Focal therapy for prostate cancer is a type of treatment that uses various types of energy (like heat or cold) to destroy tumor cells. It aims to keep healthy tissue intact and can have fewer side effects than radiation or surgery. Cancer that hasn’t spread outside your prostate and has a low risk of spreading might be treatable with focal therapy.
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Focal therapies are types of treatment for localized prostate cancer that target only the area of your prostate where the tumor is located. The tumor must be confined to your prostate (usually only on one side) without spreading to other tissue or organs around your prostate. Each type of focal therapy uses an energy source (like heat, cold or electric shock) to destroy tumor cells.
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The goal of focal therapy is to destroy cancerous cells while leaving as much healthy tissue as possible, minimizing side effects and complications. It’s an alternative treatment to surgery or radiation, which treats the entire prostate, and active surveillance, where your provider periodically monitors and tests the tumor for signs of spreading. If you have favorable intermediate-risk prostate cancer (PSA between 10 and 20, grade 2 or 3, and less than 50% of biopsies are positive), focal therapy is a potential middle ground between active surveillance and surgery or radiation.
Types of focal therapy include:
Focal therapy treats cancer that has a low risk of spreading and is completely contained (localized) in your prostate. Ideally, the tumor is also not near your urinary sphincter (muscle that controls when pee is released from your bladder) or urethra (the tube that drains pee out of your body).
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People with intermediate-risk prostate cancer are the best candidates for focal therapy. Low-risk cancers are better managed with active surveillance and high-risk cancers are better treated with whole-gland therapies (like surgery or radiation).
Before focal therapy, you may need several tests and imaging studies to determine your treatment options. These include:
Each focal therapy works a little differently. Your provider will tell you what to expect depending on which type of focal therapy you need. In general, a provider will:
Advantages of focal therapy include:
The disadvantages of focal therapy may include:
After focal therapy, your provider will monitor you closely for months or years. This includes testing and looking for signs of cancer that:
You might need additional treatment — including surgery or radiation — if tests show that there’s still cancer in your prostate.
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The effectiveness of focal therapy can vary widely (from about 30% to 96%). But these numbers aren’t apples-to-apples comparisons, and the quality of the studies vary. First, studies use different measurements to define effectiveness. They might look at the percentage of people who’ve been treated with focal therapy and:
Second, outcomes vary based on:
Focal therapies are considered less effective than whole-gland therapies like surgery and radiation. Talk to your provider about the effectiveness, benefits and risks of different types of focal therapy to understand what might be right for you.
A note from Cleveland Clinic
Focal therapy treats prostate cancer while sparing healthy tissue. It can provide a less invasive alternative to radiation and surgery and might cause fewer side effects. It can also be a more proactive approach than active surveillance for some prostate cancers.
But it’s not an option for everyone — focal therapies haven’t been studied as much as traditional treatments and some are still considered investigational. Talk to your provider about the benefits and risks of available prostate cancer treatments. They can help you decide what’s right for your specific situation.
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Last reviewed on 06/10/2024.
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