Focal therapy for organ-confined prostate cancer: an expert overview

For those who are interested in the current state of focal therapy in the management of localized, organ-confined prostate cancer, there is a nice audio overview by Dr. James Eastham of the Memorial Sloan-Kettering Cancer Center on the UroToday web site.

It is not clear where Dr. Eastham gave this presentation, and regrettably we have only the audio portion of the presentation, without the ability to see the slides he was using. Having said that, Dr. Eastham gives a clear and concise summary of what we do and don’t know (as yet) about the application of focal therapies of various types in the management of early stage forms of prostate cancer.

For some, the most interesting portion of Dr. Eastham’s presentation may be the last 5 minutes, where he focuses on the ways in which the US Food and Drug Administration and industry are trying to some to some agreement about how one might be able to do trials that could lead to the approval of new technologies for the application of focal therapy in prostate cancer (and presumably some other forms of cancer too). This is not going to be easy when it comes to prostate cancer, because it would just take way too long to use survival as an endpoint, and neither PSA levels or post-treatment biopsy data are able to provide categorical evidence of effective elimination of all relevant cancer.

For those who do not know this, any patient can sign up to be a member of the UroToday web site at no cost, so this material is accessible to anyone who wants to review it.

6 Responses

  1. Mike, although FLA looks promising for low-grade prostate, how can it be performed in the US without FDA approval?

  2. Jim:

    Listen to Dr. Eastham’s presentation. Several of the techniques being used for focal therapy (including focal laser ablation or FLA) have been approved for “tissue ablation” of any type, which would by definition include the ablation of prostate cancer tissue. However, this doesn’t mean we know how good FLA is as a method for actually treating prostate cancer specifically.

  3. Don’t know if it is OK to post a link but there is an interesting discussion of FLA by a couple of patients and a doctor who performs this on an US TOO discussion board. … A very worthwhile read for those that are interested.

  4. That is a perfect metaphor for the state of US urology today. More questions than answers and no consensus of anything. So, why would Dr. Eastham even be sharing this? To validate the state of urology in America?

  5. Jim:

    OMG … Could it possibly be that he is simply honest about it!?

  6. I agree, Mike. But stating the obvious in a professional setting and yet not sharing anything new looks compromising to me. Heck, put me on the dais at one of the conferences and I’d be happy to share the comments from patients on Us TOO, Yana, PCIL and other blogs that will not be enamoring to the urological community that seems anathema to calling out their own.

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