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- W1489134603 abstract "The urology community in the late 1990s enthusiastically adopted prostate cancer (PCa) screening and curative treatment of screen-detected cancers. The subsequent decline in PCamortality rates provided validation of progress in the war on PCa. However, over time, many of us who embraced aggressive screening and treatment began to recognize the need to reassess how we screen, detect, and treat PCa. The bottom line is that we need smarter screening and smarter diagnosis; only then will we be able to achieve smarter treatment. Will there be a role for targeted treatment in the evolving paradigm for treating PCa? The primary argument against targeted treatment of PCa is that the disease is multifocal, which mandates excision or destruction of the entire gland to achieve oncologic control. However, in most cases there is a single index or dominant lesion that drives PCa risk [1]. Magnetic resonance imaging (MRI) of the prostate has been a game changer, enabling targeted therapy. Recent studies provide compelling evidence that multiparametric MRI reliably identifies significant PCa [2]. MRI-targeted biopsy improves the ability to localize and risk-stratify PCa [3,4]. The cancers missed by MRI are typically Gleason 6 disease [3,4]. We have reported that no men with pathologic Gleason 6 disease developed metastasis following radical prostatectomy, which raises the question of whether Gleason 6 is a cancer [5]. Now that we can find significant disease, we can utilize the multitude of energy sources at our disposal to destroy prostate tissue [6]. Today there is an emerging and compelling rationale for targeted treatment of PCa. The study by Feijoo et al [7] in this issue of European Urology contributes to an increasing body of evidence that targeted therapy safely achieves early oncologic disease control with minimal adverse impact on functional" @default.
- W1489134603 created "2016-06-24" @default.
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- W1489134603 date "2016-02-01" @default.
- W1489134603 modified "2023-09-27" @default.
- W1489134603 title "Is Targeted Therapy of Prostate Cancer Ready for Prime Time?" @default.
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- W1489134603 doi "https://doi.org/10.1016/j.eururo.2015.06.049" @default.
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