Timothy J. Daskivich, MD, assistant professor of surgery, Cedars-Sinai Medical Center, discusses the future treatment landscape of prostate cancer.
Daskivichs hope is that active surveillance will be the primary therapy for very low-risk and the majority of low-risk prostate cancers. For select low-risk prostate cancers, high-intensity focused ultrasound (HIFU) or other minimally invasive and minimally morbid treatments will be used for those patients who need treatment, states Daskivich. Currently, HIFU is only approved in the United States for prostate tissue ablation, but it has demonstrated efficacy as a treatment for patients with prostate cancer. HIFU should be used sparingly, as to avoid overtreatment in patients with very low-risk tumors.
For favorable-risk, low-volume, localized, intermediate-risk tumors, HIFU will become the standard of care, predicts Daskivich. For unfavorable, intermediate-risk and higher tumors, the evidence suggests that, currently, surgery and radiation are the appropriate therapies. Time will tell, concludes Daskivich.