Long-term clinical evidence
A landmark study published in the journal European Urology has provided the most significant evidence to date that focal therapy—a minimally invasive treatment for prostate cancer—delivers successful long-term outcomes. Conducted by researchers at Imperial College London and Imperial College Healthcare NHS Trust, the study followed 3,477 men over a decade, revealing that only two patients died from prostate cancer during the period, a mortality rate comparable to radical prostatectomy or radiotherapy.
The study, which is the largest of its kind, tracked patients who received either high-intensity focused ultrasound (HIFU) or cryotherapy between 2004 and 2024. The results indicate that focal therapy is highly effective even in cases of intermediate or high-risk disease, with only 3% of patients experiencing cancer spread outside the prostate after ten years.
Reducing side effects and improving quality of life
Traditional treatments for localized prostate cancer, such as radical surgery or whole-gland radiotherapy, often result in long-term side effects including urinary incontinence and erectile dysfunction. Focal therapy, which targets only the specific cancerous tissue within the prostate, significantly reduces these risks. According to the research, patients undergoing focal therapy experience a five-fold lower risk of these life-altering side effects compared to traditional methods.
Policy and future outlook
The UK government has committed £2.8 million to expand the provision of focal therapy, aiming to make the treatment accessible to more of the 15,000 men in the UK who could potentially benefit annually. Currently, only about 1,000 men per year receive the treatment. Health officials and charities like Prostate Cancer UK suggest that the reduction in side effects could be a catalyst for implementing a national screening programme, as many previous concerns regarding over-treatment and associated morbidity are addressed by the precision of focal therapy.
While clinical experts like Dr. Alastair Lamb emphasize the need for continued randomized controlled trials to fully compare focal therapy against radical interventions, the current data serves as a compelling case for updating NICE clinical guidelines. The study provides the long-term evidence required to transition focal therapy from a specialized option to a frontline standard of care.