Basic Question About Focal Therapy

[plee12]

One of the options I'm looking into is focal therapy for my Gleason (4+3).

Forgive my ignorance, but I can't seem to understand the basic premise of focal therapy, which is to treat unilateral disease, that is the cancer is located in only one side of the prostate. Based on everything I've read and watched, so far, I haven't been able to find an adequate explanation for this restriction.

For example, if there is one cancerous spot in one side of the prostate and one cancerous spot on the other side of the prostate, why can't focal therapy be applied to each spot individually? After all, focal therapy is supposed to be a targeted approach. So, why does the target have to be limited to one particular side?

Can someone perhaps explain this to me in layman's terms?

Thank you

[Tall_Allen]

Prostate Cancer is mutifocal within the the prostate in 90% of men. We know that from looking at prostates after prostatectomy. However, mpMRI and biopsies only detect a tiny fraction of the cancer that is there. That is one reason why focal therapy has such a high failure rate. The other reason is that it fails to kill all of the cancer even in the treated area.

[fast_eddie]

Focal therapy isn't comprehensive. Should opt for full gland ablation.

[j-o-h-n]

From Online A.I.

In prostate cancer, focal therapy refers to a treatment approach that targets only the specific areas of the prostate where cancer is present, while leaving the rest of the prostate tissue intact. The term "focal" comes from the fact that the therapy is focused on the localized tumor(s) rather than treating the entire prostate.

The key goals of focal therapy are to:

Minimize Side Effects: By treating only the cancerous part of the prostate, focal therapy can help reduce damage to healthy surrounding tissue, potentially leading to fewer side effects such as incontinence or erectile dysfunction, which are common with more aggressive treatments like whole prostate removal (radical prostatectomy) or radiation therapy.

Preserve Prostate Function: Focal therapy aims to remove or ablate the cancer while preserving as much of the prostate's function as possible, including sexual function and urinary control.

Target Early-Stage or Low-Risk Cancer: Focal therapy is often used for patients with localized, low- to intermediate-risk prostate cancer, where the tumor is confined to a small portion of the prostate.

Techniques used in focal therapy may include:

High-Intensity Focused Ultrasound (HIFU)

Cryotherapy (freezing the cancerous tissue)

Laser therapy

Electroporation

Focused radiation therapy

By focusing treatment on the cancer's specific location, rather than the entire prostate, focal therapy offers a potential treatment option for men who are seeking a less invasive approach compared to traditional treatments.

This may not have answered your question.......... but it answered mine.

Good Luck, Good Health and Good Humor.

j-o-h-n

[MateoBeach]

You know that your prostate is producing cancer(s). The whole prostate must be treated (radiation or surgery). When there is one or two foci, there are likely many.

[Derf4223]

If you have advanced PCA I expect focal treatment would not be adequate. Advanced = metastatic, spread beyond the prostate.

[plee12]

Thanks for all the responses above, but no one has really addressed my question, which is NOT whether or not focal therapy works or not. It's true focal therapy is the subject of much debate and research, but on the other hand, there have been plenty of success stories.