Transurethral Vapor Ablation in Prostate Cancer

Transurethral water vapor ablation (Vanquish™ System) of the prostate is a promising minimally invasive modality for the focal treatment of prostate cancer. By utilizing the convective properties of water (or steam), large amounts of thermal energy can be released to the target tissue while respecting the boundaries and zonal anatomy of the prostate, with shorter treatment time and less energy deposition compared to other minimally invasive delivery systems which rely on conductive heat transfer. Water vapor ablation is FDA-cleared for the treatment of benign prostatic hyperplasia with the Rezum system, and initial studies for the treatment of prostate cancer have demonstrated an acceptable side effect profile and effective ablation of target lesions by imaging and histology, with negative surveillance biopsies in the majority of patients. The prospective, multicenter, single-arm VAPOR 2 trial is ongoing to confirm the safety and effectiveness of water vapor ablation for the focal treatment of men with Gleason grade group 2 localized, intermediate-risk prostate cancer.