PURPOSE: Men with localized prostate cancer currently face a number of treatment options that treat the entire prostate. These can cause significant sexual and urinary side effects. Focal therapy offers a novel strategy that targets the cancer rather than the prostate in an attempt to preserve tissue and function. MATERIALS AND METHODS: A prospective, ethics committee approved trial was conducted to determine the side effects of focal therapy using high intensity focused ultrasound. Multiparametric magnetic resonance imaging (T2-weighted, dynamic contrast enhanced, diffusion-weighted) and template transperineal prostate mapping biopsies were used to identify unilateral disease. Genitourinary side effects and quality of life outcomes were assessed using validated questionnaires. Posttreatment biopsies were performed at 6 months and followup was completed to 12 months. RESULTS: A total of 20 men underwent high intensity focused ultrasound hemiablation. Mean age was 60.4 years (SD 5.4, range 50 to 70) with mean prostate specific antigen 7.3 ng/ml (SD 2.8, range 3.4 to 11.8). Of the men 25% had low risk and 75% had intermediate risk cancer. Return of erections sufficient for penetrative sex occurred in 95% of men (19 of 20). In addition, 90% of men (18 of 20) were pad-free, leak-free continent while 95% were pad-free. Mean prostate specific antigen decreased 80% to 1.5 ng/ml (SD 1.3) at 12 months. Of the men 89% (17 of 19, 1 refused biopsy) had no histological evidence of any cancer, and none had histological evidence of high volume or Gleason 7 or greater cancer in the treated lobe. In addition, 89% of men achieved the trifecta status of pad-free, leak-free continence, erections sufficient for intercourse and cancer control at 12 months. CONCLUSIONS: Our results appear sufficiently promising to support the further evaluation of focal therapy as a strategy to decrease some of the harms and costs associated with standard whole gland treatments.
PURPOSE: Men with localized prostate cancer currently face a number of treatment options that treat the entire prostate. These can cause significant sexual and urinary side effects. Focal therapy offers a novel strategy that targets the cancer rather than the prostate in an attempt to preserve tissue and function. MATERIALS AND METHODS: A prospective, ethics committee approved trial was conducted to determine the side effects of focal therapy using high intensity focused ultrasound. Multiparametric magnetic resonance imaging (T2-weighted, dynamic contrast enhanced, diffusion-weighted) and template transperineal prostate mapping biopsies were used to identify unilateral disease. Genitourinary side effects and quality of life outcomes were assessed using validated questionnaires. Posttreatment biopsies were performed at 6 months and followup was completed to 12 months. RESULTS: A total of 20 men underwent high intensity focused ultrasound hemiablation. Mean age was 60.4 years (SD 5.4, range 50 to 70) with mean prostate specific antigen 7.3 ng/ml (SD 2.8, range 3.4 to 11.8). Of the men 25% had low risk and 75% had intermediate risk cancer. Return of erections sufficient for penetrative sex occurred in 95% of men (19 of 20). In addition, 90% of men (18 of 20) were pad-free, leak-free continent while 95% were pad-free. Mean prostate specific antigen decreased 80% to 1.5 ng/ml (SD 1.3) at 12 months. Of the men 89% (17 of 19, 1 refused biopsy) had no histological evidence of any cancer, and none had histological evidence of high volume or Gleason 7 or greater cancer in the treated lobe. In addition, 89% of men achieved the trifecta status of pad-free, leak-free continence, erections sufficient for intercourse and cancer control at 12 months. CONCLUSIONS: Our results appear sufficiently promising to support the further evaluation of focal therapy as a strategy to decrease some of the harms and costs associated with standard whole gland treatments.
Authors: Anthony N Hoang; Dmitry Volkin; Nitin K Yerram; Srinivas Vourganti; Jeffrey Nix; W Marston Linehan; Bradford Wood; Peter A Pinto Journal: Curr Opin Urol Date: 2012-07 Impact factor: 2.309
Authors: Steffen Sammet; Ari Partanen; Ambereen Yousuf; Christina L Sammet; Emily V Ward; Craig Wardrip; Marek Niekrasz; Tatjana Antic; Aria Razmaria; Keyvan Farahani; Shunmugavelu Sokka; Gregory Karczmar; Aytekin Oto Journal: World J Radiol Date: 2015-12-28
Authors: Paul L Nguyen; Ming-Hui Chen; Yuanye Zhang; Clare M Tempany; Robert A Cormack; Clair J Beard; Mark D Hurwitz; W Warren Suh; Anthony V D'Amico Journal: J Urol Date: 2012-08-15 Impact factor: 7.450
Authors: Geoffrey A Sonn; Shyam Natarajan; Daniel J A Margolis; Malu MacAiran; Patricia Lieu; Jiaoti Huang; Frederick J Dorey; Leonard S Marks Journal: J Urol Date: 2012-11-14 Impact factor: 7.450
Authors: R van Velthoven; F Aoun; Q Marcelis; S Albisinni; M Zanaty; M Lemort; A Peltier; K Limani Journal: Prostate Cancer Prostatic Dis Date: 2015-11-24 Impact factor: 5.554