Several experimental local therapies for prostate cancer are under investigation. For example, high-intensity focused ultrasound (HIFU) uses focussed sound waves to rapidly heat tissue and destroy malignant cells by coagulative necrosis.1 Cancerous cells can also be ablated by freezing during cryotherapy. In this approach, ultrathin needles inserted into the prostate under TRUS guidance produce ice-balls of extreme subzero temperatures.1,2 With recent progress in imaging, especially ultrasound, there is considerable interest in delivering these treatments as focal therapies, which aim to selectively ablate malignant cells whilst sparing non-cancerous tissue.3
Given the lack of long-term data on cryotherapy and HIFU, these therapies are considered experimental, although cryotherapy may be considered as a possible alternative for patients unfit for surgery with a life expectancy of <10 years, or in other carefully selected patients.1
References:
1. European Association of Urology. Guidelines on prostate cancer, 2010.
2. Kirby RS, Patel MI. Fast facts: prostate cancer (5th ed). Health Press Ltd: Oxford, 2008.
3. Turpen R, Rosser CJ. Focal therapy for prostate cancer: revolution or evolution? BMC Urol 2009;9:2.