Management of Recurrent Prostate Cancer After Focal Therapy

Posted by Kelly L. Stratton, MD | May 2021

Kelly L. Stratton, MD, presented “Management of Recurrent Prostate Cancer After Focal Therapy” for the Grand Rounds in Urology audience in May 2021.

How to cite: Stratton, Kelly L. “Management of Recurrent Prostate Cancer After Focal Therapy” May 2021. Accessed Apr 2024. https://dev.grandroundsinurology.com/management-of-recurrent-prostate-cancer-after-focal-therapy/

Management of Recurrent Prostate Cancer After Focal Therapy – Summary:

Kelly L. Stratton, MD, Assistant Professor of Urologic Oncology in the University of Oklahoma (OU) Department of Urology in Oklahoma City rationalizes the implementation of focal therapy despite chances of recurrence and discusses salvage therapy. He characterizes focal therapy as an option between radical treatment and active surveillance, which preserves quality of life. The perfect candidate is hard to achieve, according to Dr. Stratton, due to the rarity of a patient with intermediate-risk cancer, lesion localization, intact erections, and minimal urinary tract symptoms; however, he states that the ideal candidate doesn’t have to be perfect. Dr. Stratton overviews the two main types of recurrence: in-field recurrence and contralateral recurrence, through patient examples, which display how recurrence may occur post focal therapy and the abilities of high intensity focused ultrasound, prostatectomy, and cryoablation as salvage therapies. A multicentre study of five year outcomes post focal therapy found a failure free survival rate of 88% with 25% of patients having had undergone retreatment, data that Dr. Stratton states to suggest a need for providers to openly discuss the chances of repeat focal therapy against having a more aggressive treatment. He reviews data that supports implementation of focal therapy and displays the impact of different salvage therapies. Dr. Stratton concludes by stating that focal therapy’s success requires adherence to the principles of active surveillance, follow-up biopsies, and a willingness to provide definitive local therapy when focal treatment fails.

About The Author

Kelly L. Stratton, MD

Kelly L. Stratton, MD, is an Assistant Professor of Urologic Oncology in the University of Oklahoma (OU) Department of Urology in Oklahoma City. Prior to joining the OU Urology team in 2014, he completed his fellowship training in the Department of Surgery (Urology Service) at Memorial Sloan-Kettering Cancer Center in New York and his residency at Vanderbilt University Medical Center Department of Urology. He completed his MD with special distinction at the OU College of Medicine in 2007. Dr. Stratton brings experience with state-of-the-art imaging for the diagnosis and treatment of prostate cancer. He is interested in the application of new technology capable of blending MRI images with real-time ultrasound to improve prostate biopsy and cancer detection. Using these techniques, he can assist patients considering prostate cancer treatment options including those who are candidates for active surveillance. He also utilizes genomic testing to help provide personalized treatment plans for patients diagnosed with urologic cancer. Dr. Stratton is involved in several clinical trials that provide the most advanced treatment options currently available. Dr. Stratton holds memberships in the American Society of Clinical Oncology, the Society of Urologic Oncology, and the American Urological Association. He serves as a reviewer for the Journal of Urology and was recently recognized as the Best Reviewer in Oncology. He is a contributor to Practical Reviews in Urology.. Dr. Stratton is also an author of numerous publications and abstracts, as well as of a book chapter on inherited predisposition to cancer for the American Cancer Society.

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