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Focal Therapy for Prostate Cancer

David Chen, MD, a urologic surgeon, specializes in focal therapy for men with prostate cancer.David Chen, MD, a urologic surgeon, specializes in focal therapy for men with prostate cancer.

At Fox Chase Cancer Center, we strive to offer more advanced and less invasive procedures in the treatment of prostate cancer. Focal therapy is an emerging technique for men with small, localized prostate tumors. Using this technique, the region with prostate cancer is specifically targeted, sparing normal surrounding tissue from damage.

By focusing on treatment specifically to small tumors within the prostate, the normal portion of the prostate gland and surrounding structures are spared from unnecessary therapy and the usual side effects associated with traditional whole prostate treatments.

When appropriate, this limited and targeted treatment can be a great alternative to standard surgery or radiation therapy for eligible prostate cancer patients because it offers key benefits:

  • Fewer side effects and minimal negative impact on urinary, bowel, and sexual function
  • Fast recovery time
  • Minimal blood loss

Eligibility

The prostate cancer team at Fox Chase is commonly able to confirm the location of a man’s cancer with a high degree of certainty, using some of the latest diagnostic techniques, such as multiparametric MRI scans, MRI-ultrasound fusion targeted biopsy and transperineal mapping biopsies. These diagnostic methods allow our doctors to determine whether or not a man is eligible for focal therapy.

Focal therapy is available to:

  • Men with a small, intermediate-risk prostate tumor that is localized within a limited region of the prostate gland, where preserving function is a specifically high priority
  • Men who want to preserve sexual function and urinary continence

Details of the Procedure

Focal therapy is performed in an outpatient setting under general anesthesia. During the procedure, the target zone of prostate treatment is carefully planned and confirmed in real-time, using transrectal ultrasound guidance. Therapy is closely monitored to avoid unneeded treatment beyond the target area of cancer, minimizing any impact to the adjacent normal prostate and surrounding structures, which can greatly reduce the side effects of therapy. 

Importantly, our doctors can customize treatments to each patient when we have a precise understanding of the tumor location in the prostate.

Focal therapy is an umbrella term that describes partial prostate gland treatment, which is often performed using different treatment technology--the most common applied are cryoablation or High Intensity Focused Ultrasound (HIFU).

Cryoablation

With this approach, a needle probe is directed into the target area, to result in supercooling of the region. A small area surrounding the probe will freeze, which leads to the controlled destruction of prostate tissue. As a focal treatment, cryoablation usually causes fewer side effects than traditional cryoablation therapy that is applied to treat and freeze the entire prostate gland.

High Intensity Focused Ultrasound (HIFU)

In contrast, HIFU uses high intensity sound waves to create a zone of heating, which similarly can lead to tissue destruction. HIFU is a newer treatment approach, first FDA approved for use in the US in December 2015, and it remains an investigational treatment for prostate cancer. The prostate cancer team has unique experience with HIFU therapy, having been involved in the initial clinical trials of the device; few urologists nationally have the expertise with HIFU equal to the prostate cancer specialists at Fox Chase.

Potential Side Effects

As with any treatment for prostate cancer, side effects also may occur after focal therapy, depending on where the tumor is located and the region of the prostate receiving treatment.

Common anticipated side effects include:

  • Minor swelling
  • Localized soreness or discomfort. 
  • Very minimal change, if any, to urinary, bowel and sexual function 

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