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Focal therapy for prostate cancer: rationale and treatment opportunities.

Kasivisvanathan, V; Emberton, M; Ahmed, HU; (2013) Focal therapy for prostate cancer: rationale and treatment opportunities. Clin Oncol (R Coll Radiol) , 25 (8) 461 - 473. 10.1016/j.clon.2013.05.002. Green open access

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Abstract

Focal therapy is an emerging treatment modality for localised prostate cancer that aims to reduce the morbidity seen with radical therapy, while maintaining cancer control. Focal therapy treatment strategies minimise damage to non-cancerous tissue, with priority given to the sparing of key structures such as the neurovascular bundles, external sphincter, bladder neck and rectum. There are a number of ablative technologies that can deliver energy to destroy cancer cells as part of a focal therapy strategy. The most widely investigated are cryotherapy and high-intensity focussed ultrasound. Existing radical therapies, such as brachytherapy and external beam radiotherapy, also have the potential to be applied in a focal manner. The functional outcomes of focal therapy from several phase I and II trials have been encouraging, with low rates of urinary incontinence and erectile dysfunction. Robust medium- and long-term cancer control outcomes are currently lacking. Controversies in focal therapy remain, notably treatment paradigms based on the index lesion hypothesis, appropriate patient selection for focal therapy and how the efficacy of focal therapy should be assessed. This review articles discusses the current status of focal therapy, highlighting controversies and emerging strategies that can influence treatment outcomes for the future.

Type: Article
Title: Focal therapy for prostate cancer: rationale and treatment opportunities.
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.clon.2013.05.002
Publisher version: http://dx.doi.org/10.1016/j.clon.2013.05.002
Language: English
Additional information: © 2013 The Royal College of Radiologists. Published by Elsevier Ltd. Open access under CC BY license.
Keywords: Focal ablation, focal therapy, future perspective, outcomes, prostate cancer, rationale, Humans, Male, Prostatic Neoplasms, Risk Assessment, Treatment Outcome
UCL classification: UCL
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
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci > Department of Targeted Intervention
URI: https://discovery.ucl.ac.uk/id/eprint/1396585
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