Localized prostate cancer: Will focal therapy replace radical prostatectomy?

Focal therapy is a new therapeutic approach to the treatment of localised prostate cancer. Unlike total prostatectomy, which involves the complete removal of the gland, focal therapy specifically targets the cancerous lesions while sparing the healthy prostatic parenchyma. The aim of this technique is to minimize the side effects associated with surgery, such as urinary incontinence and erectile dysfunction, while ensuring satisfactory oncological control of the disease. To achieve this, several energy sources have been proposed with limited functional impact and a positive biopsy rate around 25% at 1 year follow-up.


Focal therapy has not been validated as a standard treatment option, as it is still under evaluation. However, because the modern diagnostic tools allow better characterisation of the tumor, as the preliminary results are confirmed, focal therapy could replace radical prostatectomy in selected patients.