Latest Videos

Focal Therapy is Now Ready for Prime Time

Hashim Ahmed, MD, PhD, advocates for wider adoption of focal therapy (FT) as a treatment option for localized prostate cancer. Dr. Ahmed contends that by identifying and ablating the index lesion, FT can control disease with fewer side effects than radical therapy.

Dr. Ahmed outlines UK criteria for FT, explaining it is an alternative to radical therapy, not an alternative to active surveillance. He lists the side effects of radical therapy compared with those of FT. He cites “reassuring” survival data on FT and calls this important because the data does not support the concern of FT resulting in greater instances of metastasis.

Dr. Ahmed explains data on outcomes of focal cryotherapy before turning to a comparison of FT vs. radical therapy outcomes, with little difference in failure-free survival. Dr. Ahmed cites randomized studies that experienced significant dropout rates in their radical therapy arms compared to FT.

Dr. Ahmed concludes by reiterating why FT confers similar oncological outcomes and improved genitourinary function compared with radical therapy. He contends FT is a legitimate treatment option, with current outcomes now justifying FT’s use in standard care, highlighting that it avoids damage to collateral tissue and the resulting side effects.

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Industry Perspective: BioProtect Balloon Implant™ System

In this Industry Perspective, supported by BioProtect, Daniel Y. Song, MD, compares the BioProtect Balloon Implant™ System to rectal gel spacers currently on the market. Dr. Song begins by presenting the composition, dimensions, and safety features of the balloon.

Dr. Song then compares the balloon’s features and implantation process to those of the two most readily available rectal gel spacers on the market. He notes that, unlike the gel spacers, the balloon creates predictable, reproducible, symmetrical results.

Dr. Song presents a step-by-step illustration of the implantation process for the BioProtect Balloon Implant™ System. He presents a video demonstration of an implantation via blunt dissection, which reduces the risk of rectal, capsular, and vascular infiltration. He adds that the balloon is simple to degrade, with 98% of the material degraded at the 6-month mark.

Dr. Song concludes by presenting the results of the BioProtect Multinational Pivotal Study. He compares the GI toxicities at 3 and 6 months of patients treated with rectal gel spacers versus those treated with the BioProtect Balloon Implant™ System. He demonstrates that the balloon achieves robust reduction in radiation dose, while being well-tolerated by patients and easy for healthcare professionals to implant and adjust.

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Selecting the Optimal Energy Source

Samir S. Taneja, MD, compares the merits and limitations of the leading energy sources used in prostate focal ablation. The sources available for use in prostate ablation today include laser, electroporation, radiofrequency, photodynamic therapy, high-intensity focused ultrasound (HIFU), cryosurgery, drugs/toxins, radiations (focal/interstitial), surgery, steam, and gold nanoparticles.

Dr. Taneja outlines the ideal criteria for an energy source based on the individual characteristics of the patient and their disease, as well as real-world considerations like ease of use and insurance coverage. He gives examples of which energy sources are best-suited for certain cases based on disease presentation and other factors.

In a full focal therapy practice, the optimal situation would be one with multiple energy sources available so that physicians can tailor treatments to each individual patient. Since this saturation of options can be daunting to physicians just starting in a focal therapy program, Dr. Taneja advises practitioners to pick one energy source to practice at first, limiting patient selection to those with disease that is best-treated with that specific modality. After becoming proficient with that energy source, more can be added to increase candidate selection.

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PI-RADS Standardization and Risk Assessment – Recent Advances and Future Plans

Clare Tempany, MB BCh BAO, gives an overview of the role that Prostate Imaging Reporting And Data System (PI-RADS) standardization plays in the treatment and detection of prostate cancer. She begins by giving a history of the RADS program, which is overseen by the American College of Radiation, and the objectives of RAD programs overall.

Dr. Tempany then goes into detail about the PI-RADS program and its specific objectives. She discusses the need to change and update existing RADS, highlighting the lack of consensus on two significant studies that would prompt such changes.

Dr. Tempany concludes by reviewing the technical specifications, clarifications in interpretation criteria and the role of Bi-Parametiric MRI in PI-RADS. She finishes her talk by going over possible research opportunities and other exciting future plans.

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Managing the Man with Ejaculatory Dysfunction

Jesse N. Mills, MD, presents management strategies for men presenting with ejaculatory dysfunctions, ranging from premature ejaculation to ejaculodynia. He begins by acknowledging that there is no current FDA-approved treatment specifically for any kind of ejaculatory dysfunction.

Dr. Mills then separates men presenting with ejaculatory dysfunction into distinct categories based on the symptom they are experiencing, and follow-up questions to ask these patients. These five main groups are Premature Ejaculation, Delayed Ejaculation, Anejaculation, Ejaculodynia, and Post-Orgasmic Illness Syndrome.

Throughout the presentation, Dr. Mills discusses each category of dysfunction and available treatment options. He concludes by highlighting the need for further study of post-orgasmic illness syndrome.

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