Novel methods of treating early prostate cancer: cryotherapy and high‐intensity focused ultrasound

The advent of widespread prostate-specifi c antigen (PSA) testing has led to an increase in the diagnosis of early prostate cancer. While surgery and radiotherapy provide excellent cancer control, particularly in low-risk disease, they are associated with signifi cant side-effects. In order to avoid these side-effects, and with uncertainty over the survival benefi t of radical treatment for men with low-risk disease, men with organ-confi ned prostate cancer can opt for a period of active surveillance. This allows men suitable for radical treatment to have their disease monitored, and to choose radical treatment at a later date, with or without evidence of disease progression. Between these two extremes of care, one maximising cancer control, and the other maximising preservation of quality of life, there is a place for the development of novel treatments that aim to offer good cancer control, while maintaining urinary and sexual function. In this review, we consider the role of cryotherapy and highintensity focused ultrasound (HIFU) in this context. Focal therapy is an emerging concept that aims to treat only the cancer within the prostate, while leaving surrounding prostate tissue untreated. The rationale for this approach is also reviewed. The need for novel treatments