Gat Goren, PAE, LUTS, Part 7

Thanks very much for all the advice. I see my Uro on Friday. Everything depends on how the PSA comes out this time. If it is still elevated (and going from 1.6 to 3.6 in one year is concerning, though I again admit that mama and I were AWFULLYl active the night before. Guess I forgot to abstain. Oh well, I HAD been away for a week, so who could blame me?), er where was I? Oh yeah, if it is elevated, I will go on antibiotics for a couple of weeks and retest. If it is STILL elevated, then I will go for the MRT(I think they call it). I don't really want to have a possibly cancer cell spreading biopsy, but how else can they stage the cancer, if it is there?

You know, I had great hopes for my PAE, because the results seemed good for quite a few months. And this, even though only the right side was done. (With a left side varicocele repair).

In any case, if it comes down to a TURP, or some kind of cancer treatment (assuming the cancer appears to be the kind one could safely watch and wait), I am indeed considering the GG. OF course 17K Euros is not chump change, and I'd feel like a chump for laying out that kind of cash for something that doesn't work.

How about some more info, gentleman, for GG as an alternative to TURP and/or early stage PC?

Again, I remain grateful to all who respond.

Post Edited (Gavrikon) : 5/18/2015 5:12:37 AM (GMT-6)

Thanks, Dave. I'm keeping my fingers crossed. I sent an email off to Olga yesterday, just in case, but no reply as yet. You might very well me right about the PAE and left varicocele making further intervention by GG impossible.

I just keep telling myself: No TURP, no TURP, no TURP!

One other little correction:

The size of my prostate prior to the PAE was 45, apparently now is 43.

Post Edited (Gavrikon) : 5/19/2015 4:12:36 AM (GMT-6)

Bob, it's gone back to every two hours on average, 3-4 times per night.

However, it seems strange because it feels more like an irritation than a full bladder. My last check of residual was about 100cc. Is it possible that there can be other reasons that my system is signaling that it wants to urinate? Maybe the bladder has just been irritated by the size of my prostate? Stream is often poor, but when I am wide awake and relaxed, the stream seems pretty good.

But I agree with you. After the next PSA test, I'll decide what to do. DRE and TRUS were both normal, size went from 45 to 43. The doc who did the PAE feels like there is a likely infection, and I need a couple of weeks of antibiotics, but my URO found no signs of infection. Still, if the PSA remains elevated, I will do the antibiotics, and if it still remains high, well, we'll go from there.

Thanks for your response. I understand that you've really been through the wringer, and I have appreciated the previous postings about your experiences.

Post Edited (Gavrikon) : 6/2/2015 3:52:22 AM (GMT-6)

Hope you guys don't get all shy about a lady joining the conversation...

I've read pretty much this entire topic with interest, because my S.O. has BPH and was initially prescribed Galebon (0.4 mg prolonged-release tamsulosin hydrochloride) which he's been taking for just over a year, but has now also been prescribed finasteride as the tamsulosin hasn't done thie trick. Which has pretty much killed our 10-year relationship

He's suggested that we 'downgrade' the relationship to 'just friends', because of the side effects of these drugs. I'm desperate to find an alternative, effective treatment for his BPH.

However, things aren't all that straightforward.

25 years ago he was diagnosed with testicular cancer and had a testicle removed (and I'm ashamed to say I can't remember if it was left or right!) However, because of post-surgical complications (bowel adhesions) he had further surgery and has internal staples still in place (very odd - feels like a zipper under his skin) and a large scar from just below his sternum to the top of his pubic bone. He also had chemo- and radiotherapy.

He did go on to have two more children with his ex-wife following surgery, so fertility was clearly not an issue!

I suspect his medical history may mean that surgical treatments are out. The transurethral treatments are simply barbaric, and the side effects of those... well, just no...

So that leaves the percutaneous treatments.

Venous coil embolisation? Possibly, but might not be possible for some of the ISV collaterals. Arterial embolisation? Nope - doesn't make sense to me. Venous sclerotherapy? Seems like the best choice.

I've read soooo many papers, articles, what-have-you. Gat and Goren's explanation of how a varicocele (even sub-clinical) can result in BPH and why their method would work makes sense on so many levels. As do their explanations of how it improves fertility.

There are a few things I wish I had the answers to; for instance the correlation between varicocele and BPH. Not all patients with unilateral or even bilateral varicocele have BPH, but do all patients with BPH have varicoceles?

The drug therapies seem to treat the symptoms (sometimes!), but don't actually address the problem, and frankly I think the side effects are pretty unacceptable - and even more so for the transurethral treatments. But then, the symptoms of BPH (and complications thereof) are pretty darn horrific for you poor guys too, so I guess you're all between a rock and a hard place on this one...

Good luck and best wishes to all of you, whichever treatment options you choose.

Hi Bevuk,
I seem to remember a 2006 Gat Goran paper on prostate cancer with 76/76
biopsy proven patients with varicocele. I may be wrong but I would imagine BPH is the inflamatory response to high levels of dihydrotestosterone in the prostate....the same high levels that go on to cause a cell mutation which is the cancer.
I had Pca but I never had BPH....so that might mean the varicocele does not always cause BPH. I had a terrible left varicocele since puberty. I may just also have a very good anti-inflamatory response.
Gat Goran might be a good first level approach to cure BPH as it is an outpatient procedure. Menachem Goran helped me get a procedure done in Australia....because now with their US patent they are trying to get other Drs
to take up their methodology. You can try to contact them in Israel directly. Seem to be fantastically aimeable (sp) guys.
You can also research 'trans-urethral prostate hyperthermia' which is spreading around Europe. Dr Dowes at Klinic StGeorg in Germany uses TUH to treat BPH.

Thanks, IRD. I can do that.

BTW, retest of PSA (after abstention) fell back to 2.18. I'm doing a 10-day course of Ofloxacin and will again test after that. Like I said, I was 1.6 for years before the PAE, and expected it to fall. I also will check into trans-urethral prostate hyperthermia. Good call, if I need it.

I was educating myself over at the PC threads. Now THOSE'll make you lose sleep!

Post Edited (Gavrikon) : 6/2/2015 3:53:23 AM (GMT-6)

Hi Ian,

You wrote,

IRD1956 said...
It may be a small stretch to say I have had a complete Gat Goran treatment but Menachem did say to me by e-mail.."Ian we have now patented out treatment in the USA and we now want to spread the treatment around the world. We would be happy to talk with your Dr if he would like to contact us"....or words there abouts.

I've checked the US Patent and Trademark Office database. No patent has issued naming Gat and/or Goren as an inventor of any invention relating to the subject matter we have been discussing in this forum. Drs. Gat and Goren had in the past a few applications for patent pending in the USA relating to this subject matter, and perhaps they have one or more other applications still pending. I'm pretty sure Dr. Goren is an American, in addition to being an Israeli, and English should not be a problem for him. [By the way, thank G-d for the English. The progeny of the English empire is Western civilization as we know it.]

You may want to query him about his confusing information.

Also, is Dr. Goren consulting with any doctors in the USA who are performing the Gat/Goren procedure?

Ira

Post Edited (Skateman) : 6/4/2015 10:14:47 PM (GMT-6)

Hi Clap,

The landing page I use to get started is here:

http://patft.uspto.gov/

Once there, you can enter the appropriate search portal. Searching takes practice.

With respect to unpublished applications for patent, generally speaking there is no way for anyone to find them.


Ira

Skateman said...
Hi Clap, 'The landing page I use to get started is here:'

Thanks very much Skateman.

Ira.
Regards the patent try US 20100286106 A1
or go to this Google link :
www.google.com/patents/US29100286106 A1 and use that to guide you.

IRD1956 said...
Ira.
Regards the patent try US 20100286106 A1
or go to this Google link :
www.google.com/patents/US29100286106 A1 and use that to guide you.

Yeah, IRD1956, I already perused that publication. I understand this from the US PTO database:
"Status: Abandoned -- Failure to Respond to an Office Action"

to mean that NO PATENT ISSUED.

As I wrote earlier, perhaps Gat and Goren have one or more other applications still pending. As of now, there is no evidence whatsoever of a US patent having issued to them regarding the subject matter we have been discussing, and there is no evidence of any other pending U.S.A. applications for patent.

Here is the list of the published applications for U.S. patents naming Gat and Goren as inventors, along with the US PTO's status entry for each one:
PUB. APP. NO.     Title
1 20100286106 METHODS AND APPARATUS FOR TREATING THE PROSTATE
Status: Abandoned -- Failure to Respond to an Office Action
Status Date: 01-10-2014

2 20100268076 METHODS AND APPARATUSES FOR VASCULAR AND PROSTATE TREATMENT
Status: Abandoned -- Failure to Respond to an Office Action
Status Date: 09-27-2013

3 20100204639 DIAGNOSIS AND TREATMENT OF VARICOCELE AND PROSTATE DISORDERS
Status: Abandoned -- Failure to Respond to an Office Action
Status Date: 09-27-2013

4 20090018486 Diagnosis and treatment of vericocele and prostate disorders
Status: Abandoned -- Failure to Respond to an Office Action
Application Type: Utility Status Date: 04-29-2014

However, the Gat/Goren procedure's patentability, or not, actually is in no way an indication of the efficacy, or not, of that procedure. Get it?

Why Gat or Goren would tell anyone that they have a U.S. patent is a mystery to me.

Patent or no patent, I HOPE IT DOES WORK!

I repeat a query I posed earlier: Does anyone know if Dr. Gat or Dr. Goren is consulting with physicians performing the Gat/Goren procedure in the U.S.A., and if so, who are those physicians?

[Edited to remove duplicate "the."]

Post Edited (Skateman) : 6/30/2015 11:30:29 PM (GMT-6)

Hi Dave,
It would be good to know at some future point in time whether your prostate stayed at the same size or continued to grow. That is, does the GG procedure permanently or temporarily stop prostate growth?
Most of the cutting procedures (turp, lasers, etc.) remove more than half of the prostate immediately. But prostate regrowth generally results in a repeat procedure being performed. The time frame varies, but from what I have read, many men start to get symptoms again after 5 years. I guess it depends on the amount removed and the person's rate of prostate growth. I wonder if anyone has been able to guage the long term efficiency of GG. Is it permanent, or is it subject to return of symptoms after a number of years like the cutting procedures, due to prostate re-growth?
Bob

Chicago Dave said...
Four-year update

I had my Gat-Goren (GG) procedure on 30 May 2011. It's been just over four years now. Pardon my tardiness; eldercare issues have been soaking up my attention.

I reported last year that I had another cycle of improvement at 36 months post-GG. This progress has persisted over the past year. That's something of a disappointment because I thought I had experienced yet ANOTHER improvement at 42 months, last Fall. Unfortunately, that improvement lasted only for 3 or 4 months and then faded. Oh, well. There was another episode of worsening earlier this year. It lasted about a month, and then went back to normal, but it did prompt me to ask the board for advice and to take some herbs for a couple of weeks.

On a 0 to 100 scale, I think I'm about 78% normal, down from 80% and 84% I reported previously. Briefly, there is a little bit of discomfort during the day, but frequency is way down, and I usually don't get up at night to pee at all. My prostate shrunk from 51 grams to about half that after only 12 months; no further measurements have been done since then. It's not like it was when I was 25, but it is a big improvement over what I started with. I'm not taking any herbs now, and I haven't taken any Rx drugs (Rapaflo or other alpha- or beta-blockers) for over two years. (But I might try some gentle terazosin (Hytrin): I would take this for one or two periods a year from 1992 all the way to 2009, when I had to "upgrade" to Rapaflo.)

I still recommend this procedure, and I still recommend getting it done EARLY. I believe that the GG procedure is fundamentally a preventative procedure, and it still surprises me that the body is usually able to partially reverse some of the damage done over the previous years or decades. I hope that in the future it will be available to guys at a much earlier stage in the development of prostate problems, not only when the situation has gotten so bad that it can't be ignored any longer.

I'll update again in six months, or sooner if there is a big change.

###
I continue to notice new positive posts about the PAE procedure on the patient.co.uk site. Could it be that we're in the early stages of a complete rethink about how to treat BPH and allied conditions?!?! I hope so. In this new paradigm, interventional radiologists would have a larger role to play.

Thanks for posting your updates, IRD, Seasign and Nosheds. Readers find them helpful, and I always find them interesting.