European Urological Review Highlights Focal Therapy As A Promising New Option For The Treatment Of Prostate Cancer

CHARLOTTE, Dec. 18, 2012 /PRNewswire/ -- Focal or tissue preserving therapy has become a topic of considerable interest among urologists and in recent years has been called a new paradigm in the treatment of prostate cancer, offering another treatment option designed to balance treatment effectiveness and quality of life.  Results of a roundtable of international prostate cancer experts reviewing focal technologies and the latest research evaluating focal lesion diagnosis and treatment were published in the current issue of the European Urological Review (2012;7(2):101-3) and is available online at www.touchurology.com/articles/roundtable-discussion-focal-therapy-prostate-cancer.

European Urological Review is a peer-reviewed journal comprising review articles, case reports, practice guides, theoretical discussions, and original research. It features balanced and comprehensive articles written by leading authorities, addressing the most important and salient developments in the field of urology. International HIFU, the international division of USHIFU, LLC (US HIFU), the manufacturer of the Sonablate^® 500, sponsored the moderated roundtable session devoted to the subject of focal therapy for prostate cancer and to review technologies currently available or in development that may impact the evolution of the 'focal paradigm'. 

Building on the success of tissue preserving therapy to treat other cancers (breast, renal, bladder and rectal), focal therapy has been proposed as a means of bridging the gap between radical prostatectomy and active surveillance for treatment of prostate cancer.  Results of large-scale studies, including the European Randomized Study of Screening for Prostate Cancer (ERSPC) and Prostate Cancer Intervention Versus Observation Trial (PIVOT), suggest that prostate cancer has been over diagnosed and over treated with minimal impact on overall prostate cancer mortality across all risk groups.  According to several panelists, clinicians must reconsider treatment strategies and whether focal therapy can help reduce the side effects of treatment while treating those cancer lesions that are likely to cause prostate cancer-specific mortality if left untreated.

Patient selection and the use of advanced diagnostics were called out as critical to the evolving treatment paradigm and the ability for focal therapy to be established as a suitable alternative to whole gland prostate cancer treatment.  According to the Panel, results on recent studies investigating the use of pre-biopsy mpMRI and MRI-Ultrasound registration have shown promise to better localize and characterize lesions. This not only has potential for improved accuracy of focal treatments, but may also improve diagnostic sampling strategies for prostate cancer. Fewer, and better, biopsies could be performed on suspicious lesions, with potentially increased diagnostic rates of clinically significant cancer, and reduced rates for over-diagnosis of clinically insignificant disease.  

Moderated by Mark Schoenberg, MD, of the James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Maryland, roundtable participants included:

• Joyce Bomers, Department of Radiology, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands;
• Louise Dickinson, Department of Urology, University College Hospitals, London, UK;
• Jurgen J Futterer  and Jelle Barentsz , Department of Radiology, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands and MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, Netherlands;
• Aaron Katz , Department of Urology, Winthrop University Hospital, Stony Brook University School of Medicine, New York;
• Laurence Klotz, Sunnybrook Health Sciences Centre, Toronto, Canada; and
• Osamu Ukimura, Institute of Urology, University of Southern California School Medicine, Los Angeles.

"The field of prostate cancer treatment is undergoing dramatic change as physicians scrutinize the impact of historical practice patterns, particularly those related to whole gland therapy, disease-specific survival and quality of life. As research on individual patient risk stratification and the use of advanced imaging and modern prostate biopsy techniques progresses, focal therapy for prostate cancer has emerged as an important topic for discussion and research," noted Dr. Schoenberg. "I'm pleased that this Roundtable was able to spark a lively discussion among leading experts and investigators in focal therapy to explore how new diagnostic and therapeutic technologies may be integrated into the broader field of prostate cancer care."

The majority of men treated for prostate cancer are treated with surgery or radiotherapy, which involve treating the whole prostate.  Both cause damage to the surrounding non-cancerous tissue and can lead to substantial side effects such as urinary incontinence and impotence.  The goal of focal therapy is to offer an alternative to men who value genito-urinary function and quality of life, allowing each patient and their physician to balance the risk and clinical benefit of individual treatment options.

High intensity focused ultrasound (HIFU) is a therapy that destroys targeted tissue with rapid heat elevation. HIFU concentrates high frequency ultrasound waves (similar to a magnifying glass) into an area the size of a grain of rice. At that location, or focal point, the temperature rapidly rises to almost 90 degrees Celsius (195 degrees Fahrenheit).  Tissue at the focal point, including cancerous tissue, is destroyed. HIFU uses non-ionizing energy, so the procedure can be repeated, if necessary. HIFU is being studied around the world to treat a wide variety of cancers and soft tissue diseases.

The Sonablate^® 500 is approved for investigational use within the U.S. and is being studied for the treatment of prostate cancer in clinical trials in the U.S. The FDA has made no decision as to the safety or efficacy of the Sonablate^® 500 for the treatment of prostate cancer. Currently, the device is available for the treatment of prostate cancer outside the U.S. in more than 30 countries.

About USHIFU, LLC

USHIFU, LLC (US HIFU), a privately held, venture-backed healthcare company, is a world leader in minimally invasive high intensity focused ultrasound (HIFU) technologies. US HIFU is committed to treating prostate cancer using HIFU with the Sonablate^® 500, a minimally invasive, outpatient procedure pioneered to control cancer and significantly improve patients' quality of life. US HIFU is engaged in ongoing research for technological advancements for the Sonablate system and/or other ultrasound applications. US HIFU was founded in 2004 and is headquartered in Charlotte, N.C. Additional information may be found at www.ushifu.com.

SOURCE USHIFU, LLC