CaP Focal Therapy Crossfire
Even though pathologically long regarded as a ‘diffuse’ cancer with multifocality that most often involves the whole prostate gland, the concept that there could exist an ‘index lesion’ in the prostate that dominates and dictates the biological aggressiveness of that cancer and the survival of that patient has evolved from merely a hypothesis to daily practice in many western countries, even though currently there is NO any guideline of prostate cancer treatment formally recommend it due to not enough high-level evidence.
Besides the complexity of letting the interested patients/family understand the RBAPC of focal therapy and the stringent protocol to follow after a focal therapy for a localized prostate cancer, the existent of multiple types of ablative energy in the market (e.g.: high intensity focal ultrasound [HIFU], cryoablation, irreversible electroporation [IRE], targeted microwave, focal radiation/brachytherapy; etc.) just makes the decision-making more challenging for both the patients and the urologists alike.
For a urologist involved in offering focal therapy for his prostate cancer patients, should he learn just one treatment modality and use it for all/majority of his patients (one size fit all?), or should he learn the tips and tricks of multiple treatments and tailor the therapy decision according the disease and anatomical details of his specific patients (custom-made?).
In this 90-min multi-side crossfire, experts with great experience in utilizing various treatments will first give a brief introduction of his armamentarium, then several cases of prostate cancer with different disease locations and severity, and prostate anatomy will be presented, and each panelist will answer if his/her equipment/instrument is a good choice for that case; why; any tips/tricks to do that specific case beautifully? After all panelists’ presentation, the commenter(s)/ moderators will challenge them with questions. Finally, the audience will vote their preference.
For anyone interested in prostate cancer focal therapy, this specific UAA2025 session is what you cannot afford to miss.
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13:30
15:00
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Cary Nobles RobertsonUnited States
Speaker
Latest Clinical Data and Operative Technique on Focal One Robotic HIFU Therapy for Prostate CancerThe lecture will cover the latest clinical data and operative advancements in Focal One Robotic High-Intensity Focused Ultrasound (HIFU) therapy for the treatment of prostate cancer.
Focal One marks a significant advancement in minimally invasive, organ-sparing treatment. This technology integrates real-time MRI and ultrasound imaging with robotic precision to deliver highly focused ultrasound energy directly to cancerous prostate tissue—while minimizing damage to surrounding healthy structures.
Peter Ka-Fung ChiuHong Kong, China
Speaker
Minimal Invasive Therapy: Where do We Stand in 2025Endourological, Laparoscopic and robotic surgeries have replaced most open surgeries in Urology. Emergence of new robotic platforms have provided urologists with new opportunities. Both boom-type and module-type robots have been used, and they each have their strengths in practice. Tele-surgeries have provided a new paradigm of long-distance robotic surgeries to facilitate new surgical possibilities and proctorship. State of the art robotic surgeries in retrograde intrarenal surgeries and enbloc resection MDT Discussion: Personalizing Treatment in High Volume CSPCN/ADebate: Should We Only Offer Consolidative Cytoreductive Nephrectomy in Metastatic RCC?N/AFocal Therapy in Asia – Is It Prime Time?The increase in incidence of Prostate cancer has been rapid in Asia in the past 10 years. While Robotic radical prostatectomy and Radiotherapy has been the commonest treatments for localized prostate cancer, significant long-term morbidities are observed after surgery or radiotherapy including incontinence, erectile dysfunction and irradiation injury to the bladder and rectum. In the current era of MRI-guided prostate biopsy, focal diseases can be targeted and diagnosed, and image-guided focal therapy emerged as an alternative treatment. Although Focal therapy has a relatively higher rate of local recurrence, it has the advantages of minimal or no long-term complication after treatment, and it is possible to perform retreatment with focal therapy, prostatectomy or radiotherapy. In properly selected patients, the need for salvage prostatectomy or radiotherapy after focal therapy is less than 20% at 8 years, and patients’ quality of life could be preserved. In well-selected patients, focal therapy is an attractive option. Current focal therapy for prostate cancer available in Asia includes HIFU, Cryotherapy, Targeted Microwave Ablation (TMA), irreversible electroporation (IRE) and TULSA.
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