TARGETED FOCAL THERAPY

Targeted focal therapy is a minimally invasive treatment that precisely targets and destroys the cancerous tissue within the prostate while preserving the surrounding healthy tissue. This approach aims to reduce side effects commonly associated with more aggressive treatments like surgery or radiation. It’s often used for men with localized, low to intermediate-risk (Grade Group 1 or 2) prostate cancer.

 

TYPES OF FOCAL THERAPY

Targeted Focal Cryotherapy 

Cryosurgery is also known as cryotherapy or cryoablation. It is destroying cancer cells by freezing. Cryosurgery is used when cancer recurs after initial treatment with radiation in early-stage prostate cancer patients. Long hollow needles are inserted through the perineum and into the prostate with the aid of transrectal ultrasound. Cold gas is sent through the needles to form ice balls that freeze and destroy cancer tissue or the entire prostate. The area is thawed by passing warm gases through the probes. Cryosurgery targets the prostate only without harming the surrounding areas. Anesthesia is given during the surgery to relieve pain. You might stay overnight at the hospital or leave after your therapy session. Side effects related to cryosurgery include pain, erectile dysfunction, urinary incontinence, blood in the urine for a day or two, swelling to the penis or scrotum, and possible fistula (abnormal connection) between the prostate and rectum.

 

Targeted Focal High-Intensity Focused Ultrasound (HIFU)

HIFU is used if cancer returns after radiation therapy in low-grade or localized prostate cancer. This procedure uses heat produced from an endorectal ultrasound probe to destroy prostate tissues. The probe focuses rapid high-frequency sound waves on the prostate without affecting the surrounding tissues. Sound energy is converted to heat energy which heats and destroys the prostate with time. There is constant ultrasound monitoring of the prostate and average treatment varies by the size of the gland but can range from 1 — 4 hours. Side effects are usually temporary and include feeling the need to urinate often, trouble urinating, blood in the urine, pain, and an increased risk of urinary tract infection. Urine incontinence and sexual dysfunction are possible.

 

Other Treatments Being Developed

Although some of these treatments are available, scientists believe they need to be further studied.

Transurethral ultrasound ablation (TULSA):

This procedure is like HIFU in using high-intensity ultrasound beams to heat and destroy parts or all the prostate. In TULSA, a thinner ultrasound probe is inserted through the penis and into the urethra (which runs through the prostate). Real-time MRI is used to image the prostate and guide treatment.

Focal laser ablation (FLA):

In this approach, a thin laser fiber is inserted into the prostate near the tumor. The fiber is activated to heat and destroy parts or all the prostate. This is done using MRI images for guidance. However, researchers are looking into the feasibility of using ultrasound.

Photodynamic therapy (PDT):

This uses light to activate the drug to destroy the blood vessels around the tumor. The drug activated by light is injected into the blood through IV. A low energy laser light source is inserted into the prostate and directed at the tumor with the aid of thin optic fibers. The drug is activated by the blood and destroys the blood vessels of the tumor. This procedure, which is also known as vascular-targeted photodynamic therapy (VTP), is not yet available in the United States.