Exploring Focal Therapy Options for Prostate Cancer Patients

New developments in prostate cancer care are providing men with localized prostate cancer more targeted and less invasive treatment options. Focal therapies, now offered at Moffitt Cancer Center, are gaining attention for their ability to treat cancer while minimizing side effects and preserving quality of life.

The minimally invasive treatment option focuses on treating only the affected areas of the prostate, leaving healthy tissue intact.

Julio Pow-Sang, MD

“Focal therapy means treating only part of the prostate, not the whole prostate. The traditional treatments are surgery or radiation therapy in which one either removes or radiates the whole prostate,” said Julio Pow-Sang, MD, chair of the Genitourinary Oncology Department at Moffitt.

Focal therapies use types of energy, like extreme cold or heat, to target cancer cells more precisely.  They offer men with localized prostate cancer an effective option for treatment with a lower risk of side effects, like erectile dysfunction and urinary incontinence.

Focal therapy options offered at Moffitt include:

• High-Intensity Focused Ultrasound (HIFU): This technique is used for early-stage prostate cancer visible in imaging scans. It is ideal for patients with a small to medium sized prostate without major calcifications. HIFU provides precise ultrasound treatment without surgical incisions, needles or radiation, allowing for quick recovery and resumption of normal activities.
• Cryosurgery: This method uses freezing temperatures to destroy cancer cells. It involves inserting cryoprobes into the prostate under ultrasound guidance to deliver sub-zero temperatures.
• Irreversible Electroporation (IRE): IRE uses short, high-voltage electrical pulses delivered through needle electrodes under ultrasound guidance. It creates nanopores in cancer cell membranes, causing irreversible damage without heating or radiation.

The decision to proceed with focal therapy is made in collaboration with the multidisciplinary teams at Moffitt, the referring physician and the patient. This team-based approach helps tailor treatment to each patient’s unique situation, maximizing the benefits of focal therapy. The process requires careful patient selection and regular follow up to monitor for cancer recurrence.

“It is a promising technology, but it hasn't been proven long term. So, men have to be aware that they must be followed up closely,” Pow-Sang said.

Prostate Cancer Awareness Month reminds all men to talk to their doctors about screening and treatment options. According to the American Cancer Society, prostate cancer is the most common cancer among men, after skin cancer, and about 299,000 men will be diagnosed with prostate cancer in the United States in 2024.