Prostate thermal therapy: technologies and treatment strategies

Abstract

Benign prostatic hyperplasia is a frequent benign disease that often requires surgical intervention. Prostate cancer affects 250,000 men annually, with surgery and radiation therapy the common form of treatment. Numerous biological and clinical investigations have demonstrated that HT in the 41 -45 °C range can significantly enhance clinical responses to radiation therapy, and has potential for enhancing other therapies such as chemotherapy, immunotherapy, and gene therapy. Furthermore, high temperature hyperthermia (greater than 50 °C) alone is being used for selective tissue destruction as an alternative to conventional invasive surgery. Thermal techniques are being utilized to complement existing courses of treatment or provide minimally invasive alternative to surgery with less complications, and morbidity for each of these diseases. This article reviews a selection of heating technology and strategies specific to prostate thermal therapy, which are either in clinical use or currently under development. Transurethral, transrectal, and interstitial systems are discussed for RF current, laser, microwave, ultrasound, and thermal conduction heating technology.