Laser in prostate cancer. Applicability.

Objectives In recent years, there has been a rise concerning the research and development of focal prostate cancer therapies as a consequence of the high percentage of low-risk and localized prostate cancers. These focal therapies aim at preserving the gland in selected patients to avoid overtreatment. The application of lasers for focal ablation and photodynamic therapy has shown promising results in exchange for a minimal rate of adverse events compared to radical treatments. Material and methods An extensive review of the available literature on focal laser treatments for localized prostate cancer was conducted. A search in PubMed and Embase was carried out by the following keywords: "Localised prostate cancer", "Low-risk prostate cancer", "Focal therapy", "Magnetic Resonance in localized prostate cancer", "Focal laser ablation" , "Photodynamic therapy" and "TOOKAD". Results Photodynamic therapy with TOOKAD is the only focal therapy evaluated in a phase III clinical trial,showing a lower rate of progression and a longer time to progression compared to active surveillance. Other studies carried out have revealed a percentage up to 80% of negative biopsies 6 months after TOOKAD. Likewise, the quality of life of patients treated using focal laser ablation techniques and photodynamic therapy has been minimally altered, as most adverse effects have been shown to be mild and transient, with dysuria and hematuria being the most frequent. Conclusions Despite the fact that focal therapies are still not recommended outside the context of clinical trials and the lack of comparative studies between the different techniques, laser focal therapies seem to havea future within the new approaches for localized prostate cancer.