Terapia focal en cáncer de próstata: una potencial estrategia para solucionar el problema del sobretratamiento

focal therapy involves destroying the cancer focus and the tissue surrounding the cancer in order to offer patients the potential of combining cancer control with minimal side-effects. current standard of care involve either surveillance or radical therapy. neither of these is ideal. active surveillance carries risk of under-treatment, psychological morbidity as a result of anxiety and is not without side-effects due to repeated biopsies., although radical therapy is the gold standard for curative treatment it carries risks of over-treatment with its numerous side-effects. with the proportion of unifocal or unilateral disease among men with low-risk disease rising, a focal approach could avoid both under and over-treatment. with the advent of improved accuracy for cancer localization provided by multi-parametric mri and new biopsy strategies such as transperineal mapping biopsies, ablative modalities such as cryotherapy, high intensity focused ultrasound, photodynamic therapy and radio-interstitial tumour ablation make a focal treatments a real possibility.