[The long journey from palpation to biopsy : The history of diagnosing prostate cancer].

Though it is thousands of years old, prostate cancer (PCa) has only been known for 200 years. Until about 50 years ago, the diagnosis could only be made by digital rectal examination. Although the first prostate biopsies were already implemented in the beginning of the last century, it only obtained importance with the introduction of prostate-specific antigen (PSA) testing in the early screening for PCa and the pathologist, thus, became an essential partner for the urologist.

[Focal therapy of prostate cancer].

The target of focal therapy (FT) in prostate cancer (PC) is partial treatment of the prostate aiming at preserving surrounding anatomical structures. The intention is to minimize typical side effects of radical treatment options combined with local tumor control. Numerous established and new technologies are used.

[MRI/TRUS fusion-guided prostate biopsy : Value in the context of focal therapy].

Background: Several systems for MRI/TRUS fusion-guided biopsy of the prostate are commercially available. Many studies have shown superiority of fusion systems for tumor detection and diagnostic quality compared to random biopsy. The benefit of fusion systems in focal therapy of prostate cancer (PC) is less clear.

Why we should not routinely apply irreversible electroporation as an alternative curative treatment modality for localized prostate cancer at this stage.

Irreversible electroporation (IRE), a new tissue ablation procedure available since 2007, could meet the requirements for ideal focal therapy of prostate cancer with its postulated features, especially the absence of a thermal ablation effect. Thus far, there is not enough evidence of its effectiveness or adverse effects to justify its use as a definitive treatment option for localized prostate cancer. Moreover, neither optimal nor individual treatment parameters nor uniform endpoints have been defined thus far.

[Focal therapy for small renal masses : Observation, ablation or surgery].

Background: The rising incidence of renal cell carcinoma, its more frequent early detection (stage T1a) and the increasing prevalence of chronic renal failure with higher morbidity and shorter life expectancy underscore the need for multimodal focal nephron-sparing therapy.

Discussion: During the past decade, the gold standard shifted from radical to partial nephrectomy. Depending on the surgeon's experience, the patient's constitution and the tumor's location, the intervention can be performed laparoscopically with the corresponding advantages of lower invasiveness.