While surgical removal of the entire prostate gland was once the treatment of choice, focal therapy now offers patients with small, localized tumors an alternative that minimizes damage to the overall gland and reduces the risk of erectile dysfunction.
In some cases, focal therapy avoids surgery altogether, relying instead on ultrasound or ablation treatments of localized tumors, followed up by careful MRI surveillance of the treated area to ensure cancer does not return. High-intensity focused ultrasound, or HIFU, uses heat to kill cancer cells, while cryoablation freezes the target area.
Track Record Is Mixed
However, focal therapy is still relatively new, and its track record is somewhat mixed. Many oncologists urge caution in selecting that treatment option over the more radical form of treatment, which consists of removing the whole prostate gland. The latter, of course, causes widespread side effects, including adverse effects, some of which may be only temporary, on urinary, bowel, and sexual functions.
One of the pioneers in focal therapy treatment of prostate cancers is Fox Chase Cancer Center in Philadelphia. One of its urologic oncologists specializing in the surgical removal of cancers of the genitourinary tract is David Y. T. Chen, M.D. He says that advances in high-definition imaging make it easier for prostate cancer specialists to assess low-, mid-, and high-risk prostate cancers. “We are now customizing treatment approaches for cancers in the middle ‘grey zone,’ where active surveillance might be enough but surgery or radiation and the potential side effects might be too much.” Patients who fall into the grey zone described by Chen might be the ideal candidates for this form of focal therapy.
Benefits of Focal Therapy
The benefits of focal therapy, according to Chen, include fast recovery, little, if any, blood loss, and fewer side effects, including minimal negative effects on urinary, bowel, and sexual function. Common side effects after focal therapy include local soreness or discomfort as well as minor swelling.
Despite the benefits touted by Chen, medical professionals specializing in the treatment of urologic cancers as stated earlier remain divided in their views about the advisability of focal therapy. At the opening session of the 9th European Multidisciplinary Meeting on Urological Cancers in Barcelona in November 2017, some specialists voiced their concern over the effectiveness, overall cost, and long-term effects on the survivability and quality of life of prostate cancer patients.
Carefully Review Your Options
If you are facing a diagnosis of prostate cancer, you should carefully review all the treatment options available to you based on the severity of cancer. With expert counsel from a prostate cancer specialist, consider all the benefits and possible adverse effects of the various therapies available to you before making your final decision.
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