Can One Biopsy Event Determine Type and Amount of Focal Therapy Treatment?

Posted by Nelson N. Stone, MD | May 2021

Nelson N. Stone, MD, presented “Can One Biopsy Event Determine Type and Amount of Focal Therapy Treatment?” during the Southwest Prostate Cancer Symposium 2020 virtual conference in December 2020.

How to cite: Stone, Nelson N. “Can One Biopsy Event Determine Type and Amount of Focal Therapy Treatment?” December 2020. Accessed Apr 2024. https://grandroundsinurology.com/can-one-biopsy-event-determine-type-and-amount-of-treatment/

Can One Biopsy Event Determine Type and Amount of Focal Therapy Treatment? – Summary

Nelson N. Stone, MD, Professor of Urology, Radiation Oncology, and Oncological Sciences at the Icahn School of Medicine at Mount Sinai and at the Derald H. Ruttenberg Cancer Center at Mount Sinai, argues for the use of transperineal mapping biopsy (TPMB), and against the use of strict criteria and cursory cancer identification methods for finding focal therapy-eligible patients. He expresses a clinical need for a process that identifies focal therapy candidates and lists which portions of the prostate require treatment, and suggests that TPMB can fulfill these goals. Dr. Stone summarizes a review of the evidence for using focal therapy for the treatment of prostate cancer and found that despite at least 50% of patients being focal therapy-eligible, only a minority of patients actually receive the therapy. He also critiques a study on focal therapy eligibility determined by MRI/US fusion biopsy on the basis of using too strict of criteria for selecting patients and in consideration of the possibility of missing many patients due to not using a biopsy. Dr. Stone discusses several other studies that depict MRI as unreliable in accurately identifying focal therapy patients compared to TPMP due to the lower accuracy of MRI across the prostate.

About the Southwest Prostate Cancer Symposium 2020 virtual conference:
Presented by Program Chairs Nelson N. Stone, MD, and Richard G. Stock, MD, this virtual conference educated attendees about advances in the management of localized and advanced prostate cancer, with a focus on imaging, technology, and training in the related devices. It included a scientific session, as well as live demonstrations of surgical techniques. You can learn more about the conference, including the 2021 iteration, here.

About The Author

Nelson N. Stone, MD

Nelson N. Stone, MD, is Professor of Urology, Radiation Oncology, and Oncological Sciences at the Icahn School of Medicine at Mount Sinai and chief medical officer at Viomerse, Inc. Dr. Stone earned his medical degree from the University of Maryland in 1979. He completed a Residency in General Surgery in 1981 at the University of Maryland, followed by a Residency in Urology at the University of Maryland. He then completed a Fellowship in Urologic Oncology at Memorial Sloan-Kettering Cancer Center and a Research Fellowship in Biochemical Endocrinology at Rockefeller University in 1986. He was Chief of Urology at Elmhurst Hospital Queens from 1986-1996. Dr. Stone has founded several medical companies and serves on the editorial board of many scientific journals. He is a member of many professional societies, including the Prostate Conditions Education Council, the Society for Minimally Invasive Therapy, the New York State Urological Society, the American Association of Clinical Urologists, and the American Urologic Association. Dr. Stone has participated in approximately 25 research studies on prostate cancer and has authored more than 500 articles, abstracts, and book chapters, primarily on prostate cancer. He invented the real-time technique for prostate brachytherapy in 1990 and has trained more than 5,000 physicians worldwide through his company ProSeed. His most recent company, Viomerse, creates synthetic body parts (phantoms) for surgical training and has recently released an extended reality remote training platform.

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