Harvard Perspectives on Prostate Disease

Promising technologies for the treatment of prostate cancer

Editor in Chief Marc B. Garnick, M.D., discusses cryotherapy, HIFU, and focal therapies, possible treatments that need more study

Thanks to widespread prostate-specific antigen (PSA) testing, most men diagnosed with prostate cancer today have small, low-grade tumors confined to the prostate gland. In fact, these tumors are so tiny that they don't cause symptoms and can't be felt during a digital rectal examination. Since many of them grow so slowly that they never cause a problem, men diagnosed with localized prostate cancer face questions for which there are no easy answers: Should the cancer be treated? If so, when and how should it be treated?

Although surgery and radiation have both proven effective in controlling cancer, most patients subsequently experience sexual difficulties, urologic side effects, or both, and their quality of life suffers. For elderly patients or those who cannot undergo surgery or radiation, physicians may prescribe hormone therapy to treat the cancer. But like surgery or radiation, it can cause serious side effects, including erectile dysfunction, loss of libido, a drop in bone mineral density and muscle mass, and an increased risk of cardiovascular trouble.

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