Focal therapy for localized prostate cancer has divided physicians. Will new data change minds?

For most localized solid tumors, it’s common for surgeons to try to preserve as much of the diseased organ as possible, removing only the cancer along with some healthy tissue surrounding it to avoid further spread. But for prostate cancer, treatment is usually all or nothing. Except for patients with low-grade disease that’s unlikely to turn deadly, the whole gland gets removed, or irradiated. The long-term consequences can be serious, notably incontinence and erectile dysfunction. 

A less aggressive alternative intended to reduce the risk of these undesirable side effects has been gaining attention among patients and physicians for several years, though treatment guidelines consider it experimental. Called focal therapy, it targets lesions visible on MRI scans, using a variety of technologies to heat and destroy, freeze, burn, or even electrocute cancer cells. Focal treatments are often delivered in single-treatment sessions and can sometimes be done in a doctor’s office, adding to their appeal. 

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