PROSTATE PROS Episode 12: Finding Focal Therapy

Listen: https://soundcloud.com/prostate-oncology/finding-focal-therapy

“I don’t think there’s any doubt that when you just treat a section of the prostate, that the chances for maintaining sexual function are much better.”– Dr. Scholz

Focal therapy treats only the section of the prostate gland that contains the cancer.  These treatments appeal to men who want to preserve sexual and urinary function while trying for a cure.  While these treatments may sound promising, keep in mind they are still in the research phase.

These procedures are complicated and being so new, much is still unknown about outcomes and risk of side effects.  When it comes to focal therapy, what matters most is the quality of the performing physician.  It is important to find someone who has a lot of experience with their chosen method, whether it be HIFU, cryo, laser, etc., the best outcome will come with the most experienced doctor.     

Requirements for focal therapy 

  1. Area must be visible on a scan 
  2. The area must be limited to one side of the gland (unilateral)
  3. Men with Intermediate-Risk or High-Risk prostate cancer

3 common types of focal therapy:

  1. High-intensity focused ultrasound (HIFU): Ultrasound waves directed at the lesion of concern to target the cancer followed by a cooling to preserve surrounding tissue.
  2. Cryotherapy: Argon gas circulated through cryoprobes strategically placed (via ultrasound) in the prostate- an expanding ice ball forms at the end of the cryoprobe to target the cancer. 
  3. Focal Laser Therapy: Placement of laser directly into lesion through perineal or transrectal puncture.

Other types of focal therapy include: TULSA, photodynamic, electroporation, focal brachytherapy, and others.  For more details on the types of focal therapy listen to the episode.  

Conclusion

Focal therapy treats only one side of the prostate gland.  This means that part of the prostate is left untreated.  Men who’ve chosen focal therapy will need to be monitored using a modern active surveillance protocol that includes regular PSA testing and imaging to make sure no new cancers appear and that the focal treatment did get all the cancer.

When researching focal therapy online, make sure you are looking at reputable sources.  When you are interviewing doctors, be sure they aren’t just recommending focal therapy to everyone– remember that there is no one-size-fits-all treatment for prostate cancer, treatment must be personalized to the individual.  As always, a great place to find good doctors is by asking members of your support group about their experiences.

Focal Therapy for Prostate Cancer: Recent Advances and Future Directions: https://www.hematologyandoncology.net/archives/february-2020/focal-therapy-for-prostate-cancer-recent-advances-and-future-directions/

Read Dr. Duke Bahn’s chapter in The Key to Prostate Cancer: www.keytopc.com   

For more on Seed Radiation listen to the Proceeding to Top Seed PROSTATE PROS podcast episode: https://www.prostateoncology.com/2019/10/07/prostate-pros-episode-5-proceeding-to-top-seed/ 

Have questions or topics you think would be great for PROSTATE PROS? Email

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Check out more episodes on podcast.prostateoncology.com 

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