Focal therapy is an emerging treatment that targets only the area of the prostate containing significant cancer while preserving as much healthy prostate tissue as possible.
The standard of care for the management of localized intermediate risk prostate cancer in Australia in most cases, involves treating the entire prostate. That is, either surgery to remove the prostate gland (robotic-assisted radical prostatectomy) or radiation therapy. For some men diagnosed with localised prostate cancer, there may now be another option. Focal therapy is an emerging treatment that targets only the area of the prostate containing significant cancer while preserving as much healthy prostate tissue as possible.
At Melbourne Urology Centre, our specialist Urologists can assess whether or not focal therapy is suitable for carefully selected men with localized prostate cancer. The goal is to effectively treat the cancer while reducing the risk of side effects such as urinary incontinence and sexual dysfunction compared with surgery or radiation. Patients will undergo a comprehensive assessment, including prostate MRI, targeted biopsy and in most cases PSMA PET scan, followed by a discussion of all suitable treatment options.
Not every man diagnosed with prostate cancer require treatment and not all men be suitable candidates for focal therapy. The best results may be achieved in men with localised, clinically significant prostate cancer confined to a specific area of the prostate. Careful patient selection is essential to achieving good cancer control.
If you are seeking a second opinion or have recently been diagnosed with prostate cancer, the specialist Urologists at Melbourne Urology Centre can discuss whether focal therapy or other treatment including robotic assisted radical prostatectomy is appropriate for your individual situation. Patients from across Melbourne and Victoria are welcome to make an appointment for a consultation to explore personalised treatment options.
Who Is Suitable for Focal Therapy for Prostate Cancer?
Focal therapy is an emerging treatment option for carefully selected men with early stage localised prostate cancer. Rather than removing the prostate (robotic-assisted radical prostatectomy) or treating the entire prostate gland with radiation, focal therapy targets the area containing the clinically significant cancer while preserving as much normal prostate tissue as possible.
The best candidates for focal therapy are men with a single, well-defined area of intermediate-risk prostate cancer that can be accurately identified using high-quality prostate MRI and targeted prostate biopsy. In order to be considered for focal therapy, patients should have disease confined to the prostate, without evidence of spread elsewhere. Prostate cancer is often multifocal (that is, multiple areas of cancer within the prostate), which means not every patient will be suitable for focal therapy. For men with multi-focal, high volume or high-grade prostate cancer it is generally more appropriate to undergo treatment with established therapies such as robotic-assisted radical prostatectomy or radiation therapy. This is to ensure the best chance of cancer cure and to minimize the risk of leaving residual cancer or progression to metastatic disease.
A thorough assessment is essential before recommending focal therapy. This typically includes PSA testing, multiparametric MRI, targeted and systematic prostate biopsy, followed by staging PSMA PET scan and discussion about the most appropriate treatment options.
Patients need to understand that focal therapy remains an evolving treatment. Ongoing follow-up is required which involves regular PSA testing, repeat MRI surveillance as well as further prostate biopsies to ensure that the treatment has been effective. Close monitoring for recurrent or untreated cancer is an essential requirement for men undergoing focal therapy for prostate cancer.
In Australia, focal therapy is not currently funded by Medicare and is not covered by private health insurance, meaning there are out-of-pocket costs. If you are interested in discussing your suitability to undergo focal therapy for prostate cancer in Melbourne, a consultation with a specialist Urologist at Melbourne Urology Centre may help determine if you are an appropriate candidate for this treatment.