishment for your team.

Yes, you are right; its been a great success so far. We needed ultra-modern, complex technology, such as the 3 Tesla high performance MRI device and the TULSA-PRO® system to achieve this. The need for experienced and trained staff for the operation of the devices, which are all digitally linked to each other, is very important.

However, because of our experience, we have optimized the procedure, reducing the TULSA Procedure to an average of less than 2 hours. This saves the patient unnecessary anesthetic time. Therefore, we have become one of the most efficient users of this new technology worldwide.

With the TULSA Procedure, I have fulfilled my dream in the ALTA Klinik, that we can offer our patients not only a high-quality and modern diagnosis or biopsy, but also a very innovative and promising therapy.

The recognition and gratitude of our patients is the motivation for us to continue. Based on this experience, I often say this sentence to my staff: “The gratitude of the patient cannot be bought with money, you have to earn it!”

Dr. Lumiani, many thanks for our conversation!

To learn more about Dr. Lumiani and the Alta Klink, visit their website here: https://www.altaklinik.com/