prostate cancer focal therapy Archives

Focal Therapy for Prostate Cancer

by Fernando J. Kim, MD, MBA, FACS | Aug 2024

Fernando J. Kim, MD, MBA, FACS, discusses the benefits of focal therapy in prostate cancer treatment. He begins with a review of the weaknesses of non-focal options in the treatment of prostate cancer.

Dr. Kim then highlights the clinical and practical benefits of focal therapy. He emphasizes the advantages that focal therapy offers to underserved and vulnerable populations, and he presents supporting data and demonstrations.

Dr. Kim concludes with a comparison of the results from mpMRI fusion biopsies and targeted cryoablation. He outlines possible future directions for focal therapy and other technologies in the treatment of prostate cancer.

Mechanisms and Management of Recurrence

by Samir S. Taneja, MD | Jul 2024

Samir S. Taneja, MD, examines the mechanisms underlying focal therapy failure and best practices in managing prostate cancer recurrence. He begins by defining “failure” in the context of focal therapy, noting that progression-free survival may be a better benchmark for determining the success of focal therapy, rather than recurrence-free survival.

Dr. Taneja then addresses the most common expressions of cancer recurrence post-focal therapy: metastatic recurrence, multifocal recurrence, and recurrence of the treated tumor. He provides real-world examples of treatment failure for each type of recurrence, illustrates the underlying mechanisms, and suggests practical techniques and tools for preventing or managing focal therapy failure.

Dr. Taneja concludes by providing guidance on when focal therapy is no longer appropriate. He advises that re-ablation is not appropriate for high-risk prostate cancer patients or in patients with extraprostatic recurrence.

Focal Therapy for Prostate Cancer: Role of Brachytherapy

by Daniel Y. Song, MD | Jun 2024

Dr. Daniel Y. Song examines the critical role of brachytherapy as a focal therapy in the management of prostate cancer, emphasizing its significance within the broader context of precision oncology. Dr. Song discusses the technical aspects and advancements in brachytherapy, including the use of image-guided techniques. He underscores the importance of meticulous planning and execution in achieving optimal therapeutic outcomes.
Dr. Song also addresses the evolving role of brachytherapy in the era of multimodal treatment approaches. He explores its integration with other therapeutic modalities, such as external beam radiation therapy and hormonal therapy, to enhance treatment efficacy and tailor interventions to individual patient profiles. This approach aligns with the principles of personalized medicine, aiming to optimize therapeutic benefits while minimizing treatment-related morbidity.

Ablative Local Technologies (HIFU, Cryo, SBRT, Laser, and Other Forms of Energy)

by David M. Albala, MD | Jun 2024

David M. Albala, MD, provides an overview and comparison of current options for focal ablative therapy in prostate cancer treatment. He begins by briefly touching on the benefits of focal therapy as a whole, before exploring the different types of focal therapy.

Dr. Albala categorizes focal therapies into temperature-based therapies and non-temperature-based therapies. He places High Intensity Focused Ultrasound, Laser Ablation, and Cryotherapy in the temperature-based focal therapies. Radiotherapies like seed, HDR, and EBRT join Photodynamic Therapy, Radiofrequency Ablation, Electroporation, and partial prostatectomy in the non-temperature-based category.

Dr. Albala discusses the importance of weighing cancer control with preservation of function and patient QoL when considering focal therapies. He discusses the assessment process and the rate of failure for focal therapies. He underscores the process of patient selection and treatment planning prior to selecting a therapy.

He concludes by reviewing the delivery methods currently available for focal therapy. For each method, he presents the advantages, disadvantages, and ideal patient profile for each treatment.

MR Fusion Targeted Therapy: Emerging Management for Localized Prostate Cancer?

by Fernando J. Bianco, MD | May 2023

Fernando J. Bianco, MD, aims to decrease the uncertainty that shrouds prostate cancer through targeted therapy like laser and AI.

Selecting Candidates for Focal Therapy

by Abhinav Sidana, MD, MPH | Apr 2023

Abhinav Sidana, MD, discusses candidate selection for focal therapy, including imaging/biopsy strategies and disease/patient characteristics.

Modalities, Maps and Margins: Optimizing Oncologic Efficacy

by Mark Emberton, MD, FRCS | Mar 2023

Mark Emberton, MD, FRCS, discusses current technologies and modern lesion management strategies for destroying prostate cancer cells.

Rationale for Focal Therapy

by Samir S. Taneja, MD | Mar 2023

Samir S. Taneja, MD, describes the basis for focal therapy for prostate cancer and how to use it successfully.