Focal therapy for prostate cancer: revolution or evolution?

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BMC Urol. 2009 Apr 23;9:2.

Focal therapy for prostate cancer: revolution or evolution?

Turpen R, Rosser CJ.
Department of Urology, University of Florida, Gainesville, Florida, USA.

The
face of prostate cancer has been dramatically changed since the late
1980s when PSA was introduced as a clinical screening tool. More men
are diagnosed with small foci of cancers instead of the advanced
disease evident prior to PSA screening. Treatment options for these
smaller tumors consist of expectant management, radiation therapy
(brachytherapy and external beam radiotherapy) and surgery
(cryosurgical ablation and radical prostatectomy). In the highly select
patient, cancer specific survival employing any of these treatment
options is excellent, however morbidity from these interventions are
significant. Thus, the idea of treating only the cancer within the
prostate and sparing the non-cancerous tissue in the prostate is quite
appealing, yet controversial. Moving forward if we are to embrace the
focal treatment of prostate cancer we must: be able to accurately
identify index lesions within the prostate, image cancers within the
prostate and methodically study the litany of focal therapeutic options
available.