What are alternative treatments for localized prostate cancer?

Updated: Dec 29, 2020
  • Author: Winston W Tan, MD, FACP; Chief Editor: E Jason Abel, MD  more...
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Answer

Answer

Other treatments that have been used in the initial management of localized prostate cancer include the following:

  • Cryotherapy
  • High-intensity focused ultrasound
  • Particle beam therapy

Cryotherapy:

  • Cryotherapy (also known as cryosurgery or cryoablation) involves using transrectal ultrasonographic guidance; percutaneous cryoprobes are placed and used to freeze prostate tissue

  • This treatment is not preferred as a standard curative treatment option but may be used in select patients with localized prostate cancer or as focal therapy in low-risk patients (experimental) [16]

  • Can also be considered as salvage therapy after failed radiation therapy [17]

  • Complications include tissue sloughing, perineal ecchymosis, stricture or contracture, incontinence, impotence, and fistula formation between the urinary and gastrointestinal tracts

High-intensity focused ultrasound  [18] :

  • Acoustic ablative technique that uses ultrasound to induces immediate and irreversible coagulative necrosis with sharply delineated boundaries; performed under spinal anesthesia on an outpatient basis
  • Widely used outside the United States; approved for ablation of prostate tissue by the US Food and Drug Administration in 2015 [19]
  • Used for both whole-gland treatment and focal therapy (“male lumpectomy”) [20]

Particle beam therapy  [21] :

  • Radiation therapy that uses protons for energy; outside the United States, carbon ions are also used
  • Performed at specialized facilities
  • Combined use of proton beam therapy with standard radiotherapy resulted in a relatively higher occurrence of severe gastrointestinal and genitourinary toxicities
  • Proton beam therapy alone has produced favorable outcomes with respect to disease control and toxicity

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