Focal Ablation for Prostate Cancer

Prostate cancer is the second leading cause of cancer death in men in the United States. With the introduction of PSA in the early 1990s, prostate cancer is detected more often at earlier stages with subsequent increase in overdiagnosis and overtreatment as many of these men may have indolent cancer. Nevertheless, there is no current clinical test that will accurately differentiate men harboring indolent cancer, affecting quality of life or shortened life expectancy due to cancer progression. Despite improvements in technology and technique with established treatment options, such as radical prostatectomy and radiation therapy, incontinence and erectile dysfunction still impacts the quality of life of some men. Focal ablation therapy may be suitable for men with low and intermediate risk prostate cancer who are not candidates for active surveillance or who wish to undergo treatment. This approach selectively treats the tumor or tumors within the prostate while sparing normal tissue. Different energy sources have been used for that purpose; Cryoablation, High-intensity focused ultrasound (HIFU), Photodynamic therapy, and Laser ablation. While cryosurgery is commercially available in the United States, the others are still being investigational, and most are still considered experimental.