Focal therapy: Non-surgical treatment for prostate cancer

Dr. Arjun Sivaraman

Prostate cancer is the most common cancer affecting men and the second most common cause of cancer-related deaths. Prostate cancer is commonly diagnosed through rectal examination and blood tests, such as Prostate Specific Antigen (PSA). More recently, Magnetic Resonance Imaging (MRI) has proven to be a valuable adjunct to cancer diagnosis.
A majority of men with prostate cancer are more likely to die of other age-related causes, such as myocardial infarction, stroke, etc. Hence, the treatment of prostate cancer is usually one of the two options — active surveillance or radical treatment. It is very important to identify the correct patient for the appropriate treatment.
Over the last 10 years, researchers in Europe and the United States have developed a new treatment option for prostate cancer. In this new treatment, the cancer inside the prostate gland is selectively killed while preserving the remaining prostate. The advantage of this treatment is that the cancer is destroyed in the body and simultaneously the harmful complications of treatment are avoided. This treatment is offered as an outpatient procedure and the patient can resume work the next day. The patient’s normal life in terms of his urinary and sexual functions are not affected with this treatment. However, this treatment cannot be offered to all the patients with prostate cancer. There is a selection process using scans and biopsy only after which this treatment can be offered.
Based on the clinical experience of Dr. Arjun Sivaraman, urologic oncologist, New York, and Dr. Mohammed Baghdadi, uro-oncologist, France, Paris, 20 to 30 percent of patients who undergo surgery can be effectively treated with this new treatment and surgery can be avoided. Also, focal therapy can be used for patients undergoing active surveillance who do not want to have the anxiety of cancer left untreated in the body. The American Food and Drug Administration has recently approved this new treatment, which is slowly becoming available in many cities in the US. This treatment will eventually become available around the world.