Title

Contemporary treatments in prostate cancer focal therapy

Document Type

Journal Article

Publication Date

5-1-2019

Journal

Current Opinion in Oncology

Volume

31

Issue

3

DOI

10.1097/CCO.0000000000000515

Keywords

focal laser ablation; focal therapy; high-intensity focused ultrasound; photodynamic therapy; prostate cancer

Abstract

© 2019 Wolters Kluwer Health, Inc. All rights reserved. Purpose of reviewRadical treatments for prostate cancer are associated with significant morbidity, including incontinence and erectile dysfunction. Advances in the field of prostate MRI and desire to reduce treatment morbidities have led to a rapid growth in focal treatments for prostate cancer. Here, we review novel focal prostate cancer treatments and their associated recent clinical data, with a particular focus on data reported within the last 24 months.Recent findingsHigh-intensity focal ultrasound, focal laser ablation, irreversible electroporation, focal cryotherapy, and photodynamic therapy have been used as treatment modalities for localized prostate cancer treatment. Despite the great variety of treatment techniques, each of these modalities is characterized by a significant rate of prostate cancer persistence within treatment zones (6-50%) and the presence of residual cancer within the prostate on rebiopsy (24-49%). These treatments, however, are associated with very low rates of high-grade complications, rare incontinence, and only mild or transient reductions in erectile function. The most common adverse events are urinary tract infections, hematuria, and urinary retention.SummaryProstate cancer focal therapy is an attractive option for well-selected patients because of its low complication profile; however, long-term oncologic outcome is still lacking and early recurrence rates are high, limiting the ability of most urologic associations from endorsing its routine use.

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