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Candidate Selection for Prostate Cancer Focal Therapy

Taneja, Samir S. and Mason, Malcolm David 2010. Candidate Selection for Prostate Cancer Focal Therapy. Journal of Endourology 24 (5) , pp. 835-841. 10.1089/end.2010.0006

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Abstract

Focal therapy has emerged as a potential treatment paradigm for men with localized prostate cancer, because it serves as a medium between the ambiguity of surveillance and the potential reduction of quality of life observed with radical treatment. Candidate selection remains the major challenge of implementing focal therapy in clinical practice. While focal therapy is potentially widely applicable, there is general consensus that initial efforts to initiate focal therapy protocols in practice should be limited to men with disease features that are low to low-intermediate risk, thereby limiting the likelihood of early systemic failure. Selection of candidates is first dependent on the intent of focal therapy. Curative intent focal therapy is limited to a small number of men with isolated, low-risk, unifocal, or unilateral disease. In men for whom local control—and potential prolongation of the natural history of disease—is desired, mapping strategies would focus on identification of the dominant site of disease and ruling out high-risk features. Tools such as conventional transrectal biopsy, transperineal saturation biopsy, and prostate MRI all have relative merits and shortcomings. While ultimately limitation of biopsy is desirable through combinations of transrectal biopsy and imaging, for now, limitations of conventional imaging modalities make it likely that most men will need transperineal saturation biopsy before inclusion in focal therapy protocols.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Subjects: R Medicine > R Medicine (General)
R Medicine > RC Internal medicine > RC0254 Neoplasms. Tumors. Oncology (including Cancer)
R Medicine > RM Therapeutics. Pharmacology
Publisher: Mary Ann Liebert
ISSN: 0892-7790
Last Modified: 04 Jun 2017 03:43
URI: http://orca-mwe.cf.ac.uk/id/eprint/25492

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