Introduction
In men, prostate cancer is the second-most common and dangerous cancer-causing more than 30,000 deaths each year in the United States. It is also so common that it is diagnosed in one in ninth men, and decisions about treatment can sometimes be difficult. However, the actual cause of the cancer is still unclear. It may vary in different patients. Conclusive treatment with surgery or radiation can cause side effects like erectile dysfunction and incontinence.
For some male patients who have a lower-risk or localized type of prostate cancer, there is another better option for the treatment. With focal therapy as a treatment modality, only those parts of the prostate gland that are cancerous are destroyed, and other surrounding tissue is left untouched.
Focal therapy is considered a minimally-invasive treatment that can be performed through cold, heat, or electrical impulses. Patients can be discharged and go home the same day after the therapy with a urinary catheter attached. The patient may require the catheter for only a day or so. Sometimes it is recommended to cope with the long-term complication of incontinence that occurs after surgery. It can be repeated if it is required, and surgical or radiation treatment can also be subsequently performed if necessary. In the meantime, nearby nerves and organs and the patient’s quality of life may be preserved.
What Is Focal Therapy for Prostate Cancer?
Focal therapy is mainly indicated for small prostate cancer, and it uses energy as the source to treat the cancer that is present in particular areas of the prostate. This therapy is also called partial gland ablation. Focal therapy is described as less invasive; it does less harm to other normal healthy tissue. It is a quite safe and very effective treatment for prostate cancer.
The doctor can treat and eradicate tiny tumors inside the prostate using focal therapy, which makes use of imaging technology like MRI (magnetic resonance imaging). It has other benefits also and is better than other treatment modalities:
-
Focal therapy is done to kill areas of cancer in the prostate without harming normal and healthy prostate tissue and function.
-
There can be fewer and less complicated side effects than there are with more aggressive and surgical treatments.
-
This procedure can also be performed in an outpatient setup or in clinics.
Cryosurgery:
Cryotherapy indicated for prostate cancer is a procedure to freeze prostate tissue which may result in the death of the cancer cells. While performing cryotherapy, the doctor will use thin metal probes and insert them through the skin and into the prostate gland. The probes will be filled with a gas that leads to the freeze of the affected tissues of the gland.
Cryotherapy is indicated to treat early-stage prostate cancer that is concentrated in one part of the prostate if other treatments are not an option. Cryotherapy for prostate cancer can also be indicated when the cancer has recurred after initial treatment.
NanoKnife:
The Nanoknife is a painless and minimally invasive surgical technique used in the treatment of prostate cancer. The NanoKnife procedure, also referred to as focal irreversible electroporation (IRE), uses electrical pulses to destroy cancer cells within the body. Irreversible electroporation uses small needles inserted into the prostate gland under guidance with specialized imaging. The needles deliver electrical pulses that destroy cancer cells. NanoKnife therapy is not indicated for all types of prostate cancer. Men suitable for Nanoknife treatment are carefully selected following MRI (magnetic resonance imaging) and prostate mapping biopsies.
Gold Nanoshell-Localized Photothermal Ablation:
Gold nanoparticles are administered through an IV (intravenous)and attach to cancer cells. Needles are then inserted to reach the tumor and generate heat that is absorbed by the particles, killing the cancer cells.
High-Intensity Focused Ultrasound (HIFU):
High-intensity focused ultrasound is the only focal therapy option that does not treat cancer with the help of a needle. HIFU involves the insertion of a specialized ultrasound probe into the rectum. The probe emits heated ultrasound waves to destroy cancer cells in the prostate.
What Happens After Focal Therapy Treatment?
The doctor will explain the patient about the post-surgical effects to the patient. For example, the patient can experience soreness, burning, or bruising after the treatment is done. It is totally normal to see small amounts of blood drop in the urine for a few weeks after the procedure. The patient can also have some swelling over the prostate gland, which can make urination difficult. A temporary catheter is placed by the doctor to ease the process of urination. It can be removed after a few days of the surgery. Follow-up appointments and routine checkups will help the doctor and healthcare team monitor the prognosis and healing process of the patient. They may ask the patient to get blood tests, imaging tests, and prostate biopsy after treatment to compare the recovery.
What Are the Possible Side Effects of Focal Therapy?
The erection may get affected after focal therapy but it is reported that it returns to normal as the patient heals. Rehabilitation is very important after the therapy, and the earlier it starts, the better the chances of a full recovery. The same is observed with urinary function.
Focal therapy rarely impacts urinary function, but it is recommended to perform Kegel exercises to strengthen the muscles that help the patient to urinate. As soon as the patient feels comfortable flexing these muscles as part of a rehabilitation routine, the faster the recovery happens.
Conclusion
Focal therapy indicated for localized prostate cancer is promising. It is minimally invasive and provides a good functional outcome for patients. However, approximately 10 to 30 percent of patients required further treatment. Moreover, in some patients, even after getting appropriate treatment, the patients may require further treatment and focal treatment can be performed at the appropriate timing to prevent metastasis or cancer death. Although focal therapy may lead to the cure of cancer, it is very important to select appropriate patients with appropriate diagnoses by magnetic resonance imaging (MRI) and targeted fusion biopsy of the patient.
