Mark Emberton, MD, presented “Changing Relationship between Active Surveillance and Focal Therapy” at the 8th Global Summit on Precision Diagnosis and Treatment of Prostate Cancer on October 8, 2024.
How to cite: Emberton, Mark. “Changing Relationship between Active Surveillance and Focal Therapy” October 2024. Accessed Feb 2026. https://grandroundsinurology.com/changing-relationship-between-active-surveillance-and-focal-therapy/
Changing Relationship between Active Surveillance and Focal Therapy – Summary
Mark Emberton, MD, Dean of the Faculty of Medical Sciences at UCL, presents an insightful discussion on the evolving roles of active surveillance and focal therapy in managing prostate cancer. This engaging presentation spans approximately 10 minutes and offers a provocative perspective on the future of prostate cancer management.
Dr. Emberton suggests that active surveillance, historically used to mitigate overdiagnosis and overtreatment, will decrease as focal therapy emerges as a preferred strategy. He highlights the transformative potential of novel imaging techniques like MRI in early detection and risk stratification, referencing a pivotal study demonstrating that an MRI-first approach effectively identifies clinically significant cancers. Remarkably, two-thirds of clinically significant cancers were detected in men with normal PSA levels, underscoring the limitations of PSA-first strategies.
Emberton emphasizes the critical role of lesions in future prostate cancer management. Emerging therapies, such as high-intensity focused ultrasound (HIFU), allow precise, imaging-guided treatment of lesions, merging diagnostic and therapeutic approaches. Dr. Emberton envisions a shift toward lesion-centric management, incorporating genetic, immune, and molecular profiling to predict progression and recurrence.
The Global Summit on Precision Diagnosis and Treatment of Prostate Cancer is a unique multi-disciplinary forum organized to inform the key health care stakeholders about the emerging advances in clinical case and research and create a consensus-based vision for the future of precision care and educational and research strategy for its realization. The mission of the Summit is to fill the currently existing gap between the key experts of in vivo imaging, the world authorities in the in vitro fluid- and tissue-based molecular diagnostics, including genomics, and thought leaders in the development of novel observation strategies (e.g., active surveillance, or AS) and therapeutic interventions.
ABOUT THE AUTHOR
Mark Emberton, MD, FRCS, is Dean for the Faculty of Medical Sciences, and Professor of Interventional Oncology for the Division of Surgery and Interventional Science at University College London in London, England. He is also an Honorary Clinical Director of the Clinical Effectiveness Unit at the Royal College of Surgeons of England, and UCL Partners' Pathway Director for urological oncology for London Cancer. Professor Emberton’s clinical research is aimed at improving the diagnostic and risk stratification tools and treatment strategies for prostate cancer. He specializes in the implementation of new imaging techniques, nanotechnologies, bio-engineering materials, and non-invasive treatment approaches, such as high intensity focused ultrasound and photo-dynamic therapy.
