An Attractive New Option for Prostate Cancer Patients

The idea of focal ablation for prostate cancer is controversial. For years the thinking has been that since prostate cancer is generally multi-focal; the entire prostate must be treated. This thinking is now being questioned just as the idea of total mastectomy for breast cancer was questioned some years ago and has since given way to the current standard of care which is lumpectomy.

Surveys have shown that only 1 in 5 men diagnosed with prostate cancer who are candidates for watchful waiting will chose this option in spite of the fact that only 9% of patients who choose watchful waiting will die of their prostate cancer and of those, the quality adjusted life years lost may be relatively few.

For the 80% of men who are candidates for watchful waiting but who don't feel emotionally comfortable with that option, focal cryoablation may be a perfect alternative. The objective of focal cryoablation is to provide men with a potentially curative treatment that eradicates the primary cancer foci that are likely to pose a risk while preserving the man's quality of life. Studies have shown that in most patients receiving focal ablation, potency and continency remain fully intact.

One study from the United Kingdom showed that in the patient population researched, 7% of the patients diagnosed with prostate cancer, in fact did not have cancer at all¹. A prominent Swedish study showed that the difference in mortality from prostate cancer between those men receiving active treatment and those receiving no treatment is only 5%. A study conducted in the United States measured the likely gain in quality-adjusted life years (QALY's) for a 60 year-old man with medium-risk disease receiving a radical prostatectomy as only 1.4 years. The gain in QALY's for such a man receiving external-beam radiation was shown to be only 1.7 years. Evidence like this is giving rise to a growing number of clinicians who are questioning the appropriateness of the aggressive highly morbid procedures currently prescribed for men diagnosed with prostate cancer.

13% to 38% (around a quarter) of prostate cancers are unifocal meaning that they exist in only one spot within the prostate gland. In many other cases patients will have a predominant "index lesion" with only incidental foci similar to those found on autopsy in men who have died of other causes (i.e. probably latent, clinically insignificant secondary foci). Based on this, many clinicians are considering it reasonable, to treat only this singular index lesion realizing that if the man truly was at risk of a shortened life due to prostate cancer, the destruction of this primary cancer foci is likely to eliminate the threat. Nothing about focal ablation precludes future treatments of any kind.

Wave Form Systems provides access to the cryosurgical systems, trained technicians and physician training that allows forward-thinking urologists to offer this new and highly attractive treatment option. Call us today to learn more about how focal ablation may benefit a select group of your prostate cancer patients.