Is there a treatment for prostate cancer without removing the entire gland? Let's talk about Focal Therapy!

Did the doctor tell you that you have prostate cancer? The first thing that comes to mind when you hear that is, "Oh, now they have to cut out the whole gland. Then there will be all sorts of problems, right?" But you don't always have to go through such a major surgery. Have you heard of a new method of treatment that targets only the cancer and doesn't harm the healthy parts? That's what we call focal therapy.

Simply put, what is Focal Therapy?

Imagine that a small part of a large fruit is spoiled. We remove only that small spoiled part and use the remaining good fruit, right? We don't throw away the whole fruit. That's how this treatment works.

Focal therapy is a treatment for prostate cancer that has not spread outside the gland, that is, it is localized . Instead of treating the entire prostate gland, it only treats the targeted area where the cancer cells are. This uses different energy sources such as heat, extreme cold, or electricity.

Common treatments for prostate cancer include:

• Surgery to remove the entire gland.
• Radiation treatment to the entire gland.
• Active Surveillance: This means that if the cancer is at a low risk level, no treatment is required, but the cancer is monitored by continuing to undergo tests as directed by the doctor.

Focal therapy can be considered a good alternative between just waiting and major treatment that damages the entire gland.

What are the main types of this treatment?

There are several focal therapy methods. Although they all achieve the same thing, the techniques used are different. Let's take a look at the main methods.

Who is suitable for this treatment?

This is not a treatment that everyone can do. To do focal therapy, you must meet certain qualifications.

• The cancer must be confined to the prostate gland. This cannot be done if it has spread to other organs.
• It is best to have an intermediate-risk cancer. For very low-risk cancers, active surveillance is best. For high-risk cancers, treatment (surgery or radiation) of the entire gland is best.
• The closer the tumor is to important areas, such as the urinary sphincter or urethra, the better.

Only your doctor can make the final decision on whether you are suitable for this.

What kind of tests are done before treatment?

Choose the treatment method that best suits you. The doctor will order several tests before treatment.

• MRI scan (Magnetic Resonance Imaging): This helps to obtain very clear images of the prostate and cancer.
• Prostate Biopsy: Under MRI guidance, a small piece of tissue is taken from the prostate gland to examine the nature of the cancer.
• Mapping Biopsy: In this, tissue samples are taken from several areas of the gland and the boundaries of the cancer are mapped out exactly like a map.
• PSMA PET scan: This scan is done to see if the cancer has spread to other parts of the body.

What are the benefits of this treatment?

There are several advantages to focal therapy.

• The damage to healthy tissue is minimal. This is the biggest advantage.
• The risk of side effects is low, especially problems like erectile dysfunction and urinary incontinence.
• There is a chance to avoid invasive treatments like major surgery and radiation therapy.
• Rather than just waiting, you can take active steps against cancer .

So aren't there any disadvantages? Things you should definitely be aware of

Along with the advantages, there are also a few disadvantages that we need to talk about honestly.

• The cancer cells may not be completely gone, which means the risk of cancer recurrence is higher than with surgery.
• If the cancer comes back, you may need more treatment (perhaps surgery or radiation).
• This treatment is not suitable for every patient.
• Although the risk is low, some people may experience some degree of sexual and urinary problems.
• These are very new technologies, so data is still being collected on long-term outcomes, just like surgery and radiation therapy.
• After treatment , you will need to be monitored very closely and frequently. This means repeated MRI scans, PSA blood tests, and possibly even biopsies.

What happens after treatment?

After focal therapy, your doctor will monitor you very closely for several months, possibly years. This will mainly include:

• Are there any cancer cells that were not detected in previous scans?
• Are there any remaining cancer cells that were not completely destroyed by treatment?
• Has the cancer recurred?
• Whether the cancer has spread to other places (metastasis).

If these tests confirm that the cancer has returned, you will need to undergo other treatments, such as surgery or radiation therapy. All of this happens under the guidance of your doctor.