Frontiers in Oncologic Prostate Care and Ablative Local Therapy Archives

Versatile Irreversible Electroporation

Posted by Phillip Stricker, MBBS | Aug 2024

Phillip Stricker, MBBS, explores irreversible electroporation (IRE), a novel non-thermal ablative technique, in the treatment of prostate cancer, highlighting its versatility and efficacy. To begin his presentation, Dr. Stricker reviews the IRE procedure, which involves inserting electrodes into the prostate under image guidance (typically ultrasound or MRI), and patient selection criteria.

Dr. Stricker continues by discussing the promising clinical outcomes of IRE, and advancements in IRE technology.

Pearls and Pitfalls Of PSMA PET

Posted by Sandeep Arora, MBBS, FSAR | Aug 2024

Sandeep Arora, MBBS, FSAR, analyzes Prostate-Specific Membrane Antigen (PSMA) PET imaging in oncologic prostate care and ablative local therapy. His discourse emphasizes the critical role of PSMA PET in the accurate diagnosis, staging, and management of prostate cancer, while also addressing the potential limitations and challenges associated with this advanced imaging modality.

Dr. Arora outlines the key advantages of PSMA PET imaging, highlighting its superior sensitivity and specificity in detecting prostate cancer lesions compared to conventional imaging techniques. Dr. Arora also discusses the utility of PSMA PET in identifying biochemical recurrences and metastatic disease, allowing for timely and targeted therapeutic interventions.

Dr. Arora also delves into potential pitfalls of PSMA PET imaging, including false positives and false negatives, and ways of mitigating these issues. In addition, he examines the availability of PSMA PET tracers, the need for specialized equipment, and the expertise required for accurate image interpretation.

The Risks and Benefits of Rectal Spacers

Posted by Srinivas Vourganti, MD | Aug 2024

Srinivas Vourganti, MD, analyzes the risks and benefits associated with the use of rectal spacers in oncologic prostate care. His discourse emphasizes the role of rectal spacers in mitigating radiation-induced toxicity during prostate cancer radiotherapy, highlighting their potential to enhance treatment efficacy and patient quality of life.

Dr. Vourganti discusses the primary benefit of rectal spacers and examines the procedural aspects and safety profile of rectal spacer insertion. Dr. Vourganti also addresses the potential risks and limitations of rectal spacers, highlighting rare but possible complications, including infection, spacer migration, and discomfort during the insertion process.

Dr. Vourganti emphasizes the importance of patient selection and individualized treatment planning when considering the use of rectal spacers, and advocates for a thorough evaluation of each patient’s specific clinical scenario to determine the potential benefits and risks.

Imaging and Biomarkers in Patient Selection for Focal Ablation

Posted by Ezekiel Becher, MD | Aug 2024

Ezequiel Becher, MD, discusses the critical role of imaging and biomarkers in selecting patients for focal ablation in prostate cancer treatment.

He highlights the advancements in imaging technologies that have revolutionized prostate cancer diagnostics, particularly multiparametric MRI (mpMRI). In addition to imaging, Dr. Becher underscores the significance of biomarkers in patient selection. While prostate-specific antigen (PSA) levels are traditionally used, they are complemented by more specific biomarkers such as PCA3, TMPRSS2-ERG, and genomic tests that provide a deeper understanding of tumor biology and aggressiveness.

Dr. Becher also addresses the challenges and limitations of current imaging and biomarker techniques. He advocates for continuous refinement of these technologies and the development of standardized protocols to enhance diagnostic accuracy. Looking forward, he points to the potential of artificial intelligence and machine learning in improving diagnostic precision and patient selection processes.

The When and How of Post-Ablation Surveillance

Posted by Soroush Rais-Bahrami, MD | Aug 2024

Soroush Rais-Bahrami, MD, provides a detailed examination of the timing and methodologies for post-ablation surveillance in prostate cancer care. His discussion emphasizes the critical importance of effective monitoring to ensure the success of ablative therapies and the early detection of any recurrence or progression of the disease.

Dr. Rais-Bahrami outlines the primary goals of post-ablation surveillance, including assessing treatment efficacy, identifying complications, and detecting residual or recurrent disease. He discusses various imaging modalities used in post-ablation surveillance, with multiparametric MRI (mpMRI) playing a central role. Dr. Rais-Bahrami also addresses the utility of PET-CT scans, particularly PSMA PET-CT. In addition to imaging, Dr. Rais-Bahrami highlights serum biomarkers, such as prostate-specific antigen (PSA), in surveillance protocols. He also discusses the timing of surveillance to ensure the detection of any issues and allow for prompt intervention.