Minimally invasive thermal ablation of tumours has become common since the advent of modern imaging. From the ablation of small, unresectable tumours to experimental therapies, percutaneous radiofrequency ablation, microwave ablation, cryoablation and irreversible electroporation have an increasing role in the treatment of solid neoplasms. This Opinion article examines the mechanisms of tumour cell death that are induced by the most common thermoablative techniques and discusses the rapidly developing areas of research in the field, including combinatorial ablation and immunotherapy, synergy with conventional chemotherapy and radiation, and the development of a new ablation modality in irreversible electroporation.

Obesity, defined as a body mass index ≥ 30 kg/m² in adults by the National Institutes of Health, is associated with an increased risk for a number of health conditions, including hypertension, unfavorable lipid level, and diabetes mellitus. During the past 2 decades of the twentieth century, the prevalence of obesity has increased in the United States. In 2009 to 2010, 36% of adults were obese, including 41 million women and > 37 million men. In addition, the prevalence of metabolic syndrome (MetS), which is a constellation of interrelated cardiac risk factors including visceral obesity, impaired insulin action (ie, insulin resistance), atherogenic dyslipidemia, endothelial dysfunction, and systemic inflammation, has been increasing in the United States. More recently, there has been greater interest in the effects of obesity and MetS on a variety of benign and malignant urologic conditions. Obesity/MetS has been shown to have an effect on urolithiasis; benign prostatic hyperplasia and lower urinary tract symptoms; female incontinence and pelvic prolapse; male hypogonadism; and male sexual function and infertility. These urologic diseases have a considerable impact on patients' quality of life. From a urologic cancer standpoint, obesity/MetS has been demonstrated to play a role in prostate cancer and in renal cell cancer; its role in bladder cancer remains ill defined. Furthermore, dietary or lifestyle modifications may improve outcomes in many of these urologic disease processes. Thus, it is imperative for physicians to understand these relationships in order to better screen obese patients and be aware of the potential impact of weight loss on affected benign and malignant urologic conditions.

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