Focal therapy, a minimally invasive treatment using high-intensity ultrasound or cryotherapy to destroy cancerous prostate tissue, demonstrates effectiveness equivalent to conventional approaches with substantially reduced adverse effects, according to a decade-long research initiative conducted by Imperial College London.
The study tracked approximately 3,500 men diagnosed with intermediate or high-risk prostate cancer who underwent the procedure. Long-term outcomes showed only two disease-related deaths over the 10-year period, matching results achieved through surgery or radiotherapy. Critically, patients experienced less than half the rate of complications including urinary incontinence and erectile dysfunction compared to traditional treatments. Researchers characterize these findings as significant because medical regulators previously identified insufficient long-term evidence as an obstacle to broader adoption.
Despite introduction over 20 years ago, the treatment remains limited in availability across the UK. Currently approximately 1,000 men annually receive focal therapy despite potentially 15,000 being suitable candidates. The therapy cannot be applied to patients with cancer in multiple prostate locations or disease that has metastasized beyond the gland. Availability is restricted to 10 centers in England with no provision elsewhere in the UK, a situation cancer advocates have characterized as inequitable.
Barriers to expanded implementation include historical concerns about recurrence rates when treating only affected portions of the prostate and uncertainty regarding long-term survival. The regulatory body NICE has not endorsed focal therapy as routine treatment, which prevents mandatory hospital provision. However, this study addresses those concerns substantially. Last month, the government allocated up to £2.8m toward establishing additional focal therapy centers in England.
Prostate cancer represents the most frequently diagnosed malignancy in UK men, with more than 64,000 annual diagnoses and approximately 12,000 deaths yearly. Researchers indicate that reducing treatment side effects could facilitate development of a national screening program, previously hindered by concerns that detection would cause more harm than benefit. An ongoing £60m trial is investigating optimized screening approaches combining MRI technology with lower-harm treatments including focal therapy.
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