Medical Suitability

Focal therapy is suitable for men with localised, low- to intermediate-risk prostate cancer, typically with a Gleason score of 7 or lower (ISUP Grade 1–3). It is most effective when the cancer is confined within the prostate gland. This minimally invasive treatment preserves bladder, erectile, and bowel function, offering an alternative to surgery or radiotherapy while maintaining quality of life. Suitability depends on factors like PSA levels, biopsy results, and mpMRI scans, which are reviewed by expert urologists. Age alone is not a limiting factor; overall health and cancer aggressiveness are more important considerations.

Men with high-risk or advanced prostate cancer, such as those with a Gleason score above 7 (ISUP Grade 4–5), or cancer that has spread beyond the prostate, are not ideal candidates for focal therapy. Additionally, those with large or multi-focal tumours, or cancer not clearly visible on an MRI, may require more extensive treatments like surgery or radiotherapy. Focal therapy is also less suitable for men in Cambridge Prognostic Groups 4 or 5, as these cases often involve more aggressive disease requiring comprehensive treatment.

To assess eligibility for focal therapy, the following tests and procedures are required:

• MRI Scan: Provides a detailed image of the prostate to locate cancer spots accurately.
• Biopsy: A small sample of prostate tissue is taken, often guided by MRI, to confirm the cancer's presence and grade.
• PSA Test: Measures prostate-specific antigen levels in the blood to evaluate cancer activity.
• PSMA PET CT Scan: Recommended in cases of higher-risk cancer to check for spread beyond the prostate.

These tests help doctors determine the cancer's size, location, and aggressiveness.

Yes, focal therapy is most suitable for men with early or intermediate-stage prostate cancer. Specifically:

• Gleason Score: 7 or lower (Grade Groups 1–3), indicating low- to intermediate-risk cancer.
• Disease Stage: Cancer confined within the prostate gland (localised disease).
• Tumour Characteristics: Visible on MRI and not too large or multi-focal.

Men with these characteristics are more likely to benefit from focal therapy, as it targets specific cancer areas while preserving healthy prostate tissue and minimising side effects.

Focal therapy is generally less suitable for men with multiple areas of cancer (multi-focal disease). It works best when the cancer is localised to one main "index" lesion that can be targeted precisely. If multiple areas are affected, or if the cancer is extensive, whole-gland treatments like surgery or radiotherapy may be recommended instead. However, eligibility depends on the extent and location of the disease, which can be assessed through MRI scans and biopsies. Consulting with a specialist is essential to determine the best approach for your situation.

Your overall health plays a crucial role in determining eligibility for focal therapy. Factors like comorbidities (other health conditions) and your general physical fitness can impact the safety and success of the treatment. For example:

• Good Health: Increases the likelihood of a smooth recovery and better outcomes.
• Chronic Conditions: Conditions like heart disease or diabetes may require additional consideration.
• Mental Health: Anxiety or stress about cancer or treatment can influence decision-making.

A holistic assessment, including your lifestyle and health status, helps ensure the treatment aligns with your needs and goals.

No, you do not need to have failed previous treatments to qualify for focal therapy. It is often used as a first-line treatment for men with localised, low- to intermediate-risk prostate cancer. However, if you have had prior treatments like radiation, focal therapy may still be an option in some cases, depending on the specifics of your cancer and overall health. Consulting with a specialist is essential to determine your suitability.

Yes, focal therapy can be used alongside or followed by other treatments if necessary. For example:

• Retreatment with Focal Therapy: If cancer recurs, another round of focal therapy may be an option.
• Surgery or Radiotherapy: These remain viable options after focal therapy if more extensive treatment is needed.
• Hormone Therapy: Can be considered in certain cases, depending on the cancer's progression.

This flexibility allows focal therapy to be part of a broader treatment plan, preserving future options while minimising side effects initially.

If you're eligible for focal therapy, the treatment and recovery process is typically quick and minimally disruptive:

Treatment Duration

• The procedure lasts about 60–90 minutes under anaesthesia.
• It is usually performed as a day case, meaning you can go home the same day.

Recovery Process

• First Few Days: You may have a urinary catheter for 3–5 days and experience mild discomfort in the perineum (area between the scrotum and back passage).
• 1–2 Weeks: Most men feel fully back to normal within this time.
• Temporary Side Effects: Some men may notice light bleeding in urine or semen, increased urinary frequency, or mild fatigue, but these usually resolve quickly.

Compared to surgery or radiotherapy, recovery is much faster, with fewer side effects.

To consult with a specialist and determine your eligibility for focal therapy, you can follow these steps:

1. Initial Contact:
   - Reach out to The Focal Therapy Clinic by phone at 0207 036 8870 or email at info@thefocaltherapyclinic.co.uk.
   - Alternatively, complete the contact form available on their website.
2. Suitability Assessment:
   - The clinic will assess your suitability for focal therapy by reviewing your biopsy and MRI results. They may also request additional tests if needed.
3. Consultation Options:
   - You can book a consultation with one of their expert urologists, either in person or virtually, for convenience.
   - During the consultation, the specialist will discuss your cancer, treatment options, and any concerns you have.
4. Next Steps:
   - If focal therapy is suitable, the clinic will guide you through the treatment process.
   - If not, they will help you explore alternative treatments.

Having a private consultation does not prevent you from accessing NHS treatment later, and it can provide a second opinion to help you make a confident decision.