Prostate cancer often harbors multiple tumors, some of which might reoccur after successful treatment. However, these tumors are not equally severe, and the tumor with the most aggressive index lesion is the most likely to cause cancer. That theory has led to developing a new treatment option known as PGA (partial gland ablation) and focal therapy.
How PGA works
The new treatment involves treating the lesion and the area surrounding it instead of surgically removing the whole tumor. This method has been found to treat prostate cancer just as effectively but with less risk of complications like incontinence.
Researchers at Memorial Sloan Kettering Cancer Center, New York, published their findings in February. These findings could help focal therapy get accepted as a way to treat cancer, especially prostate cancer. In the study, they concentrated on men who had previously gone through prostate cancer treatment, only for it to reoccur within an average of three years.
Although in early stages, the findings suggest that MRI and biopsy images can help doctors decide which patients with reoccurring prostate cancer are most suitable for PGA. Dr. Gregory Chesnut, a urologist at MSKCC, headed the study.
In the study, Dr. Gregory and his colleagues identified 77 men who had reoccurring prostate cancer at the cancer center from 2000 to 2014. They had all been through radiation therapy for prostate cancer to the point of cure, but the disease returned. At this point, they had their prostates surgically removed. Sections of the tumors were mounted on slides for pathologists to observe and then put in storage.
Biopsy complements MRI
Chesnut and his team used sophisticated equipment to observe the slides and map out the exact location of each tumor. The team also had preliminary information from MRI scans that 15 of the men were eligible for PGA. For a patient to qualify for the procedure, his index lesion had to be treatable.
The biopsy results proved that the MRI scans were correct, and the index lesions in the 15 slides were actually treatable. Additionally, the results revealed that six men whose MRI images were not eligible had treatable index lesions.
