Measuring Patient-Based Outcomes: Setting Realistic Expectations When Balancing Functional Outcomes with Cancer Control

Evidence reporting overtreatment with radical therapies for localized prostate cancer is increasing, fueling the use of focal therapy. A technique used to provide oncological control with the aim to minimize collateral damage to adjacent structures, thus optimizing post-treatment quality of life. However, the decision for focal therapy over other available treatment options needs to be carefully considered. Neither long-term oncological outcomes following focal therapy nor randomized comparative studies evaluating focal therapy against radical treatment are yet available. Within this chapter, we report on the evidence behind focal therapy and known decision regret following treatment for prostate cancer to optimize the ability to have an open and honest consultation regarding outcomes following focal treatment.