Transrectal Laser Focal Therapy of Prostate Cancer

Laser focal therapy (LFT) is an evolving ablative technique for the treatment of prostate cancer. Also referred to as laser interstitial thermal therapy (LITT) or focal laser ablation (FLA), this intervention is based on heating of the prostate with an infrared laser to produce tissue destruction from coagulative necrosis. While earlier work focused on a transperineal approach, this has evolved to a less-invasive, transrectal approach delivered in the outpatient setting. This chapter examines the history, mechanism of action, and technique of transrectal magnetic resonance imaging (MRI)-guided LFT with real-time thermometry. We describe the equipment, procedure, and early safety and feasibility results of a series of patients in a clinical trial.