Will focal therapy become a standard of care for men with localized prostate cancer?

Ahmed, HU; Pendse, D; Illing, R; Allen, C; van der Meulen, JH; Emberton, M; (2007) Will focal therapy become a standard of care for men with localized prostate cancer? Nature clinical practice Oncology, 4 (11). pp. 632-42. ISSN 1743-4254 DOI: https://doi.org/10.1038/ncponc0959

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The current treatment choice for men with localized prostate cancer lies between active surveillance and radical therapy. The difference between these two extremes of care is 5% in terms of cancer-related absolute mortality at 8 years. It is generally accepted that this small difference will decrease for men diagnosed in the prostate-specific-antigen era. Radical therapy is associated with considerable adverse effects (e.g. incontinence, impotence, rectal problems) because it treats the whole gland, and damages surrounding structures in up to half of men. Men are being diagnosed at a younger age with lower-risk disease, and many have unifocal or unilateral disease. We propose a new concept whereby only the tumor focus and a margin of normal tissue are treated. This paradigm might decrease adverse effects whilst, at the same time, retaining effective cancer control. The arguments for and against active surveillance and radical therapy are reviewed in this article, with focal therapy presented as a means for bridging these two approaches.

Item Type: Article
Faculty and Department: Faculty of Public Health and Policy > Dept of Health Services Research and Policy
PubMed ID: 17965641
Web of Science ID: 250642500022
URI: http://researchonline.lshtm.ac.uk/id/eprint/7434


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