Topic: Localized Disease

Precision Radiation Therapy: Low- to Intermediate-Risk Prostate Cancer

Michael Zelefsky, MD, discusses the need for advances in molecular imaging and radiomics and for integrating these techniques with precision radiation therapy in order to improve selective dose delivery for low- and intermediate-risk prostate cancer patients. He describes evolving methods of radiation delivery, dose planning, reducing radiation exposure to normal tissues, and delineation of the dominant intraprostatic lesion in this era of dose-escalation. 

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Locally Advanced Prostate Cancer

Dov Kadmon, MD, defines locally advanced prostate cancer and the basic principles of managing this group of patients on the basis of multiple urologic and oncologic societies’ guidelines. He discusses the current standard of care, as well as ongoing research into the addition of systemic therapies for these patients.

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Focal Therapy of Prostate Cancer

Leonard S. Marks, MD, discusses the response propelling consideration of focal therapy as a treatment option for localized prostate cancer. He reviews evidence on the three currently-FDA approved focal therapy modalities: cryotherapy, high-intensity focused ultrasound (HIFU), and laser ablation.

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TRUS Biopsy, MRI, and PROMIS Trial

John W. Davis, MD, discusses the lack of consensus regarding the definitions and benefits of focal therapy for prostate cancer. He defines the patients who would benefit most from focal therapy, as well as overcoming current challenges in this approach.

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The Pros of Focal Therapy for Prostate Cancer

Jeffrey A. Jones, MD, argues that although radical therapy leads to better oncological control than focal therapy, focal therapy may be more appropriate for certain prostate cancer patients in order to mitigate adverse effects. He examines oncological and quality of life outcomes of localized therapies, specifically cryotherapy and high-intensity focused ultrasound (HIFU).

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