As regards surgery and radiation, each in it's several forms, there have been improvements over recent years which for suitable men provide the most successful radical way of dealing with PCa, albeit often with varying degrees of side effects. Some men are not suitable for surgery or radiation or prefer a focal treatment with less extensive side effects which may be successful or defer the day when they need more radical treatment. The other time where focal therapy can be helpful is as a salvage treatment. There are a few other treatments that fall outside this category such as Irreversible Electroporation also referred to as 'Nanoknife'. The long term effects of these treatments have yet to be evaluated and compared with the long established surgical and radiation procedures (which have also improved over the last decade especially). So anybody reading this should not consider any of the new treatment options are better or necessarily as successful as surgery and radiation treatment but may prove a good answer in certain circumstances. It is to be hoped that in the not too distant future a way of treating men with PCa will be found that avoids all this brutal radical treatment, even some of the effects of some systemic treatments. One leading Urologist has speculated that this might be facilitated by introducing a virus which would attack the cancer or carry something to it that would attack it. Meanwhile, the clinicians have to work largely with the tools they have, sometimes using them in combination.
Perhaps even more important is the need to be able to distinguish more reliably between those men that need treatment from those where treatment can be deferred. Patient profiling may help and other ways are being explored. There are many trials looking at various aspects of PCa in many countries, some multinational but there is still a long way to go and so much to be found out.
I was very disappointed when Clare's husband found out his FLA treatment for early and low Gleason grade PCa proved unsuccessful both for him and potentially for me. We know that all treatments have failures but he seemed such a good candidate for FLA and I will look at this very carefully before adopting this option. Meanwhile, I will have to see what UCLH have to say about other options.
Edited by member 15 Jan 2020 at 19:35
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