FOCAL THERAPY FOR LOCALIZED PROSTATE CANCER
Authors:
K. M. Siddiqui; M. Billia; J. Izawa; J. L. Chin
Authors‘ workplace:
Division of Surgical Oncology University of Western Ontario
Published in:
Urol List 2015; 13(3): 35-40
Overview
The ubiquity of prostate specific antigen testing in certain parts of the world has led to significant stage migration of prostate cancer at presentation, apparently resulting in over-diagnosis and over-treatment. With radical definitive therapies such as radical prostatectomy and radiotherapy, patients have to endure treatment-related adverse effects. “Active surveillance with delayed intervention if necessary”, has gained popularity as a possible solution for the over-treatment problem, although this approach also has inherent limitations. Focal therapy is emerging as a viable management option for certain localized prostate cancers. Advancement in imaging technology coupled with the ability to safely and effectively deliver energy to ablate foci of localized prostate cancer has accelerated acceptance of this form of management. Level one evidence is still lacking, although a number of trials are now underway to define the role of focal therapy. Cryotherapy and high intensity focused ultrasound have an established track record as energy sources for whole gland prostate ablation. In this article we review the indications and technique of focal treatment for localized prostate cancer, as well as early published results using these two technologies.
Key Words:
prostate cancer focal therapy cryoablation high intensity focused ultrasound interstitial laser photodynamic therapy irreversible electroporation and focal brachytherapy
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