Treating Prostate Cancer: Active Surveillance, Surgery, Radiation Therapy, and New Focal Therapies

Geoffrey Sonn, MD, a urologic surgical oncologist at Stanford Health Care, details treatment options from active surveillance to “whole prostate” treatments such as surgery and radiation therapy, to newer “focal therapies” that treat early-stage cancers which are localized to one area of the prostate gland. The therapy targets the prostate cancer itself without destroying the entire prostate. Focal therapy options at Stanford Health Care include:

•High-intensity focused ultrasound (HIFU): HIFU is a promising new therapy that uses sound waves to heat and eliminate tumors. The therapy preserves the surrounding nerves, blood vessels, and muscles that are critical for sexual function and urinary continence. Stanford Health Care is one of the few hospitals on the West Coast that offer HIFU for prostate cancer.
•Magnetic resonance guided focused ultrasound (MRgFUS or MRgHIFU): MRgFUS is similar to HIFU, except you receive the treatment while lying in an MRI scanner. The MRI guides your doctor with detailed images and monitors tissue temperature during treatment using MR thermometry.
•Transurethral ultrasound ablation (TULSA): Guided by advanced imaging, your doctor uses a robotically controlled ultrasound to heat and destroy the cancer cells. The use of imaging during the procedure helps your doctor target prostate cancer while protecting the surrounding healthy tissue.
•MRI-guided cryoablation: During cryoablation, we kill the cancer by freezing the cells. A small, metal tool placed in the tumor applies extremely cold temperatures to the cancer cells. During the procedure, you will lie in an MRI scanner so that we can carefully monitor the treated area.