Guillaumier, Stephanie;
(2019)
Focal High Intensity Focused Ultrasound in the Treatment of Non-Metastatic Prostate Cancer.
Doctoral thesis (M.D(Res)), UCL (University College London).
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Abstract
Introduction This thesis will explore the adverse events, side-‐effect profile and efficacy of high intensity focused ultrasound to treat non-‐metastatic prostate cancer. I will look at the background of prostate cancer and how advances in the diagnostic pathway for prostate cancer, as well as the paradigm shifts in treatment for this disease, have defined the current treatment landscape for localized prostate cancer and how focal therapy fits in. Objectives The aim of this thesis is to evaluate the efficacy and medium-‐term outcomes of focal HIFU from a multicentre registry of over 600 cases treated over the last 10 years in the UK. In so doing, this thesis will explore the use of registries in defining novel treatments as a useful body of evidence that might be used to impact on standard care in the absence of randomized controlled studies which are difficult to conduct within surgical specialties. The future role of focal therapy and high intensity focused ultrasound will be discussed, providing insights into the evolution of this ablative therapy, and how it might take its place within the armamentarium of treatments available for localized prostate cancer. Results The multicenter academic focal HIFU registry demonstrates acceptable oncological control in men diagnosed with non-‐metastatic prostate cancer is achievable with acceptable o Conclusions The medium-‐term data presented in this thesis is the first of its kind and supports the contention that focal therapy has a role in decreasing the genito-‐urinary side-‐effects associated with standard whole-‐gland therapies. Trifecta status of leak-‐free, pad-‐free continence, erections sufficient for intercourse, and oncological control is achievable with focal HIFU with acceptable results. Ultimately, long-‐term data will be necessary, including 5 research into comparative effectiveness to further establish the future role of focal therapy in treating localized prostate cancer.
| Type: | Thesis (Doctoral) |
|---|---|
| Qualification: | M.D(Res) |
| Title: | Focal High Intensity Focused Ultrasound in the Treatment of Non-Metastatic Prostate Cancer |
| Event: | UCL (University College London) |
| Open access status: | An open access version is available from UCL Discovery |
| Language: | English |
| Additional information: | Copyright © The Author 2019. Original content in this thesis is licensed under the terms of the Creative Commons Attribution 4.0 International (CC BY 4.0) Licence (https://creativecommons.org/licenses/by/4.0/). Any third-party copyright material present remains the property of its respective owner(s) and is licensed under its existing terms. Access may initially be restricted at the author’s request. |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10080076 |
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