Introduction: The Dilemma of Intermediate-Risk Prostate Cancer
Imagine Robert, a 64-year-old retired civil engineer. During a routine physical, his doctor noted a rising Prostate-Specific Antigen (PSA) level. A subsequent MRI and biopsy revealed Grade Group 2 prostate cancer—what doctors call intermediate-risk. For decades, Robert would have faced a difficult choice: ‘active surveillance,’ which carries the psychological weight of monitoring a growing tumor, or ‘radical treatment’ (surgery or radiation), which often results in life-altering side effects like urinary incontinence or erectile dysfunction. Robert’s situation is common, but a new era of medical technology is offering a third path: focal therapy. The PRESERVE trial recently evaluated a technology called Irreversible Electroporation (IRE), using the NanoKnife System, to determine if it could effectively destroy cancer cells while leaving the rest of the prostate—and the patient’s quality of life—intact.