New Treatments for Prostate Cancer in 2026

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Medically reviewed by Dr Aqua Asif, MRCS | Updated: 18 March 2026

What Are the Latest Advances in Prostate Cancer Treatment?

Prostate cancer treatment has advanced significantly in recent years, with focal therapies like HIFU (NICE-approved, HTG667) and NanoKnife IRE (NICE-approved, HTG688) now offering men the ability to treat localised cancer while preserving urinary and sexual function. In our clinic’s experience with over 2,500 focal therapy procedures, 90%+ of men maintain sexual function and 97% maintain urinary continence (FTC audit, n=265).

Beyond focal therapy, advances in genetic testing, multiparametric MRI, PSMA PET scanning, and systemic drugs such as PARP inhibitors and Lutetium-177 PSMA are transforming how prostate cancer is diagnosed, staged, and treated at every level. A personalised approach — matching treatment to each man’s cancer profile and health — is now the standard.

How Do Genetics Affect Prostate Cancer Risk and Treatment?

Genetic testing is increasingly used to guide prostate cancer screening and treatment decisions. Men carrying mutations in the BRCA1 or BRCA2 genes face a higher risk of developing aggressive prostate cancer, and identifying these mutations early can help tailor surveillance and treatment plans. At The Focal Therapy Clinic, genetic markers are considered alongside MRI findings, PSA levels, and biopsy results when recommending a personalised treatment approach.

Men with a strong family history of prostate cancer, or those of African or African-Caribbean descent, may benefit from discussing genetic testing with their doctor. Genome-Wide Association Studies (GWAS) are now identifying an increasing number of risk-associated genetic variants (SNPs), further refining how clinicians assess individual risk.

For men found to carry BRCA2 mutations and diagnosed with metastatic castration-resistant prostate cancer, targeted drugs such as PARP inhibitors (olaparib, rucaparib) can be particularly effective — making genetic testing directly relevant to treatment outcomes.

Read: Focal Therapy for prostate cancer

Can You Reduce Your Risk of Prostate Cancer?

There is no guaranteed way to prevent prostate cancer, but adopting a healthy lifestyle may reduce the risk of developing aggressive disease. Current evidence suggests that regular exercise, a balanced diet, and maintaining a healthy weight are the most effective modifiable risk factors. For men with known risk factors such as family history or BRCA2 mutations, early PSA screening and discussion with a specialist is an important step.

• Regular exercise — staying physically active may lower the risk of aggressive prostate cancer
• Balanced nutrition — a diet rich in fruits, vegetables, and whole grains, and low in processed foods, red meat, and saturated fat
• Weight management — maintaining a healthy weight, as obesity is linked to higher-grade cancers
• Regular screening — men over 50 (or over 45 with risk factors) should discuss PSA testing with their GP

There is no definitive “prostate cancer prevention diet,” but these lifestyle measures — combined with appropriate screening — give men the best chance of early detection, when treatment options including focal therapy are most effective.

How Is Prostate Cancer Detected Early?

Early detection of prostate cancer relies on PSA blood testing and multiparametric MRI (mpMRI), which together allow clinicians to identify suspicious areas within the prostate before symptoms develop. At The Focal Therapy Clinic, every patient undergoes a detailed mpMRI review as a first step, enabling our consultants to assess whether a targeted biopsy is needed — and to avoid unnecessary procedures where possible.

If suspicious findings are detected on MRI, targeted biopsy techniques obtain tissue samples from the specific area of concern. This approach is more accurate than older random biopsy methods and helps ensure that significant cancers are not missed while low-risk disease is not overtreated.

A clear, high-quality MRI can also spare men an invasive procedure: in the PROMIS trial, MRI triage meant 27% of men could have avoided a primary biopsy altogether (Ahmed et al., The Lancet, 2017).

Beyond PSA: newer biomarker tests

While the PSA blood test remains the common starting point, its limitations are well known. Newer blood- and urine-based biomarker tests are emerging to provide a more nuanced assessment of risk — measuring different forms of PSA, other related proteins, or specific genetic markers. Biomarkers can be particularly helpful when MRI results are unclear or equivocal: by combining imaging findings with biomarker data, clinicians build a more complete picture of a man’s individual cancer profile. Although the exact role of many newer biomarkers within the NHS pathway is still being established, they hold promise for refining diagnosis and reducing unnecessary biopsies.

How Is Prostate Cancer Diagnosed?

Modern prostate cancer diagnosis centres on multiparametric MRI (mpMRI) and MRI-targeted biopsy. If a man has a raised PSA level or abnormal examination, an mpMRI scan highlights areas most likely to be cancerous, guiding the clinician to biopsy only the most suspicious regions. This is significantly more accurate than older random biopsy methods and reduces the risk of missing clinically significant tumours.

For staging, newer PSMA PET-CT scans allow doctors to visualise even small areas of cancer spread that conventional bone scans or CT scans might miss. At The Focal Therapy Clinic, our diagnostic pathway includes detailed MRI review by specialist radiologists such as Dr Clare Allen (FRCR) and multidisciplinary team discussion before any treatment recommendation is made.

The effectiveness of MRI depends heavily on scan quality, which still varies between hospitals. To address this, quality-control systems such as PI-QUAL have been developed — PI-QUAL allows clinicians to assess whether an MRI scan is reliable enough for making accurate treatment decisions. The Focal Therapy Clinic’s radiology team is at the centre of this work: Prof Francesco Giganti, Professor of Uro-Radiology, is first author of the international PI-QUAL quality study (Radiology, 2023), with Dr Clare Allen, Consultant Radiologist, among its co-authors. Every MRI referred to the clinic is second-read by these two specialist uro-radiologists before any biopsy decision — in our internal audit of MRI-ultrasound fusion targeted biopsies over the last 36 months (881 patients), this second review found areas of concern on MRI review in 40.4% of patients and identified clinically significant lesions in overall 16% of patients.

How Is Artificial Intelligence Changing Prostate Cancer Care?

Artificial intelligence (AI) is beginning to make its mark on prostate cancer care. AI algorithms are being developed and tested to assist clinicians in several tasks:

• Interpreting medical images — AI tools can help radiologists detect suspicious areas on MRI scans more consistently and efficiently
• Analysing biopsy samples — AI may aid pathologists in grading tumours more accurately and identifying subtle features
• Predicting risk — AI models can integrate diverse data points (imaging, biomarkers, genomics) to provide more personalised risk assessments and potentially predict treatment response

By reducing variability between centres and potentially speeding up diagnostic pathways, AI holds promise for improving the efficiency and accuracy of prostate cancer diagnosis and management. While still evolving, AI is expected to become an increasingly valuable support tool for clinical decision-making — supporting, rather than replacing, the judgement of experienced radiologists and urologists.

What Do Prostate Cancer Stages Mean for Treatment?

Prostate cancer staging determines how far the cancer has advanced and directly guides treatment decisions. The TNM system (Tumour, Nodes, Metastasis) classifies cancer extent, while Gleason grading and molecular diagnostics assess how aggressive the disease is. Together, these help clinicians categorise risk as low, intermediate, or high.

For men with localised, low-to-intermediate risk prostate cancer, treatment options including active surveillance and focal therapy (HIFU or NanoKnife) may be suitable. More aggressive cancers, or those showing signs of spread, typically require broader treatment such as surgery or radiotherapy combined with hormone therapy. At The Focal Therapy Clinic, every referral undergoes thorough staging with mpMRI and, where appropriate, PSMA PET-CT before a treatment recommendation is made.

What Are the Latest Prostate Cancer Treatment Options?

Prostate cancer treatment now spans a wide range of options, from monitoring low-risk disease through to advanced systemic therapies. The right approach depends on the cancer’s grade, stage, genetic markers, and the man’s overall health and preferences. Here is an overview of the latest treatment methods available in 2025.

Active Surveillance

Active surveillance is the recommended approach for many men with low-risk localised prostate cancer, allowing them to avoid or delay treatment while the cancer is closely monitored. Protocols now include regular multiparametric MRI scans and targeted biopsies, making it easier to detect any progression early and intervene with curative treatment — including focal therapy — if needed.

At The Focal Therapy Clinic, men on active surveillance who show signs of progression are assessed promptly for focal therapy suitability, offering a minimally invasive step-up from monitoring rather than jumping straight to radical treatment.

Focal Therapy

Focal therapy targets only the cancerous area of the prostate, sparing healthy tissue and preserving urinary and sexual function. In our clinic’s experience with over 2,500 procedures, 90%+ of men maintain sexual function and 97% maintain urinary continence after focal therapy (FTC audit, n=265). Techniques include:

• HIFU (High-Intensity Focused Ultrasound) — uses focused ultrasound waves to heat and destroy cancerous tissue. HIFU is NICE-approved under HTG667 and achieves 88% failure-free survival at five years (Guillaumier et al., 2018)
• NanoKnife IRE (Irreversible Electroporation) — uses electrical pulses to destroy cancer cells while preserving surrounding nerves and blood vessels. NanoKnife is NICE-approved under HTG688 and is particularly suited to tumours near critical structures
• Cryotherapy — freezes cancerous tissue using targeted probes, approved by NICE under IPG788

Source: FTC one-year outcome audit (n=265) and published literature

“Not every patient is suitable for focal therapy, and we’re transparent about that. We assess every referral carefully with mpMRI and targeted biopsy before recommending treatment.”

Regular follow-up is essential after focal therapy. Our protocol includes PSA testing at 3, 6, and 12 months, with MRI at 12 months to monitor for any recurrence. In the small percentage of cases where cancer is not fully treated or returns, further focal therapy or other treatment options remain available.

Prostatectomy (Surgical Removal)

Radical prostatectomy removes the entire prostate gland and is a standard treatment for localised prostate cancer, particularly for younger men with intermediate-to-high risk disease. The procedure can be performed as open surgery, laparoscopic surgery, or robot-assisted surgery, with nerve-sparing techniques used to reduce the risk of urinary incontinence and erectile dysfunction.

While prostatectomy remains effective for cancer control, it carries a higher risk of side effects than focal therapy. For men with localised prostate cancer who wish to preserve quality of life, focal therapy may be a suitable alternative — with 90%+ sexual function preservation and 97% urinary continence rates (FTC audit, n=265) compared to the broader range of outcomes following surgery.

Radiotherapy Advances

Radiotherapy techniques have become more precise and efficient, allowing higher doses to be delivered to the prostate with less impact on surrounding tissue. The main advances include:

• Stereotactic Body Radiotherapy (SBRT) — delivers very high doses of radiation in just 1–5 sessions, offering similar cancer control outcomes to conventional radiotherapy courses of 20–37 sessions
• Proton therapy — uses proton beams that can be more precisely targeted to the prostate, potentially reducing damage to surrounding bowel and bladder tissue
• Brachytherapy — involves implanting radioactive seeds directly into the prostate, delivering a continuous low dose of radiation to the tumour from within

Radiotherapy is a well-established treatment for localised and locally advanced prostate cancer. For men with localised disease who are also candidates for focal therapy, a comparison of side-effect profiles may be helpful — speak to a specialist to understand which approach best suits your situation.

Hormone Therapy Advances

Hormone therapy (androgen deprivation therapy) remains a cornerstone of treatment for advanced and metastatic prostate cancer. Newer agents have significantly improved outcomes:

• Abiraterone (Zytiga) — blocks testosterone production at the cellular level, now used earlier in the treatment pathway alongside standard hormone therapy
• Enzalutamide (Xtandi) — blocks the androgen receptor more completely than older drugs, extending survival in advanced disease
• Apalutamide (Erleada) — approved for non-metastatic castration-resistant prostate cancer, delaying the development of metastases

These drugs are increasingly used in combination with other treatments, including radiotherapy and chemotherapy, as part of a personalised treatment plan for men with advanced prostate cancer.

Targeted Therapies (PARP Inhibitors)

PARP inhibitors represent a significant advance for men with metastatic castration-resistant prostate cancer (mCRPC) who carry mutations in DNA repair genes such as BRCA1 and BRCA2. Drugs including olaparib (Lynparza) and rucaparib (Rubraca) work by preventing cancer cells from repairing their DNA, slowing or stopping tumour growth.

Genetic testing is required to determine eligibility for PARP inhibitors, which is why understanding your cancer’s genetic profile is increasingly important in modern treatment planning. These therapies are most commonly used in advanced disease but are being studied in earlier-stage cancers as well.

Immunotherapy

Immunotherapy harnesses the body’s immune system to recognise and attack cancer cells. While it has transformed treatment for several cancers, its role in prostate cancer remains limited. The most established approach, sipuleucel-T (Provenge), involves modifying a patient’s own immune cells to target prostate cancer and has shown modest survival benefits in men with advanced hormone-resistant disease.

Research into checkpoint inhibitors (such as pembrolizumab) and other immunotherapy approaches for prostate cancer is ongoing. These treatments are most likely to benefit men with specific genetic features, such as high microsatellite instability (MSI-H), though this applies to only a small proportion of prostate cancers.

Radiopharmaceuticals

Radiopharmaceuticals deliver targeted radiation directly to cancer cells via the bloodstream, sparing healthy tissue. The most significant recent development is Lutetium-177 PSMA (Pluvicto), which targets prostate-specific membrane antigen (PSMA) on cancer cells.

• Lutetium-177 PSMA — targets PSMA-expressing cancer cells throughout the body, delivering radiation precisely to metastatic sites. The VISION trial demonstrated improved survival in men with metastatic castration-resistant prostate cancer
• Radium-223 (Xofigo) — targets bone metastases specifically, used in men whose cancer has spread to bone

These treatments are typically used in advanced prostate cancer after other therapies have been tried, and require a PSMA PET scan to confirm that the cancer cells express the target protein.

Combination Approaches

Modern prostate cancer treatment increasingly uses combinations of therapies tailored to the individual’s tumour profile and disease stage. Evidence now supports combining treatments at earlier stages for better outcomes:

• Radiotherapy + hormone therapy — NICE-recommended combination for intermediate and high-risk localised disease (NG131)
• Hormone therapy + abiraterone — early combination in newly diagnosed metastatic disease improves survival
• Surgery + adjuvant therapy — post-surgery radiotherapy or hormone therapy for high-risk features
• PARP inhibitors + hormone therapy — emerging combinations for men with DNA repair gene mutations

The choice of combination depends on the cancer’s stage, grade, genetic profile, and the man’s overall health. Multidisciplinary team discussion is essential to determine the optimal treatment plan.

What New Research and Clinical Trials Are Underway?

Progress in prostate cancer care is driven by ongoing research and clinical trials. Key trials such as CHRONOS — comparing focal therapy against radical treatments — aim to provide high-quality evidence to guide future practice. Observational studies and registries also play a vital role, particularly in evaluating the real-world outcomes of newer treatments like focal therapy: they help build the evidence base, validate the safety and effectiveness of innovative approaches, and ensure that advancements are adopted responsibly.

The Focal Therapy Clinic’s consultants contribute directly to this evidence base — Mr Tim Dudderidge and Mr Raj Nigam, Consultant Urological Surgeons, are co-authors of the landmark UK five-year focal HIFU study (Guillaumier et al., European Urology, 2018). Participation in clinical trials offers patients access to cutting-edge care and is essential for driving future improvements.

References

1. Cancer Research UK. (n.d.). Prostate cancer treatment. Retrieved from https://www.cancerresearchuk.org/about-cancer/prostate-cancer/treatment
2. Prostate Cancer UK. (n.d.). Treatments for prostate cancer. Retrieved from https://prostatecanceruk.org/prostate-information/treatments
3. European Association of Urology. (2023). EAU Guidelines: Prostate Cancer. Retrieved from https://uroweb.org/guidelines/prostate-cancer
4. Ahmed, H.U. et al. (2017). Diagnostic accuracy of multi-parametric MRI and TRUS biopsy in prostate cancer (PROMIS): a paired validating confirmatory study. The Lancet, 389(10071), 815–822. https://doi.org/10.1016/S0140-6736(16)32401-1
5. Guillaumier, S. et al. (2018). A Multicentre Study of 5-year Outcomes Following Focal Therapy in Treating Clinically Significant Nonmetastatic Prostate Cancer. European Urology, 74(4), 422–429. https://doi.org/10.1016/j.eururo.2018.06.006
6. Giganti, F. et al. (2023). Global Variation in Magnetic Resonance Imaging Quality of the Prostate. Radiology, 309(1), e231130. https://doi.org/10.1148/radiol.231130

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