Details

Autor(en) / Beteiligte

• Ahmed, Hashim Uddin
• Pendse, Doug
• Illing, Rowland
• Allen, Clare
• van der Meulen, Jan HP
• Emberton, Mark

Titel

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

Ist Teil von

• Nature clinical practice. Oncology, 2007-11, Vol.4 (11), p.632-642

Ort / Verlag

England: Nature Publishing Group

Erscheinungsjahr

2007

Quelle

MEDLINE

Beschreibungen/Notizen

• 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.