Focal therapy has been introduced as a novel treatment option for clinically localized prostate cancer. However, defining its role in the clinical space is still debated, especially with regards to identifying eligible candidates who will stand to benefit from treatment. Active surveillance (AS) is established as the preferred treatment for low-risk prostate cancer, with the goal of identifying those experiencing risk re-classification for curative intervention if it occurs. AS has been shown to be inferior to whole-gland treatments in to preventing progression or metastases. As a result, the field has sought solutions outside of the dichotomous options currently presented to men with low-risk cancer. Finally, the acceptance of preservation of sexual/urinary function and the avoidance of definitive therapy as valid endpoints has forced providers to think outside of survival alone as meaningful measures of success. It is here that focal therapy has emerged as a prospective replacement to AS or definitive treatment in carefully selected men. Combined with available risk stratification tools, focal ablation may afford patients durable oncological benefit while maintaining quality of life even in low-risk cancers.
Keywords: Cryoablation; Focal therapy; HIFU; Prostate cancer; active surveillance.