Targeted focal therapy for prostate cancer: a review

Prostate cancer screening has shifted the diagnosis of prostate cancer to lower grade, organ confined disease. Radical prostatectomy or radiation therapy has been shown to be overtreatment in 30% of patients. In this review, we will discuss targeted focal therapy (TFT) using the modalities of cryotherapy or high intensity focused ultrasound as an alternate treatment for low-risk prostate cancers.

TFT uses 3-D mapping biopsies to guide treatment so lesions of interest are ablated whereas sparing surrounding healthy tissues, avoiding the side-effects associated with more invasive treatments. In recent years, improvements in cryotherapy and HIFU have increased efficacy whereas decreasing complications. Prostate cancer control reported following TFT is promising.

With data demonstrating effective treatment in select patients, physicians can better inform their patients of the options available to eradicate their prostate cancer. TFT provides an alternative to active surveillance and more aggressive treatments for patients with low-risk tumors. As studies mature, more information regarding long-term survival and benefit will become more evident.