Focal therapy treats only the section of the prostate gland that contains the cancer. These treatments appeal to men who want to preserve sexual and urinary function while trying for a cure. There are numerous types of focal therapies but they are all still in the research phase and much is still unknown about outcomes and risk of side effects.

This episode of PROSTATE PROS introduces listeners to focal treatment options and discusses benefits and drawbacks of these new, experimental therapies. Discover how to find experts and where to access the latest information on focal therapy.

Focal Therapy for Prostate Cancer: Recent Advances and Future Directions

Dr. Scholz:      [00:04] Welcome to PROSTATE PROS. I’m Dr. Mark Scholz and this is my cohost Liz Graves. 

Liz:      [00:09] Traditional treatments like surgery and radiation treat the entire prostate gland. This episode we’re going to talk about focal therapy, which is a type of treatment that’s directed at the section of the gland where the tumor is.  Focal therapy may appeal to men who want to reduce the risk of common treatment side effects. 

Dr. Scholz:      [00:32] Men are often surprised when they hear that standard treatment targets the whole gland.  Why would they do that?  When women have breast cancer treatment, they just take the cancer out.  They don’t take the whole breast off anymore, at least not very often.  The answer is, of course, that until recently we didn’t have accurate imaging that could delineate exactly where the cancer is located in the prostate.  Now that we have that ability to know where the cancer is, it’s very logical to pursue treatments that are directed at the tumor instead of destroying the whole gland. 

Liz:      [01:10] So by not destroying the whole gland, you can preserve things like sexual function and urinary function. 

Dr. Scholz:     [01:17] Exactly.  With modern radiation treatment, thankfully, urinary function is generally not impaired.  But if you take your average 60, 65-year-old who has standard radiation, excellent work at a state of the art facility, there is up to a 50/50 chance that he’s not going to be able to get erections unless he gives himself a shot in the penis or has a prosthetic device put in his penis afterwards, I mean total impotence that doesn’t respond to Viagra or Cialis. 

Liz:      [01:50] So does focal therapy really help prevent these things from happening? 

Dr. Scholz:      [01:55] I don’t think there’s any doubt that when you just treat a section of the prostate, that the chances for maintaining sexual function are much better. Now we’re going to go through and talk about some different approaches and some of the methods seem to have somewhat better or less likely problems with impotence, but there is always going to be a small risk, but the risk is much less. 

Liz:      [02:21] This sounds like a pretty appealing treatment choice.  Can we talk about who is eligible for focal therapies? 

Dr. Scholz:      [02:27] The spot of cancer needs to be visible on a scan.  Some men have very tiny areas or others may have two or three spots on perhaps on both sides of the gland. These sorts of things don’t really lend themselves to the possibility of focal therapy, but a good number of men have a visible cancer that’s been biopsy proven and there’s really no evidence of anything on the other side of the prostate. 

Liz:      [02:54] What about the stage of men with prostate cancer?  Who’s looking at this treatment? 

Dr. Scholz:      [03:00] That’s a really good q