Focal Therapy for Prostatic Carcinoma

Medical therapeutics has solidly evolved in the last decades based on bright ideas and hard work. Thinking outside the box remains essential if one's idea is to make his/her specific fields move forward. Some years ago we were lucky to become part of the surgical evolution in radical prostatec-tomy; the development of laparoscopic radical prostatectomy followed by the robotic version of the procedure not only transformed the actual operation, but also brought up a minutely precise analysis of surgical outcomes. Prostate cancer remains one of the most rapidly evolving areas in medicine and perhaps after a massive application of surgical concepts to treat disease, we have come to the point to question ourselves about overtreatment. This is how the genius idea of active surveillance was born and the evolution of this approach has offered thousands of patients the logical option of a less aggressive approach to deal with a positive prostatic biopsy. More recently, many of us have questioned both active surveillance and any other more aggressive treatment options, based on an oncological concept previously applied with success in other organs: partial treatment (partial mastectomy, partial nephrectomy, and partial cystectomy), meaning to treat only the diseased portion of an organ and not the whole thing. Today, this is how we aim to make the field move forward in prostate carcinoma therapeutics; with focal therapy, a logical intermediate option to treat patients only was the positive biopsies are located aiming to obtain solid cancer control while maintaining quality of life. We were pleased to guest this special issue, as we consider there is much to do in order to further improve this novel idea, that, as any other idea ever presented in medicine, remains a rather controversial issue where once again brilliant thoughts must be backed up with enormous effort to rapidly evolve beyond the proof of concept. Focal therapy for prostate cancer should be established on three basic concepts: first, a reliable determination of cancer location within the prostate, second, a convenient type of energy providing safe and reliable intervention on the diseased portions of the organ, and third, a follow-up approach allowing physicians to objectively decide on further actions to control the disease. The mentioned concepts have not yet been completely defined and a great part of today's research is focused on the improvement of these elements. We would like to highlight some of the manuscripts presented in the …