Abstract

LECORNET, Emilie; AHMED, Hashim Uddin; MOORE, Caroline  and  EMBERTON, Mark. Focal therapy for prostate cancer: a potential strategy to address the problem of overtreatment. Arch. Esp. Urol. [online]. 2010, vol.63, n.10, pp.845-852. ISSN 0004-0614.

Focal therapy involves destroying the cancer focus and the tissue surrounding the cancer in order to offer patients the potential of combining cancer control with minimal side-effects. Current standard of care involve either surveillance or radical therapy. Neither of these is ideal. Active surveillance carries risk of under-treatment, psychological morbidity as a result of anxiety and is not without side-effects due to repeated biopsies., Although radical therapy is the gold standard for curative treatment it carries risks of over-treatment with its numerous side-effects. With the proportion of unifocal or unilateral disease among men with low-risk disease rising, a focal approach could avoid both under and over-treatment. With the advent of improved accuracy for cancer localization provided by multi-parametric MRI and new biopsy strategies such as transperineal mapping biopsies, ablative modalities such as cryotherapy, high intensity focused ultrasound, photodynamic therapy and radio-interstitial tumour ablation make a focal treatments a real possibility.

Keywords : Focal therapy; Cryotherapy; HIFU; Photodynamic therapy; Prostate cancer.

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