NHS Imperial College London Archives

NHS Imperial College London

Focal versus Radical – At What Cost

Posted by Deepika Reddy, MD | Aug 2024

Deepika Reddy, MD, examines the comparative impacts of focal and radical treatments for prostate cancer, focusing on their efficacy, side effects, and overall costs.

Dr. Reddy underscores the growing interest in focal therapies due to their potential to minimize treatment-related side effects; however, Dr. Reddy emphasizes the importance of careful patient selection and thorough pre-treatment imaging to ensure the appropriateness of focal therapy. In contrast, radical treatments provide a comprehensive approach to cancer eradication, offering lower rates of recurrence in appropriately selected patients. These benefits come at the cost of higher rates of adverse effects. Dr. Reddy presents data comparing long-term outcomes of patients undergoing focal versus radical treatments.

Cost considerations also play a crucial role in the treatment decision-making process. Dr. Reddy discusses the direct and indirect costs associated with both approaches.

Clinical Trials in Focal Therapy – Endpoint, Design, Updates

Posted by Taimur Shah, MD | Aug 2024

Taimur Shah, MD, provides an in-depth analysis of clinical trials in focal therapy for prostate cancer, focusing on endpoints, design, and recent updates.

Dr. Shah emphasizes the importance of carefully defined endpoints in clinical trials for focal therapy, including oncologic control measures such as progression-free survival, biochemical recurrence rates, and cancer-specific mortality. Secondary endpoints typically assess functional outcomes, including urinary continence and sexual function, to gauge the impact on patients’ quality of life. These criteria are crucial for determining the effectiveness and safety of focal therapy compared to traditional treatments.

The design of clinical trials in focal therapy is discussed in detail. Dr. Shah highlights the need for robust methodologies, including randomized controlled trials (RCTs) and prospective cohort studies. He discusses the latest data on various focal therapy modalities, including high-intensity focused ultrasound (HIFU), cryoablation, and photodynamic therapy.

The presentation also addresses the challenges and limitations of current clinical trials. These include the need for standardized treatment protocols, variability in imaging and biopsy techniques, and the difficulty of conducting long-term follow-ups. Dr. Shah emphasizes the importance of continued research and collaboration among institutions to overcome these challenges and refine focal therapy approaches.