Focal Therapy for Prostate Cancer in London
A targeted treatment option for selected men with early prostate cancers
For some men with early prostate cancer, focal therapy offers a middle ground between active surveillance and whole-gland treatment. Instead of removing or treating the entire prostate, focal therapy targets the known area of cancer while aiming to preserve as much normal tissue as possible within and around the prostate. Focal therapy is increasingly sought by men who want effective cancer treatment with a lower risk of side effects than surgery or radiotherapy may carry. Techniques such as high intensity focused ultrasound (HIFU), cryotherapy, and irreversible electroporation (NanoKnife) are offered for carefully selected patients.
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What is Focal Therapy?
Focal therapy is a precision treatment for prostate cancer that treats only the tumour and a margin of surrounding tissue, rather than the whole gland. It is designed for men whose cancer is localised and sufficiently well defined on MRI and biopsy to allow accurate targeting. The aim is to control the cancer while reducing treatment-related side effects by avoiding unnecessary damage to healthy prostate tissue, the urinary sphincter and the neurovascular structures involved in erections.
Types of focal therapy offered privately in London
The most widely used focal therapy techniques are:
- HIFU (High-Intensity Focused Ultrasound) – uses focused ultrasound energy to heat and destroy the targeted cancer tissue.
- NanoKnife / IRE (Irreversible Electroporation) – uses electrical pulses to burst open and kill cancer cells while aiming to spare surrounding supporting structures.
- Cryotherapy – uses freezing to destroy the targeted cancer area.
These treatments depend on high-quality imaging, careful case selection and experienced surgeons and radiologists.
Who is suitable for Focal Therapy?
Focal therapy is not appropriate for every man with prostate cancer. It is generally considered for men with localised disease, often intermediate-risk (Gleason 3+4 or Cambridge Prognostic Group 2) cancers, confined to one part of the prostate and clearly characterised by MRI and biopsy, not too large, or too close to structures around the prostate. Focal therapy assessment must be thorough and reliant on the quality of MRI interpretation and biopsy information which directly determines whether treatment can be offered safely and effectively.
Benefits of Focal Therapy
For the right patient, focal therapy can offer several important advantages:
- Lower risk of urinary incontinence compared with whole-gland treatment.
- Lower risk of erectile dysfunction compared with whole-gland treatment.
- Shorter recovery time, often with day-case treatments.
- The possibility of repeat focal treatment or later surgery/radiotherapy if needed.
Limitations of Focal Therapy
Although focal therapy is an attractive option, there are some caveats. Prostate cancer is sometimes multifocal, which means there may be disease in more than one area of the gland, and not every tumour is suitable for focal treatment. Focal therapy requires ongoing follow-up, often similar in structure to active surveillance, including PSA monitoring, MRI and sometimes repeat biopsy.
It is a treatment pathway, not a one-off event that removes the need for future assessment. Cancer control or cure rates are less than surgery or radiotherapy, so there is a trade-off between side effects and cancer outcomes.
Questions to ask at a Focal Therapy consultation
Before deciding on focal therapy, useful questions include:
- Is my cancer clearly localised enough for focal treatment?
- Which energy source is most appropriate in my case: HIFU, NanoKnife or Cryotherapy?
- What are the realistic risks to urinary and sexual function for someone like me?
- What follow-up will I need after treatment?
- If focal therapy is not suitable, would active surveillance, robotic surgery or radiotherapy be more appropriate?
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