Focal therapy for prostate cancer is a new strategy to address this pathology. It is selectively destroy cancer within the prostate, preserving healthy tissue. If diagnosed early it is estimated that one out of three or four patients could benefit from this therapy.
Focal therapy for prostate cancer: what is
Patients with localized prostate cancer is not high risk face the difficult situation of choosing between active monitoring and radical treatment (radical prostatectomy or radiotherapy). The latter provide maximum guarantees of disease control, but with significant risk of causing side effects, mainly impotence and urinary incontinence.Focal therapy is a strategy, still under development, which it complements the current choice. It involves the selective destruction of cancer within the prostate, preserving healthy tissue, which functions compromised by radical treatments are preserved.This paradigm shift is similar to that carried out in other tumors, such as breast, kidney, liver or lung, among others.
What steps are necessary to know if you can be a good candidate?
The first step is to achieve visualize the tumor. This requires a multiparametric MRI, which should be performed and interpreted by an experienced radiologist is used. Then it should proceed to make, by one skilled in Urology , a directed biopsy to check that said lesion actually corresponds to the tumor and in the rest of the prostate tumor there is no significant. Maximum accuracy achieved with the transperineal biopsy techniques that allow, in real time, merging images of resonance with ultrasound.
How to destroy the tumor
There are different techniques (electroporation cryotherapy, radiofrequency, HIFU, etc.) capable of destroying the tumor. We use electroporation because it produces irreversible thermal damage and can control the range with high accuracy. All our patients so far have retained potency and continence.
Focal limitations of prostate cancer therapy
The main limitations associated with focal therapy are related to the diagnostic and therapeutic precision and with the fact that many tumors are multifocal. For maximum accuracy we perform biopsies guided transperineal image fusion resonance and ultrasound.The fact that prostate cancer is usually multifocal, conditions that unfortunately not all patients may be candidates. We know that in our country about 25% of operated patients have unilateral, accessible tumors focal therapy. Therefore, if diagnosed in time, one out of three or four patients could be beneficial for focal therapy.