Selecting the Optimal Energy Source
Samir S. Taneja, MD, compares the merits and limitations of the leading energy sources used in prostate focal ablation. The sources available for use in prostate ablation today include laser, electroporation, radiofrequency, photodynamic therapy, high-intensity focused ultrasound (HIFU), cryosurgery, drugs/toxins, radiations (focal/interstitial), surgery, steam, and gold nanoparticles.
Dr. Taneja outlines the ideal criteria for an energy source based on the individual characteristics of the patient and their disease, as well as real-world considerations like ease of use and insurance coverage. He gives examples of which energy sources are best-suited for certain cases based on disease presentation and other factors.
In a full focal therapy practice, the optimal situation would be one with multiple energy sources available so that physicians can tailor treatments to each individual patient. Since this saturation of options can be daunting to physicians just starting in a focal therapy program, Dr. Taneja advises practitioners to pick one energy source to practice at first, limiting patient selection to those with disease that is best-treated with that specific modality. After becoming proficient with that energy source, more can be added to increase candidate selection.
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