Future perspective of focal therapy for localized prostate cancer

Abstract In an effort to decrease the morbidity associated with prostate cancer treatment, many urologists are turning to focal therapy as an alternative treatment option. With this approach, the cancer bearing portion of the prostate is targeted while leaving the benign tissue untouched. Multiparametric magnetic resonance imaging (mpMRI) remains the gold standard for visualization during focal therapy, but new imaging modalities such as prostate specific membrane antigen/positron emission tomography (PSMA/PET) and contrast-enhanced ultrasound (CEUS) are being investigated. Furthermore, several biomarkers, such as prostate cancer antigen 3 (PCA 3) and prostate health index (PHI), are used in conjunction with imaging to improve risk stratification prior to focal therapy. Lastly, there are several novel technologies such as nanoparticles and transurethral devices that are under investigation for use in focal therapy.