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Focal Therapy Versus Surveillance in Intermediate-Risk Cancer

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Prostate Cancer

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Abstract

Active surveillance has been proposed as a way to continue current prostate cancer screening programs while mitigating the risk of prostate cancer overdetection. Conversely, focal therapy has often been criticized based on the potential that multifocal disease may be missed. Unfortunately, the development of clinical trials to evaluate focal treatment of prostate cancer has been hampered by uncertainty with end points, the need for very long follow-up, and the desires by patients to undergo novel treatments in hopes that side effects will be minimized. In this clinical scenario, a 58-year-old man with a normal rectal exam presents with a PSA that is below the typical threshold but may be considered elevated after adjustment for age. He has undergone a systematic transrectal ultrasound-guided biopsy with low-intermediate risk prostate cancer identified in 1 out of 12 cores. He is now considering active surveillance or focal therapy.

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Authors and Affiliations

  1. Department of Urology, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA

    Kelly L. Stratton M.D. & Daniel Parker M.D.

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Correspondence to Kelly L. Stratton M.D. .

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  1. Department of Urologic Surgery and Oncology, Vanderbilt University Medical Center, Nashville, Tennessee, USA

    Sam S. Chang

  2. Department of Urology, University of Oklahoma Medical Center, Oklahoma City, Oklahoma, USA

    Michael S. Cookson

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Stratton, K.L., Parker, D. (2018). Focal Therapy Versus Surveillance in Intermediate-Risk Cancer. In: Chang, S., Cookson, M. (eds) Prostate Cancer. Springer, Cham. https://doi.org/10.1007/978-3-319-78646-9_5

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  • DOI: https://doi.org/10.1007/978-3-319-78646-9_5

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