Lynchburg Journal of Medical Science

Lynchburg Journal of Medical Science




Dr. Tom Colletti


The purpose of this paper is to present a perspective on the current status and future directions of focal therapy (FT) as a primary treatment option for prostate cancer (PCa).

FT for localized PCa is a rapidly evolving field. Various recent concepts – the index lesion driving prognosis, the enhanced detection of clinically-significant cancer using multi-parametric magnetic resonance imaging (mpMRI) and targeted biopsy, improved risk-stratification using novel blood/tissue biomarkers, the recognition that reducing radical treatment (RT)-related morbidity (along with reducing pathologic progression) as a clinically meaningful endpoint - have all led to a growing interest in FT. Novel FT modalities are being investigated, mostly in phase I and II studies. Recently, level I prospective randomized data comparing partial gland ablation to standard-of-care treatment became available from one study by Azzouzi, et al1. In addition, recent developments in imaging, including 7-Tesla mpMRI, functional imaging, radiomics and contrast-enhanced ultrasound show early promise. The author also discusses emerging concepts and expanding indications in patient selection for FT.


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