Focal therapy is a specialized form of prostate cancer treatment that seeks to treat prostate cancer and a margin of normal tissue while sparing the surrounding critical structures responsible for urinary continence and erectile function.
There are multiple different energy types available for focal therapy. At UF Health we offer:
Focal cryoablation, sometimes called cryotherapy
Irreversible electroporation ablation, also known as IRE
Making sure the tumor is localized and that appropriate margins are achieved is less important than the energy used.
Ablative therapies such as cryoablation, irreversible electroporation ablation, and high-intensity focused ultrasound (HIFU) have been studied as a way to limit treatment to the focal location of the cancer instead of treating the entire prostate. With these advances, focal therapy is known to be associated with fewer side effects than other non-focal prostate cancer treatments. The prostate cancer doctors at UF Health are experts in using these therapeutic treatments that target only the cancer, and not the whole prostate.
Selection of appropriate, low-risk patients is essential because less therapy may not be adequate to control higher-volume or high-risk prostate cancer. Other concerns regarding focal therapy include targeting the tumor within the prostate accurately, identifying other areas of cancer within the prostate and offering more effective management compared with active surveillance.
UF Health Urology: Take Control of Prostate Cancer & Understand Focal Therapy
Discover the importance of prostate cancer screening and explore the latest leading-edge treatments for prostate cancer, including noninvasive options like focal therapy.
Who is a candidate for focal therapy?
A good candidate for focal therapy treatment is someone who:
Greater than a 10 year life expectancy
Intermediate risk prostate cancer
Small cancer volume
Ability to achieve an adequate margin without damaging critical structures
Patients considering focal therapy will also undergo a specialized prostate MRI called micro-ultrasound
The above images demonstrate a tumor imaged with 3 separate imaging modalities enabling us to carefully delineate the tumor margins prior to treatment.
What are the side effects of focal therapy?
In general, side effects of focal therapy are not as severe as with whole gland therapy (surgery and radiation). This is because nerves and muscles responsible for urinary continence and erectile function are avoided. An important consideration of focal treatment is that cancer control is not as good as whole gland therapy. However, prostate cancer can often grow slowly, allowing us to catch recurrences and intervene if needed.
How successful is focal therapy?
The need for additional treatment (such as radical prostatectomy or radiation therapy) is about 30% at seven years. Additional focal therapies may be used to ablate prostate cancer recurrences; however, this is not traditionally performed more than once prior to referring patients for whole gland therapy.
How is one followed after focal therapy?
Follow-up after focal therapy is important as some men will have a cancer recurrence. PSA is an unreliable marker, as the remaining non-ablated portion of the prostate continues to produce PSA . At the University of Florida, patients are followed with novel urinary biomarkers, imaging and biopsy 6-12 months following focal therapy to ensure successful treatment. Patients also obtain a surveillance biopsy 18-24 months after treatment to ensure no prostate cancer recurrence.
What happens if prostate cancer comes back?
As long as patients continue to be surveyed, the prostate cancer recurrences are found early and can be treated. Salvage treatment options include repeat focal therapy, surgery and radiation. While side effects are similar to those who have primary treatment, the extent of initial focal therapy, and baseline urinary and erectile function all influence outcomes.
Clinical Trials: Focal Therapy for Prostate Cancer
UF Health research scientists make medicine better every day. They discover new ways to help
people by running clinical trials. When you join a clinical trial, you can get advanced
medical care. Sometimes years before it's available everywhere. You can also help make
medicine better for everyone else.
If you'd like to learn more about clinical trials, visit our
clinical trials page. Or click one of the links below:
This phase III trial compares less intense hormone therapy and radiation therapy to usual hormone therapy and radiation therapy in treating patients with high risk prostate cancer and low gene risk score. This trial also compares more intense…
The purpose of this study is to see what effects, good and/or bad, proton radiation, and/or conventional radiation and hormonal therapy (if applicable), has on prostate cancer that has already returned or the risk of prostate cancer returning.
Status
Accepting Candidates
Ages
18 Years - N/A
Sexes
Male
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