Mark Emberton, MD, FRCS, presented “Focal Modalities, Maps and Margins: Optimizing Oncologic Efficacy” during the 2022 Frontiers in Oncologic Prostate Care and Ablative Local Therapy symposium on September 23, 2022, in Los Angeles, California.
How to cite: Emberton, Mark. “Focal Modalities, Maps and Margins: Optimizing Oncologic Efficacy.” September 23, 2022. Accessed Jul 2024. https://grandroundsinurology.com/rationale-for-focal-therapy/
Focal Modalities, Maps and Margins: Optimizing Oncologic Efficacy – Summary
Mark Emberton, MD, FRCS, Professor of Interventional Oncology at the University College London, discusses the options for destroying prostate cancer tissue in a predictable and reliable manner, including the current technologies and their impacts on treatment strategies. He ends with examples of modern lesion management. He explains the range of options available and how they have evolved over time. He classifies these methods as externally applied, interstitial, and mixed. Dr. Emberton states that mixed methods provide the biggest field of development, where nanoparticles and laser light, sound waves, or magnetic fields initiate a toxic payload that has some degree of cancer cell activity. However, current technologies require physicians to target areas and not cancer cell activity directly. Furthermore, energy sources are limited by their physical attributes, and physicians adjust by overlapping and repeating treatments. An August 2022 study’s findings indicate that different energy sources seem to have different effects on prostate tissue, in contrast to the standard belief that the energy source used to remove the tissue does not matter. Next, Dr. Emberton denotes who is eligible for focal therapy, but also how eligibility is only a component of modern lesion management. Abnormalities in MRIs include visible and non-visible lesions that qualify the disease. Imaging allows physicians to see a range of phenotypes from prostate cancer, including PSMA and MRI positive and negative lesions. He then highlights cases and their subsequent treatment strategies, demonstrating how far physicians can push the limits with focal therapy while maintaining efficacy.
The annual symposium on Frontiers in Oncologic Prostate Care and Ablative Local Therapy (FOCAL) is an outstanding program on prostate imaging, transperineal interventions, and ablative treatments for prostate cancer and benign prostatic hyperplasia. Bringing together community-based, academic, and industry partners, FOCAL offers lectures by world-renowned faculty and hands-on training workshops on in-office transperineal interventions, fusion-guided prostate ablation and state-of-the-art BPH management with novel technologies. For more educational activities from the symposium that took place from September 23-24, 2022 in Los Angeles, California, visit our collection page.
ABOUT THE AUTHOR
Mark Emberton, MD, FRCS, is Professor of Interventional Oncology at the University College London. He is an Honorary Consultant Urologist at University College Hospitals NHS Foundation Trust and Founding Pioneer of The Charity Prostate Cancer UK. He was appointed Dean of UCL Faculty of Medical Sciences in 2015.
Professor Emberton’s clinical research is aimed at improving the diagnostic and risk stratification tools and treatment strategies for prostate cancer (PCa). 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.
His research has been published in over 300 peer-reviewed scientific papers in journals including BMJ, Lancet Oncology and European Urology. He has also contributed to the development of guidelines for the management of PCa and lower urinary tract symptoms, published by the International Society of Geriatric Oncology and the European Association of Urology.
Professor Emberton is also involved in teaching within UCL and the London and South East Urological Training scheme. In addition to being a member of various urological and medical organisations (American Association of GenitoUrinary Surgeons, British Association of Urological Surgeons, European Association of Urology). He is a founding partner of London Urology Associates.
