"Going with Focal Laser Ablation for BPH"....Yes! That was the headline on a Google website that more or less has changed my life. I will admit, it is still a little early to completely define my experience but for the benefit of others who suffer from this condition with or without cancerous lesions, I thought my journey would be interesting. My prostate size was never really large. Just 50 grams, but it wasn't about size. It was about location. A very large median lobe had engulfed about 2/3 of my prostate interfering with my urination and literally as I was told, forming a plug around my bladder neck. Of course, getting up at night to pee multiple times interfered with my sleep and my energy levels. I had tried multiple holistic solutions including saw palmetto, nettle root, hormone balancing, green juicing etc etc. all to no avail. I even traveled to Israel, spent $17,000 for the Gat Goren procedure which embolized my internal spermatic veins (ISV's) but to my consternation I later learned this promising procedure did not work for those with a large median lobe nor did PAE. And after 6 years of suffering, that Google website caught my attention. I learned a large group of individuals who all had the same BPH affliction were members of a club called the K Club. What did K stand for? It stood for Karamanian, a doctor who had treated each individual, with success, compassion and a deep knowlege of the affliction at hand. On January 7th, I traveled from South Florida to Houston, Texas and underwent a 3 hour focal laser treatment at Houston Medical Imaging under the care of Dr. Ara Karamanian. Why undergo the expense of traveling to Houston and incurring hotel and airline costs in addition to the $21,000 for the surgery? The answer was simple! Dr. K not only had a medical degree but also was a graduate of Duke University with an engineering degree. When he examined the MRI of my prostate, unlike my urologist and those in South Florida who do FLA, he found two other areas that needed ablation aside from the median lobe. It was both his engineering and medical experience that convinced me (despite my initial objection) that to do the job right, as much as 50% of the prostate tissue needed to be removed. The facility was Houston Medical Imaging. In all of Houston, I learned that there were only two Siemens Skyra 3T MRI Magnetom imaging machines. Just about the latest technology with each machine costing $3 million dollars. Obviously, if surgery were to be done on my prostate, I wanted a machine with the latest web technology that was MRI compatible, unlike the older GE machines that some doctors use at more that half the price. Approximately 30% of my prostate was removed. Intravenous IV conscious sedation presented a higher level of care. At no time during the 3.5 hours of surgery did I feel any pain or discomfort. I have heard of patients that have had oral valium sedation with nerve block. This I learned is less costly but can involve some pain for the patient. It is now 18 days since I have had the operation. For a 75 year old man, having a catheter in his bladder for 8 days was no fun. I was warned of spasms and though I took uribel (?) to ease the discomfort, the spasms which occurred several times a day initially, can make a grown man scream like a baby. Throughout this period I began to understand why a fan club grew around Dr. K. When it was an unusually cold day, below 15 degrees in Houston, Dr. K came to my hotel not once but twice to check on how I was doing. I did not expect that level of care as most doctors do not provide home visits anymore. Not even 30 minutes in an office before you are rushed out for another patient. Today it is hard to fine optimized clinical care, much less a doctor who is willing to speak to you for multiple hours and even be on call at any time of the night. Dr K was the exception and I am very thankful. Results so far have been beyond my expectations for such a short period of time. Of most concern to me was that my pipes were all working well. No damage to the neuromuscular bundle or the ejaculatory ducts etc. Yes, this 75 year old previously had a perfect score on a sexual health questionnaire and I didn't want that changed. After 10 days, ejaculation was better than I expected....A climax that a 30 year old would relish!!! Imagine that! Ejaculatory fluid actually increased. Hard to expect that when 30% of your prostate is removed. No retrograde! Those poor naive TURP sufferers. They forgot what they are missing. I currently release close to 200 ml upon urination, double the increase before the surgery. I have been told the best results come after 30 days for which continual improvement will happen for 6 months. Yes, their is still some blood in the urine which I was told can be expected for a while as the prostate inflammation goes down and healing progresses. I hope I haven't bored anyone with my journey. Good luck and success to all of you! Support (3) Tha read more

Review of my PCa Screening (Dr. Joseph Busch) and FLA Treatment ( Dr. Ara Karamanian) My alarm bells began around March 2019, after separate blood tests, including PSA, Free PSA, and PC3A, 4K Score all suggested a high probability of PCa. The highest PSA (tracking 10yrs) was around 3.5. I compared having a TRUS biopsy vs a newer in-bore mpMRI biopsy. It appeared the advantages of mpMRI far exceeded TRUS on all aspects, including directly imaging any PCa. After many days/nights of researching this mpMRI screening technology and some luck finding the website, Inspire.com, I found a top Oncological Radiologist MD, Dr Joseph Busch, specializing in prostate mpMRI and image technology. I made the decision of going to Dr. Busch in Chattanooga for my prostate screening. The June screening included an initial mpMRI, which resulted in clearly detecting a tumor. A follow up in-bore mpMRI guided biopsy was performed the next day. Both of these MRI procedures were not painful. The results were bad in location (near the wall and nerve bundle), grade (4+3) and bad PTEN/ERG. So after a second opinion of my pathology report, from Dr. Epstein of John Hopkins and with similar results from my Polaris genomic report, the necessity for treatment was obvious. The only good news was it appeared the tumor was contained within the gland. Dr. Busch spent a very long time on multiple sessions, explaining details of the mpMRI tumor imagery, giving his opinion of how aggressive and treatable the tumor appeared and possible treatment options to consider. Selecting the best treatment type was my next issue. My primary research tools were the website Inspire.com and YouTube. There were many PCa treatments available, each with recurrence statistics and side effects statistics. It took a lot of time asking many questions and doing research, but I narrowed the treatment types to either Focal Laser Ablation or Proton Beam Therapy. Both treatments seemed like a good choice. I consulted with Kathy Busch [BS, RT(N),(CT),(MRI),CNMT(PET)] for discussing advantages of Proton Beam Therapy for whole gland treatment; to negate possible microscopic migrating PCa cells. Both treatments had roughly similar chances of recurrence, considering limited FLA data. The FLA laser had the best accuracy, 1-1.5mm, but the least long-term data. The accuracy was appealing since my tumor location was near the wall and the nerve bundle. The probability of side effects and costs (including insurance reimbursement) varied. All of these variables had to be carefully weighed, understood and risks prioritized. My primary goal was to select the most effective treatment to get rid of the complete index tumor including adequate margin volumes. I chose the Focal Laser Ablation treatment, primarily because with my poor pathology prognosis, PCa may recur and with FLA if recurrence happens, I will have more re-treatment options available to select from. Also I felt FLA would be best treatment at fully destroying the index tumor. If I chose Proton Beam Therapy for my initial treatment and there was recurrence, the re-treatment options are more limited. After a very complete in person consultation, I selected Dr. Ara Karamanian at the Prostate Laser Center in Houston to preform the in bore FLA procedure (September, 2019). Dr. Busch and Dr. Karamanian together reviewed the imagery and discussed how to proceed. Both Dr. Karamanian and Nurse Donnie Sartin spent a lengthy time explaining in detail the preparations, the actual procedure and the post procedure evaluation. The procedure was not painful, but the night after the procedure I did have bladder spasms due to the catheter. When the catheter was removed the day after the procedure, these stopped. I appreciate Nurse Donnie helping me through the preparation, the procedure, the post procedure and explaining final dismissal instructions. Since the procedure I have had no side effects issues. Donnie did an excellent job during each phase of the treatment. After the post procedure MRI/FLA consultation I believe Dr. Karamanian demonstrated exceptional skill at balancing the tumor and margins ablation while minimizing any damage to other critical structures around the prostate. Dr. Karamanian showed a high level of attention and concern 24/7 before, during and after the treatment, which demonstrates his personal care for the patient. At the first follow-up MRI at 6 months (March 2020), at the Busch Center in Alpharetta, GA there was very good results, no appearance of PCa. In summary, I appreciate and recommend both, Dr. Busch for his outstanding screening expertise in detecting the PCa using mpMRI and for Dr. Karamanian, for his preforming the FLA procedure in an excellent manner. I feel very fortunate in finding and using this team, Dr Joesph Busch and Dr. Ara Karamanian. read more

I was diagnosed with prostate cancer in October of 2024 and elected to have a laser ablation performed by Dr. Ara Karamanian at the Prostate Laser Center in Houston, TX. My laser ablation was on December 18th, and I could not be more pleased with my results. I just completed my six month follow up tests and my PSA score is 1.7, and my MRI shows no signs of cancer. Ariana Mobley in the front office was very helpful coordinating a consultation and guiding me through the steps to share scans and reports to see if I qualified for the procedure, and the financial aspects for the procedure. The nurse that worked with me in prep, surgery, and recovery, Donny Sartin, was absolutely wonderful and always there to answer any questions. He walked me through what to expect and after surgery and through the following weeks of recovery - what to expect, and what to watch out for and act on. I felt very well prepared for the procedure and what was to follow. There needs to be more awareness of this treatment option for prostate cancer. Laser Focal Therapy for prostate cancer, or the TULSA - Pro procedure for prostate cancer, are options available at the Prostate Laser Center that were not even presented by my urology clinic. Here is my story. I had a painful battle with a kidney stone, and through a follow-up visit found that PSA score came back very high. It was 13.5 where the normal range is 1-4. An MRI scan that found a small suspicious lesion that a biopsy confirmed to be cancer. My Urologist told me the results and said that I had two options. I could have it surgically removed, or treat it with radiation. Either option could cause long term loss of bladder control and/or sexual function. I was 64 years old and overweight, and recovering bladder control after surgery would be more difficult due to my weight. I did not have an enlarged prostate and no urinary function issues, and the long-term ramifications of either procedure were very concerning. From the very first day I thought that there should be a way this day and age to remove the lesion and not the entire prostate. I started to search online for options. The first thing I found was the Prostate Laser Center in Houston and started learning about the option of a laser ablation of the lesion on my prostate. I when though a series of scans/tests to confirm that my cancer had not metastasized anywhere else in my body, and fortunately it had not. A scan did notice blood clots in my lungs which put me in the hospital and on blood thinners, and there was a lump in my stomach that later proved to be benign. I discussed the options of a laser ablation or the TULSA-Pro procedures with Dr. Karamanian and elected to go with the laser ablation option. It was a more precise targeted approach where I would destroy just the lesion and an area around the lesion, instead of destroying larger area of my prostate. Recovery time from the procedure also looked to be the most appealing. I am very happy with my decision. I had my prostate surgery in the morning, and was my in my hotel room around 2:30 that afternoon. I walked out with urinary catheter and a collection bag strapped to my leg. I thought this would be very uncomfortable, but it was not really that bad. By dinner time that night I felt like going out. My wife and I went out to Lupe Tortilla and had their great steak fajitas. I did my follow-up the next morning and was amazed at how good I was feeling. We reviewed the images with the doctor where we could see the ablation result and received all my post op instructions from Donny. My only complication was some blood clots in my bladder that was most likely related to the blood thinners I had been on previously. Recovery was very quick, and I was back to normal in no time. For many men like me, the Prostate Laser Center and a laser ablation procedure is an option that should be considered. If I had not researched options on my own, I would have never found the option that was best for me. I am very thankful to Dr. Karamanian, and his team for removing my cancer and allowing me to continue a normal life. Jeff S - Keller, TX read more

Procedure date: 01/29/19 Assessment: 63-Year-old male with clinically significant, G3+4 right anterior midgland lesion, no evidence of ECE. G3+4 discovered on MRI guided Multi-parametric MRI performed by Dr. Joseph Busch. G3+3 was discovered in January 2018 by Dr. Richard Prior at the Urology center in Spartanburg SC. Dr. Karamanian using images on his office computer, showed us what the Multi-parametric MRI found in Dr. Busch's report and explained what he thought would be my best options for treating the G3+4 and the G3+3 cancer on the prostate. Please note: Dr. Karamanian spoke with me one on one regarding risk, benefits, alternatives and his and recommendation and reasons prior to bringing in my wife and sister to first make sure I fully understood what he wanted to do to Laser the cancer. Once my wife and sister entered the office and sat down, Dr. Karamanian proceeded to explain to them exactly what him and I discussed and why we choose that decision to proceed. Dr. Karamanian then explained in detail of how the Focal Laser Ablation procedure worked. He showed us the MRI images and explained the process including showing us the tools he would use to perform the ablation right down to the actual wire fiber that would carry the laser power. At first this was a bit scary to see all the images of cancer, the tools to be utilized and hearing the risk and benefits again. However, I gained trust in both nurse Donnie and Dr. Karamanian and we all agreed that it would be best to go ahead with the Focal Laser Ablation process to kill the cancer in my prostate. Dr. Karamanian's plan for my procedure was to be aggressive with the G3+4 cancer and moderate aggressive with the G3+3 cancer. All of us made the agreement with Dr. Karamanian that we 100% trusted his experience and ability to perform the FLA process on me the patient. Summary: 1/30/19 I would highly recommend Dr. Karamanian to others for the Focal Laser Ablation procedure. I am convinced 100% that his staff, nurse and Dr. Karamanian all have the best interest into helping save the patient's life. One week after surgery the pain level is about a 1 of 10 where 1 is the least amount of pain and discomfort. I had some drips of blood in my urine for the first 7 days and now have no outside signs of ever having the procedure done. Knowing that the cancer is gone is a fabulous feeling thanks to Dr. Karamanian superior expert skills, nurse Donnie and his staff. Current Multi-Parametric MRI results 8 months after FLA procedure:10/23/19 I went to Dr. Joseph Busch on 10/23/19 at the new Busch Center in Alpharetta Ga to have the Multi Parametric MRI with Contrast to see the results of Dr. Karamanian's FLA procedure. Dr. Busch showed me and my wife the results and I have zero re-occurrence of cancer in my prostate and don't have to be checked for another year. Dr. Busch and Dr. Karamanian and their staff have exceeded all expectations from finding the Gleason 7 cancer to removing the cancer from my prostate. Both doctors have eliminated the thought of having my prostate removed the second dangerous painful surgery to man after the open-heart surgery, from radiation and hormone shots and all the horrific side results from both procedures. I would 100 percent recommend men with Gleason 6-7 to see Dr. Busch to find out what cancer they truly have, where it is located (often missed by a Trus biopsy), then go to Dr. Karamanian to have the cancer removed utilizing the Focal Laser Ablation (FLA) procedure. read more

I have just turned 77 years old and was told in 2007 after biopsy that I had prostate cancer. Now it was up to me to decide which treatment to go with. I chose radiation mainly because the radiation doctor said he had been tracking his cases for years with excellent results. What he didn't tell me is that if there is a recurrence there is very little if anything that can be done. Well last year my family urologist had me get a pet scan which came back with suspicious activity in my prostate. He did a biopsy that verified that there was a recurrence and that the tumor had a score of gleason 9. He said at that time since i had prior radiation that freezing the prostate was probably only thing that could be done.. He did send me to another doctor that does a procedure where he implants a nuclear seed into the prostate. After reviewing my MRI he turned me down. Then back to my family doctor and now he has decided that freezing was not an option. ( Thank God for that). So now I am offered hormone therapy as only alternative. Started doing my own research online and found Prostate Laser Center and was impressed with reviews. I called there number around 8pm figuring I would not get a person, but some info to follow up on. Got an answer from Donnie Sartin, RN and he was extremely courteous and helpful explaining procedure and what they needed from me to be evaluated. I explained to him my situation and he did let me know that a gleason 9 tumor was not a good candidate, but to send MRI cd and Dr. Ara Karamanian would review it and get back with me. After about a week Dr. K did call and said he was not comfortable doing laser surgery on me. Now I have nowhere to go and basically excepting my situation. Few days later Dr. K calls back and said he had been reviewing my MRI again and now feels that there is a chance to help. Made appointment and met with Dr K day before the procedure and he explained in detail while I was looking at MRI with him why he thought procedure would work and what could possibly go wrong. Next morning he did the procedure and met with him that afternoon and he showed me on new MRI that the tumor had been eradicated and there was just dead tissue where the tumor had been. I live in Ft Worth area and drove back home with no pain or side effects other then he had me wear a catherter for 2 weeks. Now I am doing lab every 3 months to check psa and doing yearly MRI. It has been almost 18 months since laser surgery. My last MJRI shows prostate still clear and the amazing thing is that my last psa numbers were "0.02". I cannot say enough good about Dr Karamanian, Donnie Sartin, and the office staff. Dr K actually gave me his cell phone number and to call with any concerns. I did twice and got reply within 15 minutes. If this procedure was available back in 2007 I could have led a more normal life without side effects of my prior cancer treatment. Dr. K and Donnie Sartin are very patient friendly and I can tell they are sincere in wanting to help their patients. I hope this review helps others to know that this procedure should be considered ahead of any other alternatives. Francis Scheirmann read more

It is an amazing feeling. The physical side was painless, there have been no side effects and the mental relief is phenomenal ! The process was quick and painless...Wow! The experience with the Prostate Laser Center was fabulous. After all the historical information was submitted, the most difficult part was waiting to find out if I was a good candidate. Dr. Harman was wonderful: patient, understanding, helpful and without a doubt, thorough, meticulous, empathetic and superb in his specialty. Donnie Sartin was a great complement to the entire experience with the same great traits. They both made me feel comfortable in describing and understanding the process, before, during and after. I've never felt better in the hands of medical professionals ! The day of the pre-op was very helpful. One cannot be prepared for the procedure without some nervousness and trepidation but Dr. Harman and Nurse Donnie did their utmost to explain everything, from the process, to the benefits, to the potential outcomes. I don't think I could have been better prepared. The procedure itself went smoothly and quickly. If it wasn't for the catheter and the associated leg-keg, one would never know anything had happened. I don't mean to imply the procedure itself was simple. In my case, it took 4 hours and involved 15 ablations. I was completely amazed there was no pain or discomfort. That is why I am so impressed. It speaks highly to the skill of Dr. Harman. The post-op was a great experience as well, with a detailed briefing on the process and what to expect going forward, from both of the professionals: Aaron and Donnie. It was fascinating to get a full de-briefing on the procedure complete with before and after MRI pictures to enhance the understanding of it all. To have the cancer removed simply and with precision, with no side effects and (for me) absolutely no after effects or complications is such a relief and joy that it is almost indescribable. While there are no guarantees, I don't believe there is a prostate cancer solution that can come close to the best prospects for complete resolution with limited, if any, side effects. I can only begin to give the Prostate Laser Center, Dr. Aaron Harman and Nurse Donnie Sartin, the highest possible accolades and recommendation !! I would be remiss to not acknowledging the others that make this process possible: Susan, introduction, Olivia, reception, Juliana, logistics, Dr. K (also the IT guy), Olivia, nurse. My heartfelt thanks to all. read more

21 month update: Still going strong and am very satisfied with my decision and am now into my 60s. Initial Review: I am now 8 months out from Dr. Karamanian's surgery, the MRI-guided Focal Laser Ablation (FLA). I continue to be incredibly thankful for the new life that it has given me. The burden of frequent, urgent, painful, incomplete urination was significantly degrading my quality of life. I chose Dr. Karamanian because of the considerable precision (lower risk) that he offers with this unique procedure versus the (higher) risks related to other options. The MRI guided process is what cemented my decision, because reducing risk of incontinence and reduced sexual function to the lowest possible level was primary in choosing which procedure to use. Additionally, any biopsies needed are completed with the same precision and in the exact area that is ablated at the same time as the biopsy. The personal focus and care that both Dr. Karamanian and Donnie give is really wonderful. They made sure that all my questions were answered in pre-op meetings, post-op checkups, and later followups. I rapidly resumed activities and after the requisite recovery period ran 5k the next day, started skiing and running, and worked up to a 50k race 5 months post surgery. From a function standpoint, my urination went from frequent, urgent, low volume, weak, and strained to something I have not experienced for decades - strong stream, comfortable bladder control, full emptying, and the confidence not to worry about having a bathroom always accessible. My sexual function was not disrupted at all. The extreme precision that the MRI affords allows the surgeon to ablate the needed prostate areas without damaging surrounding tissues and nerves. My procedure was to reduce the size of my prostate, and to biopsy an area of question. The biopsy benefits from the same precision to assure exact targeting of the area of concern and then immediate ablation of the same exact area rather than a separate needle biopsy procedure. In my opinion, the TURP or GreenLight alternatives could not provide the precision to reduce risk of damage to the nerves controlling continence and sexual function, nor the biopsy precision that the MRI/FLA delivers. The specter of incontinence and sexual dysfunction were too great for me. The MRI guidance gave me the confidence to go into this surgery with the lowest risks possible. I am incredibly thankful to Dr Karamanian and team and so pleased with the result. read more

I am now 8 months out from Dr. Karamanian's surgery, the MRI-guided Focal Laser Ablation (FLA). I continue to be incredibly thankful for the new life that it has given me. The burden of frequent urination was significantly degrading my quality of life. I chose Dr. Karamanian because of the considerable precision (lower risk) that he offers with this unique procedure versus the (higher) risks related to other options. The MRI guidance is what cemented my decision, because reducing risk of incontinence and reduced sexual function to the lowest possible level was primary in choosing which procedure to use. Additionally, any biopsies needed are completed with the same precision and then the exact area is ablated. The personal focus and care that both Dr. Karamanian and Donnie give is really wonderful. They made sure that all my questions were answered in pre-op meetings, post-op checkups, and later followups. I rapidly resumed activities and after the requisite recovery period ran 5k the next day, started skiing and running, and worked up to a 50k race 5 months post surgery. From a function standpoint, my urination went from frequent, urgent, low volume, weak, and strained to something I have not experienced for decades - strong stream, comfortable bladder control, full emptying, and the confidence not to worry about having a bathroom always accessible. My sexual function was not disrupted at all. The extreme precision that the MRI affords allows the surgeon to ablate the needed prostate areas without damaging surrounding tissues and nerves. My procedure was to reduce the size of my prostate, and to biopsy an area of question. The biopsy benefits from the same precision to assure exact targeting of the area of concern and then immediate ablation of the same exact area rather than a separate needle biopsy procedure. In my opinion, the TURP or GreenLight alternatives could not provide the precision to reduce risk of damage to the nerves controlling continence and sexual function, nor the biopsy precision that the MRI/FLA delivers. The specter of incontinence and sexual dysfunction were too great for me. The MRI guidance gave me the confidence to go into this surgery with the lowest risks possible. I am incredibly thankful to Dr Karamanian and team and so pleased with the result. read more

After a very extensive search and speaking with numerous doctors and ...reviewing their results data (as best as one can, as many do not want to share their results data); posing all of my questions and evaluating and taking note of their answers (or not/avoidance; note that I did not want any personal data of patients, primarily just aggregate data); getting a feel for their demeanor as well as what was important to them and what their priorities are; gauging with my best assessment of integrity and authenticity; ...my short list came down to Dr. Ara Karamanian at the Prostate Laser Center and Dr. John Feller at Desert Medical Imaging. Ultimately, I chose Dr. Karamanian at the Prostate Laser Center. Dr. K was one of the most attentive and responsive FLA doctors I spoke with. Dr. K called me back promptly whenever I had any question or request. Dr. K's assistant and nurse, Donnie Sartin, was also great to have caring for me. He replied thoroughly and articulately and took the time needed to fully address any questions or concerns. My perception of, and ultimately experience with, Dr. K and Mr. Sartin were very positive. Adjectives that come to mind are: real, genuine, caring, responsive, knowledgeable, skilled, intelligent, experienced, receptive, thorough. In my various other research efforts, including seminars and support groups, I had occasion to run into a couple of other men who had FLA performed by Dr. K. Both of them had nothing but positive things to say, including the most important, no residual or recurrent cancer as of the time I spoke with them. On a technical/clinical note, not all doctors sought the same margins. The more margin, the less chance or residual/recurrence, as the cancer has "tentacles/roots" (non-medical terms). I liked what Dr. K told me about his grid pattern in ablating as well as the margins. It has been 8 months since my FLA procedure. I have had zero encounters of incontinence, which was my #1 concern regarding side effects. At 6 months, my PSA was 0.3 and my 3TMRI, reviewed by two radiologists, including Dr. K, both stated there was no residual or recurrent cancer. I am feeling blessed and pleased with the success to-date and would certainly highly recommend Dr. K to anyone seeking FLA. read more

David H. I am 68 years old and on March 21, 2017 my PSA reading was 9.6 and I was suffering from moderate erectile dysfunction. My doctor ordered a MRI for April 4, 2017 that showed two lesions one central and one peripheral. After a biopsy which resulted with a Gleason score of 7 with and one with a Gleason score of 6, my doctor scheduled a full body bone scan which showed no malignant migration. I researched extensively all therapy covered by insurance including, Cryo, Prostatectomy, Radiation and Hormone Deprivation. All of the insured procedures had one thing in common, they were whole organ therapy and with horrible side effects. After finding Artemis, then HIFU and finally FLA on YouTube I decided on Focal Laser Ablation for my therapy. Researching the providers in my area I chose Prostate Laser Center in Houston with Dr. Ara Karamanian. Dr. Karamanian spent more than an hour on the phone with me discussing my case on more than one occasion. I spoke to every Dr. that does FLA and he was by far the most generous with his time and he was very honest about the possible risks and outcomes. In my case, saving the left nerve bundle was impossible using full organ removal or radiation and it would be very difficult even with FLA. Dr. K said he thought it was possible and he would do his best, but he could not guarantee that the nerves could be saved due complexity and location. The multiple tumors complicated my situation and I needed more time and attention than most patients and Dr. Karamanian once again was very generous. He blocked off extra time for the 3T MRI machine and allotted extra time for the procedure. Twenty one months later, I couldn't be happier with the results. My PSA is now 1.0, my erectile dysfunction has improved and I have an easy and constant stream when voiding the bladder. I am better in every way. It's just awesome! Dr. Karamanian and the Prostate Laser Center was definitely the right choice for me. https://www.prostatelasercenter.com read more

I would like to heartily endorse the Prostate Laser Center of Houston for their expertise and professionalism during my bout with prostate cancer and BPH. I can't say enough about MD Radiologists Harman and Karamanian and RN Donnie Sartin for their efficient and personable service. As the events below unfolded, all three provided their mobile phone numbers with expectations for me to call if there were any questions or concerns they could address. The office staff, including Juliana Flores and Olivia Morales, is also knowledgeable, and easy to work with via phone and email. Dr. Harman contacted me following an MRI guided biopsy he performed on me and reported that the tissue in the suspected location contained prostate cancer. The pathologist graded me at 4+3 on the Gleason scale. This was Stage 2a which Dr. Harman said was beyond the option of active surveillance such as a rating of 3+4 might suggest. This was not a brief phone conversation. Dr. Harman explained thoroughly what the results meant and answered all my questions. He delivered the "bad news" simply but encouragingly. He pulled up studies and research algorithms while we talked to respond to questions about mortality and other issues. He was knowledgeable, articulate, personable, professional, and compassionate. I found Drs. Harman, Karamanian, and Donnie were also very responsive to my questions and concerns during recovery. Dr. Harman stayed on the phone with me for several extended periods following emails to him, inquiring, answering, and assisting. I have not found this level of support in my dealings with other medical professionals. PLC is committed to improving men's prostate and urinary health. The focal laser ablation went well and I am now both cancer and BPH free now. You cannot go wrong working with the fine staff at PLC. God bless their work at preserving life and joy. read more

I was diagnosed with Prostate Cancer (Gleason 6) in March 2021 after many years of tracking a slightly increasing PSA trend over the previous ~ 7 years. My risk was considered low and thus I went on Active Surveillance Protocol. My baseline MRI (December 2020), showed ~ 0.5 cm tumor. PSA had increased from about 4.5 to 6.2 in the prior year. Early 2020 biopsy was benign but early 2021 biopsy confirmed cancer. In 2024 (April-May), PSA had a very sharp rise (8.6, 12.4, 17.0) but then a decrease was noted (June-July) and PSA dropped (9.3, 7.2). This could have been attributed to COVID, but with a family history of Prostate Cancer, I had initiated consultation with Dr. Karamanian in June 2024. I decided it was time for treatment. Latest MRI in July showed a modest tumor increase (0.8 cm) from the baseline. I was very fortunate to have a friend who had Focal Laser Ablation (FLA) treatment by Dr. K in 2018. My friend spoke very highly of Dr. K and Nurse Donnie Sartin, so that was of great help as were other on-line reviews. My cancer and BPH condition were treated by FLA on August 29. 2024. Dr. K is excellant at explaining the surgery and the risks involved. I would highly recommend Prostate Laser Center (PLC). The education care and treatment met all my expectations. I experienced no side effects and am living a normal life at age 64. The entire PLC staff is very professional and nurse Donnie is the best. I highly recommend the PLC without hesitation. I just recently had my first Post-Op MRI and the local radiologist noted "No definable residual malignancy. In my phone consultation with Dr. K, he also noted my tumor is gone and no evidence of cancer. Post-Op protocol calls for regular PSA check and MRIs. Thank you Dr. Karamanian and Nurse Donnie! read more

There is nothing I could possibly say to add to John A.'s review of the care I received from Dr. Karamanian except "ditto" and "...62 years." (Apparently John is a few years older than I am.) Therefore, I'm going to make a few observations beyond Dr. K's bedside manner: 1) He was unflinchingly honest in all of our interactions. If he said "most likely," I could bank on it. And, I presume, if he didn't think he could have helped me (and he did!), he would have been equally direct--without being painfully blunt. 2) He was always compassionate as to my feelings, fears, concerns, etc. 3) He is a uniquely gifted physician who definitely does not present as God's gift to the world. If you cite a contrary opinion, another treatment option or provider, he does not appear to have a defensive bone in his body. I happened to witness the man unfairly attacked by a competitor in a heavy-handed marketing guise, and his response was, "That really makes me mad," in the same conversational tone, seated upright at his desk, as he resumed our conversation. 4) Finally, I don't think I have ever interacted with a professional who was more passionate about his work, about being the best he can be, and about the quality of life of his clients. I have no doubt that I got the best medical care that was to be had from Dr. K, just as I'm equally certain that his next patient got just a little bit better care. I do not ever envision him ever running a medical mill or a half-dozen clinics. He's much more interested in the work than in the business. The number of walking wounded PCa survivors with which the current standard of care has left us is a disgrace on the modern medical profession, and my family and I are so grateful to Dr. Karamanian for doing something about it. Joe T. read more

My experience is unique because I have been a doctor of veterinary medicine for 42 years. My medical training has helped me to completely understand and properly evaluate my treatment, as a doctor. I can say my treatment was excellent and much better than my original urologist recommended at a prominent hospital complex in a nearby, major city. The other doctor recommended "HIFU" which is not as precise of a treatment as the TULSA procedure done by Dr. Karamanian. The HIFU treatment is not done in an MRI like the treatments done by Dr. Karamanian. It doesn't give the temperature readings nor is it as precise as treatments done by Dr. Karamanian. The TULSA procedure shows destruction of the cancer in real time. All of this is a major advantage of the PLA or TULSA treatments In addition to this, the radiologist at this other prominent hospital complex missed an area of cancer that Dr. Karamanian detected. This lesion was close to the prostate capsule and could have spread to my adjacent tissues. Dr. Karamanian actually called that radiologist from his office while I was present to inform him of the missed cancerous lesion. That radiologist agreed and changed his original report to include Dr. Karamanian's interpretation of the MRI. If I had chosen to get treated with HIFU at my original hospital, the treatment would have missed some of my cancer. I would still have cancer today. My follow-up MRI 6 months post-op shows no cancerous lesions anywhere. My PSA dropped dramatically from 14 to 2! I had Dr. Karamanian look at this 6 month post-op MRI. He personally called me and confirmed that I have no sign of prostate cancer. I have had absolutely no side effects from this treatment and highly recommend Dr. Karamanian! read more

I am 58 and was 3 weeks away from an ORP at Toronto General Hospital set for July 30 2018. Gleason 3+4 and a Pirads 5 lesion....PSA 11.4 visible on MRI. AS since 2013 when PSA went from 4.7 to 11.4 in Jan 2018. PC fully localized as per CT and bone flow scans but was refused for RALRP at Canada's leading hospital....?!!!! I was told that the prostate would be fully removed along with the seminal vesicles and whatever lymph nodes they felt like ripping out....no guarantee that maybe one side of the nerves would be spared....recovery and Foley catheter for 7-8 weeeks. I am a medical device sales professional and I looked into alternatives....RALRP in the US, HIFU at Cleveland Clinic Toronto and Germany, and then I came across FLA. Sperling Clinic was too busy to respond on time. Dr Karamanian and the Prostate Laser Centre in Houston responded immediately. Donnie Sartin is a pro. Dr K is the real deal. As an interventional radiologist with prostate specialty he is also a biomedical engineer who understands MRI imaging better than the manufacturers! He uses state of the art technology and most importantly he gave me his full time and attention during pre/post op questions and reviews. Full pre and post op 3t MRI imaging clearly detailed the successful result. My sense of relief left me speechless! He was personally available along with Donnie during the two days I stayed in Houston before flying home. Painless prodecure, foley for one night only, no retention....just a little restricted but improving daily on day 4 after surgery! Golfing with my son next week. Will follow-up in 6 months with 3t MRI and live life fully. Thank you Dr K! read more

Diagnosed in November 2023 with prostate cancer .3+4 Gleason scale went to memorial Sloan they suggested radical prostatectomy. I had a few colleagues who had recently gone thru this procedure. They were all dealing with serious sexual and incontinent side effects researched the prostate laser center spoke with their team. They told me I was a candidate I had the procedure performed in April 2024. Their team is extremely professional. Dr Karmanian goes into great detail to explain the procedure and what to expect. Nurse Donny is always available for a follow up phone call or any questions and is extremely helpful Ariana and the team at the front desk were extremely responsive to any questions I had before and after procedure I am now one year out from the procedure. I have had MRI and PSA's performed at six month and one year intervals. My PSA has dropped from 4.4 to 1.39 all MRI scans show no lesions and no tumors and I feel great. Best of all no side effects sexually or with incontinence I have now recommended this procedure to another friend of mine who was diagnosed with prostate cancer (4 +4) He also went down to the prostate laser center and has had the same experience as I both he and I are thrilled with the fact that this procedure was available and that we were able to choose this path as opposed to radical prostatectomy and all the side effects that come with it which can really changed the quality of your life I could not speak more highly of Dr Karmanian and his team and I highly recommend MEI guided focused laser ablation for anyone who is in this situation read more

I started having prostate problems at 35. My PSA was never higher than 3.4 and that was an anomoly, but median lobe enlargement was bad. By age 50, symptoms were severe and had a PAE that was only moderately successful. Median lobe enlargement is hard to treat and the side effects of procedures are more pronounced and more likely. And PAE is not effective on Median Lobe. At 57, I was in terrible shape. The options urologists gave me guaranteed retrograde ejaculation with incontinence somewhat likely and impotence was possible. No! After some research, I found Dr. K. My wife and I traveled to Houston and talked with him and his staff. They were fantastic. The next day I had the procedure. Dr. K said my case was the 2nd worst he had seen with the median lobe enlargement and might take me more time to see the hoped for results. Less than 2 months is the norm, Mine took 3 months, but when my healing came, it was complete. I am 3.5 years post procedure. I have no side effects from the procedure. I urinate like I was 20 again. I do not suffer from ED and have no problems with incontinence. Also, after stopping flomax and other medications, I have no retrograde ejaculation. I am no longer waking up at night to urinate. I have my life back. My last PSA result was 1 year ago and was 0.46. I tell people that my insurance didn't cover the procedure (3 years ago), but it was the best money I ever spent. Thanks Dr. K., Jerry read more

Ive been watching my PSA since i was 30. My Urologist did a few random TRUS biopsies when i got to PSAs of 5 and 7 and given that i had a Gleason 6 and the "only real options" were to use radiation or remove the prostate (with high chance of serious side effects) i waited . . . . turns out the random biopsies had missed the more serious cancer and the MRIs had not been done with the proper protocol and didnt show the affected area. When my PSA hit 10, the Urologist said its time to take out the prostate and i looked for options. Looked at everything! Cryo, Cyber knife, HIFU etc. Dr Ks Laser ablation procedure made the most sense. Targeted, Can Repeat if needed, uses new technology, many great reviews. Agree with all the overwhelmingly positive comments you will read on this site about Dr K and Donnie about their dedication, desire to serve and motives to do what they do to change the way prostate cancer is treated. My ablation was more difficult as it was close (2mm) to the nerve bundle. At 6 months post surgery, my PSA is 1.6 and the MRI showed no signed of the cancer!. Really grateful for Dr K and Donnie and Juliana and the advance in technology that allows a targeted surgery vs. the cave man club of the old radical protatectomy for moderate growth cancers! read more