UroToday - Focal Therapy for Prostate Cancer - Abstract

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Monday, 21 April 2008

Division of Urologic Surgery and Duke Prostate Center (DPC), Department of

Surgery, Duke University Medical Center, Durham, North Carolina, USA.

Nowadays the treatment paradigm for localized prostate cancer is to

distinguish patients with clinically relevant cancers who may benefit from

radical treatment, or perhaps an organ-sparing approach, from the remainder

who may not need intervention at the time of diagnosis. We review new

concepts of parenchymal preservation as possible new frontiers in the

treatment armamentarium for this malignancy.

For a select cohort of patients with low-risk unifocal or unilateral

prostate cancer lesions, a number of ablative treatment options for focal

therapy are available with cryotherapy having the most clinical experience.

Technologies that have the ability to be utilized for focal therapy include

high-intensity focused ultrasound, brachytherapy, interstitial laser

thermotherapy, stereotactic radio surgery, and vascular-targeted

photodynamic therapy. Further basic and animal research along with the

conduction of large-scale randomized clinical trials demonstrating long-term

disease-free survival and quality of life outcomes are necessary.

The concept of focal therapy is evolving with the understanding of the

biologic variability (clinically aggressive, significant or insignificant)

of various prostate cancer lesions that may require different treatment

approaches. Minimally invasive, parenchyma-preserving therapies can assume a

greater role in the treatment of unilateral or unifocal lesions,

representing an alternative approach to the current treatment extremes of

whole-gland treatment and watchful waiting.

Written by

Polascik TJ, Mouraviev V.

Reference

Curr Opin Urol. 2008 May;18(3):269-74.

PubMed Abstract

PMID:18382236