Focal therapy with TOOKAD®
What is it?
VTP targeted vascular photodynamic therapy with Tookad consists of a targeted, minimally invasive treatment for low-risk prostate neoplasms.
When is this procedure indicated?
This procedure is indicated in low-risk prostate tumors with precise clinical features: Gleason score not higher than 6, unilateral, and PSA ≤ 10 ng/ml).
How is it performed?
Treatment of prostate cancer by focal therapy approaches using TOOKAD® involves the use of a drug with intravenous antitumor activity. This medicine is activated by a laser light emitted along some fibers that are inserted inside the prostate. The position of the fibers is determined by the experience of the operator, who may be assisted by computerized methods that assess the volume and position of the lesion to be treated. An ultrasound probe introduced endorectally, through which the region of the prostate to be treated will be constantly displayed and monitored, will also be used. Finally, a bladder catheter will be placed and usually removed one or two days after the therapeutic procedure.
The procedure is performed under general anesthesia.
Recovery
After the focal treatment, the patient is taken back to his or her room, where he or she is provided with protective glasses to be kept worn until the day after surgery.
It is important to totally avoid exposure to light sources for 6 hours after surgery. The day after the treatment and up to 48 hours after the treatment, the patient can gradually lead his daily life, being careful to keep away from exposure to direct sunlight. After 48 hours of treatment the patient can safely return to everyday life.
Short-term complications
- Pain, hematomas at the site of treatment.
- Visceral lesions among which the most frequent, although rare, are those affecting the rectum.
- Macrohematuria (loss of small amounts of blood with urine) for some days.
- Hemospermia (presence of blood in the semen) for a few weeks.
- Acute urinary retention with the need for catheterization.
- Lipotimia and vagal crisis (bradycardia, drop in blood pressure, sweating).
- Urinary tract infections, usually without the need for hospitalization.
Long-term complications
The development of long-term complications related to focal therapy is a rare event. Among the complications described are:
- New onset erectile dysfunction.
- Urinary incontinence.
- Recto-urethral fistulas.
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