A recently published survey of European men examined how different prostate cancer treatments affected quality of life. The men surveyed had undergone radical prostatectomy, radiotherapy and active surveillance. Focal Therapy was not included, and had it been we would have a much fuller picture of treatments and their impact on quality of life. But by its absence, focal therapy stands out in this survey.
Active Surveillance performs best on many quality of life measures, including erectile function, continence, and fatigue. However, in addition to focal therapy, the survey omitted two things:
- Compliance: did the process of complying with the treatment impact quality of life?
- Mental health: how did the treatment impact patient mental health?
On these quality of life aspects, Active Surveillance often scores quite poorly.
As Alan Doherty, Clinical Director at the Birmingham Prostate Centre, suggests in our recent On Focus interview, patients undergoing Active Surveillance must comply with a sustained level of diagnostic activity, and many aren’t prepared to continue this indefinitely. Which leads to the very relevant question, as Alan puts it, what’s the endgame?. “The cancer isn’t going to go away under AS”, says Alan, “and this can cause needless anxiety in some men. If a curative treatment exists that is safe and effective, as is focal therapy, why wouldn’t you use it?”
TFTC patient Perry Letcher also has strong views on AS. In his case, described with great honesty in a recent On Focus interview and in his own words here AS didn’t accord with his personal mental and physical needs. A committed triathlete, Perry admits that he “needs to be in control” of all aspects of his life and is prone to anxiety. “I needed to feel in control, not that the prostate cancer was in control of me.”
TFTC Consultant Urologist Raj Nigam sees this all the time. As he states in his recent On Focus interview, “Too often AS is prescribed without an understanding of the whole patient context, or of the ‘whole man’”, says Raj. “Mental health is as important as physical health and must be investigated before proceeding with any treatment.”
The main issue today – as compared with five years ago – is that a treatment for prostate cancer exists that is continually improving in its efficacy and availability, and incurs minimal, if any, impact on quality of life. This is focal therapy, and The Focal Therapy Clinic is proud to be a world leader in its continued development.