Focal therapy will be the next step on prostate cancer management? | Opinion: Yes

Vol. 43 (6): 1013-1016, November – December, 2017

doi: 10.1590/S1677-5538.IBJU.2017.06.02


DIFFERENCE OF OPINION

Stênio de Cássio Zequi 1,2
1 Editor Associado, International Braz J Urol; 2 Divisão de Urologia do A.C. Camargo Cancer Center Fundação A. Prudente, São Paulo, Brasil

Keywords: Therapeutics; Prostatic Neoplasms; Disease Management; Kidney Neoplasms


In the last decades, the main goal of the treatment of several solid malignancies was the maintenance of high cure rates, along with morbidity reduction. As occurred with the drastic reduction of radical mastectomies for breast cancer and popularization of nephron sparing surgeries for kidney cancer, winds for reducing the radicality of prostate cancer (PC) treatment are blowing the candles.

Despite of recent recommendations against PC screening, the high rates of overdiagnosis and overtreatment of PC patients are still observed and relevant. Nowadays, many of PC cases are diagnosed in early stages, comprising no more than 5 or 10% of the gland, and much of them are low or intermediate risk PC (1-3). However, for decades, the accepted treatments for all localized PC cases have not changed and were based in whole gland therapies (WGT), for example: radical prostatectomy, or radical external beam radiotherapy, brachytherapy, cryotherapy, HIFU or androgen deprivation (1-3).

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