Use of Laser Interstitial Thermal Therapy in the Focal Treatment of Localized Prostate Cancer

Inclusion Criteria: * Subjects with initial presentation of organ confined prostate cancer (clinical stage ≤ T2b) * Negative metastatic workup with bone scan and CT abdomen/pelvis, within 6 months of study treatment, if indicated by PSA \>10 * Age 40 years to 85 years of age * Multi-parametric MRI at UCLA within 6 months of study treatment, demonstrating a * Region of interest (ROI) of MRI suspicion level 3 or higher * ROI located proximal to the external sphincter by a margin of at least 2 cm * Transrectal ultrasound-guided biopsy with ≥ 10 systematic biopsy cores and ≥ 2 MRI-ultrasound fusion targeted biopsy cores from above MRI-derived ROI * Histologically-confirmed adenocarcinoma from targeted biopsy cores (≥ 2 cores) * Overall Gleason score not to exceed 3+4 * Subjects desire focal therapy and declined conventional treatment (active surveillance, radical prostatectomy, radiation therapy, cryosurgery and hormone therapy) * Signed informed consent for the LITT treatment through the 12 month follow up visit Exclusion Criteria: * Any significant cancer outside of MRI target (ROI) area, defined as Gleason score \> 3+4 * \< 10 years life expectancy * American Society of Anesthesiologists (ASA) criteria of IV or higher * Unfit for conscious sedation anesthesia * Active bleeding disorder as determined by abnormal prothrombin time, partial thromboplastin time, INR or platelet count (as determined by institutional lab parameters) at the time of screening * Use of coumadin or any other anticoagulant, unless anticoagulation can be temporarily reversed or stopped for a window of at least 7 days peri-procedure * Active urinary tract infection * Prostate abscess, chronic or acute prostatitis, or neurogenic bladder * Any prior treatment for prostate cancer * Radical prostatectomy * Radiation therapy (external beam or brachytherapy) * Cryotherapy * High intensity focused ultrasound treatment * Photodynamic therapy * Androgen deprivation therapy * Prior prostate, bladder neck, or urethral stricture surgery * Any prostate debulking procedure, including: transurethral resection of prostate, photovaporization, or electrovaporization * Transurethral incision of bladder neck * Urethral stricture dilation or reconstruction * Any current 5-alpha reductase inhibitors (history of use ≥ 6 months prior to MRI is acceptable) * Prior significant rectal surgery (hemorrhoidectomy is acceptable) * Rectal fissure, fibrosis, stenosis, or other anatomic abnormality precluding insertion of transrectal device * History of inflammatory bowel disease * Urinary tract or rectal fistula * Any contraindication to MRI (contrast allergy severe claustrophobia, MRI-incompatible prosthesis)