Focal Brachytherapy for Prostate Cancer in 2025 with Dr. Peter J. Rossi, MD

Peter J. Rossi, MD, Valley View Hospital, Glenwood Springs, California, discusses the argument for whole gland therapy, focal therapy, and focal brachytherapy in prostate cancer treatment. In this 10-minute presentation, Dr. Rossi evaluates the benefits.

First, Dr. Rossi highlights the established success of whole gland therapy, particularly with brachytherapy, which offers durable outcomes with minimal severe side effects. Guidelines do not yet support focal therapy, largely due to questions regarding data, clinical trials, toxicity outcomes, and criteria for success or failure. However, he acknowledges the growing interest in focal therapy as a targeted, minimally invasive option that aligns with patient preferences to preserve sexual function.

Dr. Rossi presents MRI-based brachytherapy as a precise and effective approach that utilizes technological advancements like PSMA PET for improved targeting and MRI for preserving healthy tissue. He demonstrates a detailed treatment planning example using MRI-based focal brachytherapy, emphasizing its precision in dose delivery while avoiding organs at risk.

Dr. Rossi advocates for continued clinical trials incorporating biomarkers, molecular imaging, and sexual function endpoints to expand the evidence base. He affirms that focal brachytherapy offers a precise and effective treatment option for selected patients, ensuring durable tumor control while preserving salvage options.

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