How to cite: Sidana A. Focal Therapy Recurrences and Management. Grand Rounds in Urology. October 8, 2024. Accessed Jan 2026. https://grandroundsinurology.com/focal-therapy-recurrences-and-management/
Summary
Abhinav Sidana, MD, MPH, Director of Focal Therapy, University of Chicago Medicine and Biological Sciences, Chicago, Illinois, explains that focal therapy offers the advantage of minimizing morbidity by targeting cancer while preserving surrounding tissue, but recurrences remain a significant issue. Dr. Sidana describes recurrence as multifactorial, influenced by patient selection, tumor biology, and treatment modality. He emphasizes that recurrences may be local, within untreated regions of the prostate, or systemic, underscoring the need for ongoing surveillance.
Dr. Sidana highlights the role of imaging, particularly multiparametric magnetic resonance imaging (mpMRI), and biopsy in detecting recurrences. He noted that integrating advanced imaging with biopsy improves diagnostic accuracy and guides personalized management. Dr. Sidana outlines several management strategies, including repeat focal therapy, whole-gland treatment, and systemic therapy, emphasizing that decisions must be individualized based on the extent of the disease and the patient’s preference.
Emerging approaches, including molecular imaging and biomarkers, may refine risk stratification and recurrence detection in the future. Dr. Sidana emphasizes the importance of multidisciplinary care in optimizing outcomes for patients undergoing focal therapy.
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
Abhinav Sidana, MD, MPH, FACS, is an Associate Professor of Surgery, the Director of the Prostate Cancer Focal Therapy Program, the Co-Director of the High-Risk and Advanced Prostate Cancer Clinic, and a Urologic Oncologist at the University of Chicago in Illinois. Dr. Sidana specializes in prostate and kidney cancer, performing both robotic and open surgery for patients diagnosed with urologic cancers. He offers robotic prostatectomy for patients with more aggressive prostate cancer, and performs open and robotic surgery for patients with complex, multifocal, and advanced kidney cancers. Dr. Sidana’s research focuses on providing organ-preserving treatment, with lower side effects, for prostate cancer. He has extensive experience with cryoablation, high-intensity focused ultrasound ablation, TULSA Pro, and irreversible electroporation of the prostate.
