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Advancing Ablative Tumor Therapies Into Primary Treatments

For many cancers, there is a need for a third option between the two current choices of radical tissue destruction and watchful waiting. New cancer ablation devices in development have the potential to fill that gap. Ablative tumor therapies can play a role in eradication of early-stage and localized tumors, as salvage therapies in patients who've failed other therapies, and for patients whose health precludes surgery or further radiation. Ablation has many advantages. It's a cost-effective and minimally invasive alternative to robotic surgery or radiation devices, and may lead to fewer side effects and complications than current primary tumor treatments. But proving that ablation can save lives compared to more radical forms of therapy requires clinical evidence from multiyear outcome trials that few smaller companies are willing to invest in. There's little evidence to date that venture investors will see returns. But the race is on among companies hoping to become the first device approved for low-risk, localized prostate cancer, a potentially game-changing event.

One in every six men will get a prostate cancer diagnosis at some point in his lifetime – an estimated 219,000 new diagnoses in 2007. When their urologist gives men the bad news, many face a difficult, binary, and potentially life-altering decision. Should they have the prostate surgically removed or just wait and see how the cancer grows? Neither choice is easy to make. On one hand, admits William Huang, MD, a urological oncologist at New York University's Langone Medical Center, "The treatment can be worse for the person's quality of life than the cancer itself." In support of the latter choice, in some cases the cancerous lesions are so small and grow so slowly that they will most likely never develop into clinically detectable disease or have any detrimental impact on a man's health or longevity. But physicians can't predict from present forms of testing whether a tumor will grow quickly or slowly, whether the cancer will metastasize or not. Left untreated, the disease can kill: More than 27,000 men died of metastatic prostate cancer in 2007.

So, for lack of a better option, each year around 60,000 patients choose some form of radical treatment (surgery or radiation), a course that can lead to treatment-related complications such...

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