Focal therapy Changing the landscape of prostate cancer treatments

Prostate Cancer (PCa) is among the leading causes of cancer-related death in men. Recommended therapies by guideline for localized PCa are radical prostatectomy (RP), radiotherapy using either brachytherapy or external beam radiotherapy (EBRT) or active surveillance. Radical treatment is associated with side effects that have a detrimental impact on the quality of life of PCa patients. This sparked the interest to improve current techniques and to develop new PCa treatments.
In focal therapy only the tumor lesion is targeted, while sparing adjacent anatomical structures that are of importance for urinary, bowel and sexual function. At present focal therapy is been evaluated in patients that harbor low- to intermediate-risk PCa, a population in which the equilibrium of quality of life versus the oncological benefit of treatments is delicate. Accurate PCa diagnosis and lesion localization is required to allow focal treatment.
The main aim of this thesis was to evaluate the current standard of focal therapy and to advance this treatment paradigm by improving patient selection, treatment planning and follow-up and to identify risk factors for impaired outcomes.