Targeting the cancer lesion, not the whole prostate

Abstract

Modern cancer treatment aims to conserve as much healthy tissue as possible. This has been challenging in the treatment of prostate cancer due to the difficulty in imaging the gland and concerns over leaving multifocal cancer untreated. With improvements in imaging and understanding of multifocal prostate cancer evidence now shows accurate treatment of just the primary focus of cancer or the index lesion can control progression or recurrence of the disease. Many different energy sources are now available to target the cancer lesion within the prostate with less significant side-effects on urinary and sexual function compared to radical treatment. Evidence shows that men value these functions highly and would even trade years of life in exchange for preserved retention of continence or erectile function. Focal treatment of prostate cancer aims to provide both cancer control and preservation of sexual and urinary functions so that men do not have to make a choice between the two. This is a treatment option that men clearly want and deserve.

Keywords: Prostate cancer; cryotherapy; focal brachytherapy; focal radiofrequency ablation (focal RFA); focal therapy; high-intensity focused ultrasound (HIFU); index lesion; irreversible electroporation (IRE); laser interstitial therapy (LITT); photodynamic therapy (PDT); vascular-targeted photodynamic therapy (VTP).