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.

As the use of breast conserving lumpectomy expands as a treatment for early-stage breast cancer, interest has surged in alternatives to whole breast irradiation. Follow-on radiation treatment is crucial to the success of this therapy, but a significant number of women are either unable or unwilling to undergo the typical treatment course involving five to seven weeks of daily radiation therapy. The device industry is responding with technologies aimed at delivering post-lumpectomy radiation therapy in a more convenient, potentially safer way.

In breast cancer, the need for less invasive alternatives to surgery is gaping, particularly on the diagnostic side. Following routine screening mammography, 1.4 million women in the US each year have breast biopsies once a radiologist identifies a suspicious lesion. However, only 20% of women undergoing biopsies will be found to have cancer and not just abnormal, but benign growths. Several new companies have gone to the drawing board to remedy the shortcomings of biopsy devices.