Focal cryoablation of the prostate

Govorov A.V., Vasil'ev A.O., Pushkar' D.Yu.

Patient with low-risk prostate cancer who previously had to choose between radical treatment and active surveillance may have a new treatment. The study of prostate cancer, technological advances in imaging and biopsy tools offer novel approaches to focal therapy. Focal therapy for prostate cancer eradicating the known and targeted cancer while sparing unaffected tissue and reducing the morbidity of treatment. Focal cryoablation of the prostate can selectively destroy tumor and preserve organ function without reducing quality of life of the patient. The main objective of the focal cryoablation is to keep the urethra and sphincter function, as well as the contralateral lobe and neurovascular bundle. Preliminary evidence on the short-term efficacy of focal therapy show good results - comparable with those after radical prostatectomy or radiation therapy in low-risk patients. In the vast majority of patients the erectile function remains preserved and there is no urinary incontinence. Many investigators consider the focal cryoablation the "golden mean" between active surveillance and radical therapies of prostate cancer. Focal cryoablation may be more effective than bilateral nerve-sparing prostatectomy in preserving potency in appropriately selected patients. By offering a high rate of sexual function and urinary continence preservation and effective cancer control, focal cryoablation may fill a void in the therapeutic options available to patients with unifocal or unilateral prostate cancer who desire to maintain their quality of life. Due to the lack of long-term data focal cryoablation is still experimental type of treatment.

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