Focal ablation is a treatment for localized prostate cancer that uses extreme temperatures to destroy abnormal or diseased tissue. Focal ablation can include cryotherapy, photodynamic therapy, laser ablation, and high intensity focused ultrasound (HIFU).
Who is a Good Candidate for Focal Ablation?
Focal therapy was first used in 2007 as an alternative to active surveillance in low-risk patients. Today, focal therapy is offered to patients with favorable intermediate risk disease.
The best candidates for treatment have a single visible tumor on MRI, a prostate gland of about 40cc in size or a tumor in the lower half of a larger gland, and no spread to other parts of the gland.
To determine whether a patient is a good candidate for focal ablation, the physician will also consider the patient’s overall mental and physical health, the size and location of the tumors, and the risk of further spread. Patients may need to undergo MRI scans, ultrasound testing, and a biopsy to provide additional information about the potential benefits of focal ablation.
What to Expect After Treatment
Patients will be actively monitored for disease that may have gone undetected, returned, spread, or appeared for the first time. If follow-up testing shows that the treated cancer still remains, patients may need to undergo surgery, radiation, or additional ablation.
Types of Focal Ablation
Focal ablation utilizes extreme temperatures to destroy tissue. The methods used to do this can include:
Cryotherapy: During cryotherapy, the surgeon applies liquid nitrogen, liquid nitrous oxide, or argon gas to freeze damaged or diseased tissue. The patient will be placed under anesthesia before the surgeon can insert a cryoprobe through a small incision in the skin. After the procedure, patients may have mild pain or soreness in the treatment area for up to three days.
High Intensity Focused Ultrasound (HIFU): HIFU uses highly focused ultrasound to pinpoint, heat, and destroy cancerous prostate cells. Treatment is non-invasive and doesn’t harm healthy tissue. During treatment, the physician inserts an ultrasound probe into the rectum and targets prostatic tissue with a highly-focused and intense beam. Ultrasound beams pass through layers of tissue, without harming them, until they reach the cancerous cells.
Photodynamic therapy: Photodynamic therapy involves a combination of photosensitizing medication and light energy to treat various cancers, skin conditions, and other diseases, including:
- Bladder cancer
- Pancreatic cancer
- Urinary tract infections
During treatment, the physician will administer a photosensitizer in the form of a pill, IV, or topical application. The drugs will concentrate in the cancerous and unhealthy cells, increasing their sensitivity to light. A special light or laser will be moved across the treatment area to cause a chemical reaction that destroys unhealthy cells.
Laser ablation: Laser radiation energy is applied to a very small area to burn away cancerous tissue. Some forms of laser ablation can be done with MRI simultaneously to target very specific areas and provide a real-time view of results.
