Focal therapy in the management of localized prostate cancer

OBJECTIVES To assess the rationale, efficacy, and morbidity of various methods of achieving focal prostatic ablation. To determine the current role of focal therapy in the management of localized prostate cancer. METHODS We performed a literature review of focal therapy in prostate cancer, with an emphasis on more established methods such as cryoablation and high-intensity focused ultrasound. RESULTS AND CONCLUSIONS Focal ablative methods allow targeted destruction of prostatic tissue while limiting the morbidity associated with whole-gland therapy. Local cancer control after focal therapy appears promising but does not approach that of established whole-gland therapies. Until we have the ability to identify patients reliably with truly focal disease and predict their natural history, focal therapy cannot be considered to be the definitive therapy for localized prostate cancer.