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Focal Therapy Considered As Prostate Cancer Treatment

Armen Hareyan's picture

Gold Supplement is focused on a series of 12 peer-reviewed studies on the use of focal therapy in the treatment of prostate cancer.

The studies were conducted by a group of leading urologists and radiologists led by David Bostwick, M.D., a pathologist specializing in urology, and Gary Onik, M.D., an interventional radiologist, both of whom served as co-editors of the supplement. This is the first published scientific compendium dedicated solely to focal prostate cancer treatment. One of the leading focal treatment methods is cryoablation, or the minimally invasive freezing of the cancerous tumors to destroy them.

The studies presented in the supplement cover a broad range of issues related to focal therapy for prostate cancer including cancer volume; patient selection; biopsy techniques to adequately find and diagnose the extent of the cancer and the long-term effectiveness of focal treatments.

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In basic terms, focal therapy for prostate cancer, also known as "the male lumpectomy," is a new method of treating prostate cancer where the primary objective is to destroy the cancerous tissue in the prostate gland and avoid damaging the healthy tissue including the nerve bundles at the base of the gland that control potency and continence. In the current standard of care treatment for prostate cancer, the physician surgically removes the entire prostate gland and portions of the surrounding tissue.

Dr. Bostwick offers a parallel for discussion between the focal treatment for prostate cancer and a similar debate approximately 30 years ago between advocates of radical mastectomy and those who favored lumpectomy in appropriate breast cancer patients. He and Dr. Onik noted that their objective was to "generate spirited and thoughtful debate on focal therapy...It will be interesting in the next few years to watch how the growth of knowledge in this domain parallels that of lumpectomy for breast cancer. Will history repeat itself?"

Dr. Onik, one of the early pioneers of focal prostate cancer treatment using cryoablation, welcomes further study of the issue but maintains that, thanks to advances in targeting, diagnosing and cancer ablation modalities, the time has come to move away from the destruction of the entire prostate when treating prostate cancer.

"In this era, when male patients must choose between 'watchful waiting' and high morbidity whole gland treatments, a lumpectomy treatment, which has so markedly changed the management of breast cancer for women, would be a welcome addition to the male cancer population," Dr. Onik notes in his study.

Craig T. Davenport, Chairman, Chief Executive Officer and President of Endocare, commented, "This supplement explores the important issue of how to treat or kill the cancerous prostate tissue balanced with the increasing demand by patients to avoid or minimize becoming impotent or incontinent, whenever possible. Prostate cancer is being diagnosed in men at earlier and earlier ages and these men now are very concerned about the quality of their life following surgery. It is particularly gratifying that the unique attributes and advantages of cryoablation are being recognized as a significant option for many patients."



I had focal cryotherapy treatment for 2 small areas of Gleason 6 cancer and an area of PIN in October '08 at the University of Denver Cancer Center. About half my prostate was frozen. There were no incisions. After less than a month, I was continent and potent. All treatment options remain open should any be needed in the future. This may be an experimental procedure, but it is one worth considering by men with low to medium risk prostate cancer.