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Medically Approved by Dr Aqua Asif (May 1st 2025)
Written by Brian Lynch
Prostate cancer care is evolving rapidly, with new technologies shaping how the disease is diagnosed and treated. Consultant Urologist Tim Dudderidge, a leading voice in this space, shares insight into how clinical practice is adapting to new tools and research. His work at The Focal Therapy Clinic places him at the heart of some of the most significant prostate cancer trends in the UK today.
This article draws on key moments from his recent interview to highlight the most relevant developments for patients and clinicians alike. From next-generation imaging to minimally invasive treatments like HIFU and NanoKnife, innovation is helping to personalise care and reduce long-term side effects. Understanding the latest trends in prostate cancer can help men make more informed, confident decisions about their treatment path.
Advances in diagnostic techniques
Achieving earlier and more accurate diagnosis is fundamental to improving outcomes for men with prostate cancer. Diagnostic methods have advanced considerably, moving beyond traditional tests to incorporate sophisticated imaging and biomarker analysis. These improvements help doctors identify significant cancers sooner and guide men towards the most appropriate management strategies, while also avoiding unnecessary interventions for low-risk disease.
Imaging innovations
High-quality multiparametric MRI (mpMRI) scans now play a central role in both diagnosing prostate cancer and planning treatment. National guidelines recommend mpMRI before biopsy for men with suspected localised disease. This advanced imaging technique is better at detecting clinically significant cancers and can help about a quarter of men avoid an invasive biopsy altogether if the scan is clear.
However, the effectiveness of MRI depends heavily on scan quality. To address variability, quality control systems like PI-QUAL have been developed. PI-QUAL allows clinicians to assess the quality of MRI scans, ensuring they are reliable enough for making accurate treatment decisions. Implementing standardised protocols and quality checks helps improve consistency across diagnostic centres. These imaging advances are particularly important for selecting men who may be suitable candidates for targeted treatments like focal therapy, ensuring that therapy can be delivered precisely to the cancerous area.
Biomarker developments
While the PSA blood test remains a 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. These tests might measure 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 can get 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, reducing the need for unnecessary biopsies, and helping to minimise both under- and over-treatment of prostate cancer.
Personalised medicine and genetic profiling
The future of prostate cancer care lies in personalised medicine. Instead of applying a one-size-fits-all approach, treatments are increasingly tailored based on an individual’s genetics, the specific biology of their tumour, and their overall health and preferences. This allows for more effective care while minimising the risk of unnecessary side effects.
Understanding a man’s genetic predisposition is becoming more important. Family history and specific inherited gene mutations, such as those in BRCA1 and BRCA2, can significantly increase risk and may influence screening strategies and treatment choices. Genomic testing of the tumour itself can identify specific mutations that make the cancer vulnerable to targeted therapies, particularly in advanced disease.
This personalised approach also influences decisions about managing localised cancer. Men with low-risk disease are often recommended active surveillance, which involves close monitoring rather than immediate radical treatment. This preserves quality of life without compromising safety for many men. Conversely, those with higher-risk disease can be identified earlier and offered more definitive treatments like surgery or radiotherapy when appropriate. This trend towards truly individualised care empowers men to choose treatments based on their unique situation and priorities.
Innovative treatment modalities
While surgery and radiotherapy remain important options, the treatment landscape for prostate cancer is broadening. There is growing recognition that treatment needs to be tailored, with less invasive approaches gaining momentum for their ability to control cancer effectively while preserving quality of life.
Focal therapies
Focal therapies, such as HIFU (High-Intensity Focused Ultrasound) and NanoKnife (Irreversible Electroporation), represent a significant shift in treatment philosophy. These techniques precisely target and destroy the cancerous portion of the prostate, aiming to leave the surrounding healthy tissue, nerves, and urinary sphincter intact.
This precision significantly lowers the risk of common side effects like urinary incontinence and erectile dysfunction that can occur after whole-gland treatments. Focal therapy is increasingly considered a primary treatment option for appropriately selected men with localised prostate cancer. As awareness grows, it’s important to explore all the focal therapy options for prostate cancer available to you to understand how they compare with traditional approaches.
Advanced surgical techniques
For men who require removal of the entire prostate (radical prostatectomy), robotic-assisted surgery (RARP) has become the standard technique in many centres. Using a sophisticated robotic platform, surgeons operate through small incisions with enhanced vision and dexterity. This minimally invasive approach is associated with benefits such as shorter hospital stays, reduced blood loss, and potentially faster recovery compared to traditional open surgery. Careful patient selection ensures this option is used appropriately.
Radiotherapy enhancements
Modern radiotherapy techniques have become highly precise, allowing doctors to target cancer cells effectively while minimising damage to nearby healthy organs like the bladder and rectum. Techniques like Intensity-Modulated Radiation Therapy (IMRT) and Stereotactic Body Radiation Therapy (SBRT) use sophisticated imaging and computer planning to deliver focused radiation doses. Furthermore, treatment courses have become significantly shorter (hypofractionation), often delivered over just five sessions in the case of SBRT, making treatment more convenient for patients without compromising effectiveness.
Systemic treatments
For men with aggressive or advanced prostate cancer, systemic treatments remain essential. Hormone therapies and chemotherapy are increasingly combined with local treatments for a more comprehensive approach. Ongoing research is refining how these therapies are timed and tailored for optimal results.
Integration of artificial intelligence in 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 various 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.
Emerging research and clinical trials
Progress in prostate cancer care is driven by ongoing research and clinical trials. Studies are constantly evaluating new diagnostic tools, refining treatment techniques, and testing novel therapies. Key trials, such as CHRONOS (comparing focal therapy against radical treatments), aim to provide high-quality evidence to guide future practice, although challenges like patient preferences can sometimes make direct randomisation difficult.
Observational studies and registries also play a vital role, particularly in evaluating the real-world outcomes of newer treatments like focal therapy. These studies help build the evidence base, validate the safety and effectiveness of innovative approaches, and ensure that advancements are adopted responsibly. Participation in clinical trials offers patients access to cutting-edge care and is essential for driving future improvements.
Challenges and considerations in current practice
Despite significant progress, challenges remain. Variability in the quality of MRI scans across different hospitals can impact diagnostic accuracy and eligibility for treatments like focal therapy. Ensuring consistent, high-quality imaging nationwide is an ongoing priority.
Patient preferences also play a significant role. Men often have strong ideas about the treatment they want, which can complicate recruitment into randomised clinical trials designed to compare different approaches objectively. Balancing patient choice with the need for robust evidence requires careful communication.
Furthermore, resource constraints within healthcare systems mean that adopting innovative technologies and treatments must be balanced against costs, training requirements, and ensuring equitable access for all patients.
Explore your treatment options with expert support
If you’ve been diagnosed with prostate cancer, it’s important to understand all your treatment options, not just the most common ones. The Focal Therapy Clinic provides second opinions, personalised care plans, and access to the latest technologies in prostate care. Our team specialises in non-invasive prostate cancer treatment, helping men make choices that protect their health without compromising their quality of life.
Every prostate cancer case is different, and the right approach depends on your diagnosis, imaging results, and personal priorities. By working with experienced specialists, you can confidently navigate your options and avoid unnecessary or overly aggressive treatment. Our focus is always on supporting your long-term wellbeing with evidence-based, minimally disruptive care.
Whether you’re just beginning your journey or seeking clarity after a diagnosis, expert guidance can make all the difference. The earlier you explore your choices, the more options you may have. Reach out to our team today and take the first step toward a more personalised treatment path.
References
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
de Rooij, M. et al. (2024). PI-QUAL version 2: an update of a standardised scoring system for the assessment of image quality of prostate MRI. European Radiology, 34(11), 7068-7079. https://doi.org/10.1007/s00330-024-10795-4
Giganti, F. et al. (2020). Prostate Imaging Quality (PI-QUAL): A New Quality Control Scoring System for Multiparametric Magnetic Resonance Imaging of the Prostate from the PRECISION Trial. European Urology Oncology, 3(5), 615-619. https://doi.org/10.1016/j.euo.2020.05.007
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
Hamdy, F.C. et al. (2023). Fifteen-Year Outcomes after Monitoring, Surgery, or Radiotherapy for Prostate Cancer. New England Journal of Medicine, 388(17), 1547-1558. https://www.google.com/search?q=https://doi.org/10.1056/NEJMoa2214122
Imperial College London. (Accessed 2025). CHRONOS: A clinical trial investigating the outcomes of new prostate preserving surgery against whole prostate treatment. https://www.imperialprostate.org/chronos/
Kasivisvanathan, V. et al. (2018). MRI-Targeted or Standard Biopsy for Prostate-Cancer Diagnosis. New England Journal of Medicine, 378(19), 1767-1777. https://doi.org/10.1056/NEJMoa1801993
Mateo, J. et al. (2020). Olaparib in patients with metastatic castration-resistant prostate cancer with DNA repair gene aberrations (TOPARP-B): a multicentre, open-label, randomised, phase 2 trial. The Lancet Oncology, 21(1), 162-174. https://doi.org/10.1016/S1470-2045(19)30684-9
National Institute for Health and Care Excellence (NICE). (2021). Prostate cancer: diagnosis and management (NG131). https://www.nice.org.uk/guidance/ng131
National Prostate Cancer Audit. (2024). NPCA State of the Nation Report 2024. https://www.npca.org.uk/reports/npca-state-of-the-nation-report-2024/
PI-CAI Grand Challenge. (Accessed 2025). Prostate Imaging: Cancer AI. https://pi-cai.grand-challenge.org/
Saha, A. et al. (2024). Artificial intelligence and radiologists in prostate cancer detection on MRI (PI-CAI): an international, paired, non-inferiority, confirmatory study. The Lancet Oncology, 25(8), P1127-1137. https://doi.org/10.1016/S1470-2045(24)00220-1
Sartor, O. et al. (2021). Lutetium-177–PSMA-617 for Metastatic Castration-Resistant Prostate Cancer. New England Journal of Medicine, 385(12), 1091-1103. https://doi.org/10.1056/NEJMoa2107322
