What are disadvantages of targeted therapy in treating prostate cancer?

Marc B. Garnick, MD
Hematology & Oncology
A limited number of studies of focal therapy (targeted therapy) have been completed, and those that have been done included only a few dozen patients, used varying techniques, and lacked solid data on adverse effects. Proponents of focal therapies also assume that tiny secondary tumors won't become a problem later on, but that's not certain; in some cases, such tumors have metastasized. Then there's the possibility that cells from the primary tumor may have already spread; these micrometastases can escape detection with current technology. (Estimated accuracy rates for magnetic resonance imaging [MRI] in focal therapy range from 40% to 90%.) Incomplete treatment or a missed spot of cancer could have profound consequences. And although one would think that the extent and number of complications would be less with focal therapies than with whole-gland treatment, that isn't known for certain.

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