What is Focal Therapy for Prostate Cancer?
- Focal therapy targets only the cancer-affected areas of the prostate.
- It preserves more healthy tissue compared to traditional treatments.
- Focal therapy minimizes side effects like impotence and incontinence.
Our focal therapy treatment options
HIFU
High-intensity focused ultrasound (HIFU) is one of two types of focal therapy we offer. It uses ultrasound waves to target cancer in the lower, or posterior, part of your prostate. HIFU is a non-invasive treatment that is guided by advanced 3D MRI imaging to destroy cancer cells while protecting healthy tissues.- Soundwave-based treatment
- Preserves urinary and sexual function
- Day procedure and rapid recovery
NanoKnife
NanoKnife is the other type of focal therapy we offer and uses electrical pulses to target the upper, or anterior, part of your prostate. Guided by 3D MRI imaging, NanoKnife is a minimally-invasive treatment that destroys cancer cells that may be hard to reach with HIFU.- Needle-based treatment
- Preserves urinary and sexual function
- Day procedure and rapid recovery
Learn more about Focal Therapy
Mr Raj Nigam Is focal therapy approved by NICE
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Learn more about Focal Therapy
SUMMARY
Mr. Raj Nigam (Consultant Urologist, The Focal Therapy Clinic): Focal therapy has been approved in the UK since 2012, with HIFU and cryotherapy gaining NICE approval that year. NanoKnife, the newest focal therapy option, was approved more recently in 2023.
This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Read more.
Mr Marc Laniado Is focal therapy safe
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Learn more about Focal Therapy
SUMMARY
Mr. Marc Laniado (Consultant Urologist, The Focal Therapy Clinic): Focal therapy is NICE-approved for prostate cancer, utilizing HIFU, cryotherapy, and NanoKnife. Studies indicate a low risk of serious side effects, making it a safe and effective treatment option for suitable patients.
This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Read more.
Mr Raj Nigam Where can I get focal therapy
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Learn more about Focal Therapy
SUMMARY
Mr. Raj Nigam (Consultant Urologist, The Focal Therapy Clinic): Focal therapy is widely available in the UK, offered both privately and within the NHS. Leading centers include University College London, Imperial College London, and other expanding locations such as Southampton, providing patients with more treatment options.
This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Read more.
ALL What are the different types of focal therapy v2
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Learn more about Focal Therapy
SUMMARY
Mr. Tim Dudderidge (Consultant Urologist, The Focal Therapy Clinic): Focal therapy can be delivered through three main energy sourcesHIFU, cryotherapy, and NanoKnife. HIFU is the least invasive, making it ideal for posterior tumors, while needle-based therapies like cryotherapy and NanoKnife are better suited for anterior tumors. Understanding these options helps patients make informed treatment choices.
This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Read more.
Meet our World Leading Clinical Specialists
At The Focal Therapy Clinic, we’ve assembled a team of urology, radiology, oncology and patient care experts to support and provide world-class treatment to people with prostate cancer.
“[Marc Laniado, my Focal Therapy Clinic consultant] described the possible side effects….and basically it was a no brainer to have the focal therapy because that obviously carried the least side effects and, because of the cancer, he said he felt that it would be very successful.”
Brian Bishop
The Focal Therapy Clinic patient
Is Focal Therapy right for me?
Focal therapy is usually only considered for localised prostate cancer. We can also only make a definitive judgement after we’ve reviewed your test results, include PSA level and MRI scan. Whether focal therapy is suitable for you and your cancer depends on a number of factors, but generally:
Early or intermediate stage
Gleason score of 7 or lower
Your prostate cancer is confined within the prostate gland
Our expert urologists will be able to guide you on your treatment options after your initial consultation. They will look at your PSA, your Grade/Gleason score and biopsy results. We will also independently review your mpMRI scan.
Check your suitability
At one year after one focal therapy treatment
Of clinically significant cancer is eliminated*
Of men are fully continent*
Of men retain erections*
*Based upon a review of 270 patients who all had treatment at The Focal Therapy Clinic using advanced MRI-ultrasound fusion technology to ensure treatment accuracy
Mr Marc Laniado MRI US Fusion technology and focal therapy success rates
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NanoKnife (IRE) Focal Therapy for Prostate Cancer
SUMMARY
Mr. Marc Laniado (Consultant Urologist, The Focal Therapy Clinic): MRI fusion improves focal therapy accuracy, ensuring over 90% of men are cancer-free at one year. Globally, 7580% of men avoid radical treatment for 610 years post-focal therapy, making it an effective and minimally invasive option for prostate cancer.
This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Read more.
Advantages and Disadvantages of Focal Therapy
Advantages
- Minimally invasive - No incisions, no radiation, no hormones
- Preserves sexual function & continence - spares nerves and urinary structures
- Outpatient procedure - Go home the same day. Rapid recovery
- Repeatable if needed - Can be combined with other treatments
- Effective cancer control - equivalent to radiotherapy or surgery at 8 years
Disadvantages
- Not suitable for all prostate cancers - Advanced cases may require other treatments
- Follow-up monitoring required - Regular PSA testing and MRI scans needed
- Risk of incomplete treatment at front of prostate - HIFU has a range of 3.0 cm from the rectum. Tumours at the front of the prostate care hard to reach
What to Expect Before, During, and After Treatment
What to Expect Before, During, and After Treatment – Hifu
- Pre-treatment imaging (MRI/ultrasound) to pinpoint the cancer
- Blood tests (PSA levels, general health)
- Discussion of anesthesia options (general or spinal)
- Bowel preparation (as advised by your medical team)
Mr Tim Dudderidge How should I prepare for focal therapy
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Care: Before Treatment
SUMMARY
Mr. Tim Dudderidge (Consultant Urologist, The Focal Therapy Clinic): Before focal therapy, youll receive fasting instructions and arrival details. Avoid a heavy meal the night before, and if you have any questions, check with the ward nurses to ensure youre fully prepared for your procedure.
This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Read more.
Mr Tim Dudderidge What happens on the day of a focal therapy treatment
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Care: On the Day
SUMMARY
Mr. Tim Dudderidge (Consultant Urologist, The Focal Therapy Clinic): Focal therapy is a day-case procedure performed under general anesthesia, typically lasting 6090 minutes. A catheter is required for 57 days, and most patients resume normal activities soon after, making it a minimally invasive and efficient treatment option.
This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Read more.
05 Mr Tim Dudderidge Do I need a general anaesthetic for focal therapy
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Care: On the Day
SUMMARY
Mr. Tim Dudderidge (Consultant Urologist, The Focal Therapy Clinic): **Most patients can safely undergo general anesthesia for HIFU, NanoKnife, and cryotherapy**. **Spinal anesthesia is not suitable for HIFU or NanoKnife but may be an option for cryotherapy**.
This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Read more.
Mr Tim Dudderidge What happens during focal therapy
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Care: On the Day
SUMMARY
Mr. Tim Dudderidge (Consultant Urologist, The Focal Therapy Clinic): Focal therapy procedures last 6090 minutes under anesthesia, using MRI-ultrasound fusion to precisely target cancer. HIFU, cryotherapy, and NanoKnife effectively destroy cancer cells while preserving healthy tissue, offering a minimally invasive alternative to surgery or radiotherapy.
This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Read more.
Mr Tim Dudderidge Recovery after focal therapy
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Care: Recovery
SUMMARY
Mr. Tim Dudderidge (Consultant Urologist, The Focal Therapy Clinic): Pain after focal therapy is uncommon, but bladder spasms are the most frequent discomfort, typically lasting 2448 hours. Antispasmodic drugs and simple painkillers help manage symptoms, ensuring a smoother recovery.
This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Read more.
Mr Tim Dudderidge How long does it take to recover from focal therapy
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Care: Recovery
SUMMARY
Mr. Tim Dudderidge (Consultant Urologist, The Focal Therapy Clinic): Recovery after focal therapy is quick. Most patients resume light activities within a week and return to normal physical activity soon after. Some may experience temporary urgency or fatigue, but side effects are typically mild compared to traditional treatments.
This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Read more.
Mr Tim Dudderidge Will I need to wear a pad after focal therapy
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Care: Recovery
SUMMARY
Mr. Tim Dudderidge (Consultant Urologist, The Focal Therapy Clinic): Post-surgery pad use is usually due to sphincter damage, leading to long-term incontinence risks. In contrast, focal therapy may cause only temporary urgency-related leakage, with most patients regaining full bladder control quickly. Website: https://www.thefocaltherapyclinic.co.uk LinkedIn: linkedin.com/company/the-focal-therapy-clinic/ Facebook: facebook.com/TheFocalTC Telephone: +44 (0) 207 036 8870 #FocalTherapy #ProstateHealth #MinimallyInvasive #MensHealth #ProstateCancerTreatment #Urology
This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Read more.
Mr Tim Dudderidge When can I go home after focal therapy
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Care: After your treatment
SUMMARY
Mr. Tim Dudderidge (Consultant Urologist, The Focal Therapy Clinic): Most patients go home within a few hours after focal therapy, once theyve eaten, had fluids, and been shown how to use the catheter. Those traveling far may choose to stay in a nearby hotel overnight for added convenience and comfort.
This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Read more.
Mr Marc Laniado Will I need help getting or maintaining an erection after focal therapy
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Care: After your treatment
SUMMARY
Mr. Marc Laniado (Consultant Urologist, The Focal Therapy Clinic): Most men regain normal erections within a few months after focal therapy, though medications can help. By one year, function is usually restored, with rare cases needing further treatment or additional support.
This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Read more.
Mr Raj Nigam After focal therapy what tests are done to see if it was effective
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Care: After your treatment
SUMMARY
Mr. Raj Nigam (Consultant Urologist, The Focal Therapy Clinic): We closely monitor all focal therapy patients with regular PSA tests and MRI scans to track treatment success. If recurrence occurs (510%), further focal therapy or traditional treatments like surgery or radiotherapy remain viable options, ensuring flexible and effective cancer management.
This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Read more.
What are the side effects of Focal Therapy?
| Symptom | Frequency | Duration |
|---|---|---|
| Increased Urinary Frequency | Common | Usually temporary |
| Mild discomfort in perineum area | Common | 2-3 Days |
| Erectile dysfunction | Rare <5% | Usually temporary |
| Blood in urine or semen | Rare | - |
| Urinary Catheter required | Sometimes | 3-5 Days |
| Risk of incontinence | Rare | - |
| Repeat Treatment | Sometimes | - |
Questions to ask your doctor
Am I a good candidate for focal therapy based on my PSA, Gleason score, and MRI results?
Focal therapy works best for men with prostate cancer that is small, early-stage, and clearly visible on an MRI. It’s often offered to men with a Gleason score of 6 or 7, PSA under 10–15, and cancer in just one area of the prostate. Ask your doctor how your scan and biopsy results compare to these typical criteria. They may also consider your age, general health, and whether you’re likely to live at least another 10 years—because focal therapy is intended to control cancer while preserving quality of life.
What type of focal therapy would be most suitable for my cancer – HIFU or NanoKnife?
Both HIFU (which uses sound waves) and NanoKnife (which uses electric pulses) can treat prostate cancer while protecting healthy tissue. But the choice depends heavily on where your cancer is. HIFU is more effective for tumours near the back of the prostate, while NanoKnife is often used for harder-to-reach areas at the front or near sensitive structures like nerves or the urethra. Your doctor will review your MRI scan and may recommend one method over the other based on safety, accuracy, and their own experience with each technique.
What are the chances I will need more treatment after focal therapy?
Focal therapy is designed to treat the visible cancer while preserving the rest of the prostate. It’s not always a one-time cure, so it’s fair to ask about follow-up plans. Around 1 in 4 men may need another treatment later—often another round of focal therapy. But having this treatment doesn’t rule out surgery or radiotherapy in the future. Make sure your doctor explains what signs they’ll look for after treatment (like changes in PSA or MRI scans), and what the plan would be if any new cancer appears later.
What side effects might I experience, and how long do they usually last?
Focal therapy has fewer side effects than surgery or full-gland radiotherapy, which is why many men choose it. Most men go home the same day and recover quickly. You might notice mild discomfort, more frequent urination, or blood in the urine for a few days. Incontinence and erectile problems are rare, but still possible—especially if the cancer is near nerves or other sensitive areas. Ask your doctor honestly about what they’ve seen in patients like you, based on tumour location and your current function.
“I have absolutely no incontinence and I'm fully sexually active without any side effects.” — Graham Pipe, FTC HIFU Patient
“I have absolutely no incontinence and I'm fully sexually active without any side effects.” — Graham Pipe, FTC HIFU Patient
How experienced is your team with focal therapy, and how are the results monitored?
Experience really does matter when it comes to focal therapy. You can ask how many cases your doctor and their team have done, and whether they use advanced tools like MRI-ultrasound fusion to plan and deliver treatment. After treatment, you’ll need regular PSA tests, follow-up MRIs, and sometimes another biopsy to make sure the cancer hasn’t come back. Ask how often they’ll check you and what signs might trigger further action. Knowing that your team has a clear plan in place can be very reassuring.
“MRI gives precise tumour location for targeted treatments.” — Mr Tim Dudderidge, Consultant Urologist
“MRI gives precise tumour location for targeted treatments.” — Mr Tim Dudderidge, Consultant Urologist
What happens if the cancer returns – can I still have other treatments later?
One of the biggest advantages of focal therapy is that it leaves the door open for other treatments in the future. If the cancer comes back or new areas are found, you may be able to have another round of focal therapy, or choose surgery or radiotherapy if needed. Your doctor should explain how well other treatments work after focal therapy and whether your case would be more complex. It’s important to feel confident that you’ll still have options if things change down the line.
Choosing Between NanoKnife & HIFU: Key Factors
Both NanoKnife IRE and HIFU are focal therapy options that treat localized prostate cancer while preserving quality of life. The choice between them depends on tumor location, treatment goals, and patient preferences.
| Benefit | NanoKnife | Hifu |
|---|---|---|
| Best for Tumour Location | Irregularly shaped or near critical structures (nerves, urethra) | Well-defined tumors in specific prostate zones |
| Preservation of Nerves | No heat damage; excellent for preserving erectile function | Low risk, but heat may affect nearby structures |
| Suitability for Recurrent Cancer | Ideal for post-radiation recurrence | For tumors near the base of the prostate |
| Side Effects | Minimal impact on urinary function and sexual health | Low risk of incontinence and erectile dysfunction |
| Treatment risk | Risk of rectal injury at base of prostate | Risk of under treatment at front of prostate |
Frequently asked questions
Will focal therapy cure my prostate cancer?
Focal therapy aims to control the cancer in the treated area, and for many men, that’s enough. It’s not always called a "cure" because some cancer might still exist in untreated parts of the prostate. However, with regular follow-up, any new or returning cancer can be caught early and treated again. Studies show good long-term results for men with intermediate-risk cancer when focal therapy is used properly. It offers a balance between treating cancer and avoiding the side effects of full prostate removal. At 5 years, cure rates are equivalent between focal therapy, prostatectomy, and radiation treatments for men with intermediate disease.
How long does recovery take after focal therapy?
Most men recover quickly. You’ll likely go home the same day, and many return to normal activities within a few days. You may have a urinary catheter for 3 to 5 days, and feel some discomfort in the perineum (the area between the scrotum and back passage) for a short time. Light bleeding in the urine or semen can also happen but usually clears on its own. Most men feel fully back to normal within 1 to 2 weeks, much faster than with surgery or radiation.
Will focal therapy affect my sex life or bladder control?
One of the biggest benefits of focal therapy is its ability to protect sexual and urinary function. Because it targets only part of the prostate, most of the nerves and muscles that control erections and urination are left alone. While every case is different, most men keep full bladder control, and 85–95% maintain erections—especially if function was good before treatment. Side effects, if they happen, are often mild and short-lived and tadalafil can be useful. Ask your doctor what to expect based on your cancer’s location.
What kind of follow-up will I need after focal therapy?
You’ll have regular PSA tests to check how your levels are changing. An MRI scan is usually done at 6 and 18 months, and a follow-up biopsy may be suggested at 6–12 months to confirm the cancer is gone if indicated by the MRI scan. You may also be asked about any changes in urinary or sexual function during check-ups. This follow-up is important because it helps spot any cancer that might have been missed or come back, so it can be treated early.
Is focal therapy available on the NHS or only privately?
Focal therapy is available in some NHS centres, but access is limited. At the moment, only a few hospitals offer it routinely, often through research programmes or specialist units. Private clinics, such as The Focal Therapy Clinic, have more experience and treat higher numbers of patients. If you're interested, you can ask your NHS urologist for a referral or seek a second opinion. Many patients choose to explore private treatment if they want faster access or more advanced technology.
Reference List
Ahmed HU et al. (2015). Focal therapy for localized prostate cancer: a systematic review of the literature. Nature Reviews Urology.
Ganzer R, Fritsche HM, Brandtner A, et al. (2017). Five-year outcome of HIFU treatment for localized prostate cancer. Urologia Internationalis.
The Focal Therapy Clinic – Prostate Cancer Treatments (Internal Resource).
NHS Resources on Prostate Cancer (Internal/External Resource).