Focal therapy in prostate cancer

Interesting developments took place in the treatment of prostate cancer including focal therapy for less aggressive organ-confined prostate cancer. Fortunately, curative treatment is often still an option for patients suffering from the lower staged tumors. In carefully selected patients, the prostate cancer may be focally treated followed by careful post-treatment evaluation, and if necessary by focal re-treatment. During the past decades, the age of men at prostate cancer detection has decreased by approximately ten years and men’s life expectancy has increased by almost four years. Together with the increased diagnosis of low- and intermediate risk prostate cancer, interest in the minimally invasive focal treatment with its lower side-effect profile has grown. The present thesis deliberates on a minimally invasive approach of treating prostate cancer within the concept of focal therapy. Focal therapy offers a middle ground between active surveillance and radical treatments as surgery or radiation therapy. Focal therapy is a minimally invasive treatment concept whereby active therapy is targeted to the malignant areas of the prostate gland while sparing the benign tissue and vital structures of the prostate aiming at better preservation of the quality of life. Additionally, this thesis provides the initial results of IRE research in prostate cancer that show the safety and feasibility of the procedure, quality of life, post-procedural imaging and histopathological outcomes after an IRE-procedure in the prostate