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Alternative therapies for localized prostate cancer
1Department of Urology, Jeroen Bosch Hospital, PO Box 90153, 5200 ME's-Hertogenbosch, The Netherlands. hpbeerlage@hotmail.com
Current Urology Reports
|May 21, 2003
Summary
Minimal invasive treatments for prostate cancer offer improved safety over older methods. Brachytherapy is a current effective alternative, while newer techniques require further study.
Area of Science:
- Urology
- Oncology
- Minimally Invasive Surgery
Background:
- Prostate cancer is a leading male malignancy, with increasing localized detections expected.
- Radical prostatectomy, a common treatment, carries significant morbidity.
- Minimally invasive options aim for equal efficacy with reduced side effects.
Purpose of the Study:
- To review and compare minimally invasive treatments for prostate cancer.
- To evaluate the safety and efficacy of alternative prostate cancer therapies.
Main Methods:
- Literature review of MEDLINE search (1966-2002).
- Evaluation of cryosurgical ablation, brachytherapy, high-intensity focused ultrasound (HIFU), and radiofrequency interstitial tumor ablation (RFITT).
Main Results:
- All reviewed alternative treatments show increased safety compared to 1960s-1970s methods, aided by advanced technology like ultrasonography.
- Five-year data for cryosurgical ablation show a prostate-specific antigen (PSA) < 1 ng/mL in 60% of cases, but long-term data are limited.
- Brachytherapy outcomes approach those of radical prostatectomy, establishing it as a viable alternative.
- HIFU and RFITT demonstrate potential for extensive necrosis, but require longer follow-up.
Conclusions:
- Brachytherapy is currently the most established minimally invasive alternative to radical prostatectomy for prostate cancer.
- High-intensity focused ultrasound and radiofrequency interstitial tumor ablation are promising but need further long-term evaluation for definitive placement in treatment protocols.