Sperling Prostate Center

Focal Therapy Evidence from 107 Articles

What do Italy and China have in common? At first glance, the two countries don’t appear to share much by way of geography (Europe vs. Asia), size (small vs. gigantic), or culture (Western vs. Oriental). However, according Eastant, a market research and consulting team, the two nations embrace four similar characteristics: a proud history, family as a pillar, relationships are key, and love of their cuisine. (Although many of us were taught that the 13th century Italian explorer Marco Polo brought noodles (pasta) from China to Italy, it’s more likely that they developed independently of each other, though parallel).

Now, in addition to past roots, another commonality has appeared in the form of published research on focal therapy for prostate cancer (PCa). In July, 2023 a team of 21 academic and clinical Chinese and Italian researchers assessed focal treatment in terms of safety and functional outcomes (urinary and sexual function after treatment). They found common agreement in pronouncing it as having achieved “excellent results in terms of safety and functional outcomes.”[i]

The authors searched three publication databases for all articles on focal treatments, including those that reported after-treatment urinary, sexual and bowel function (articles on whole-gland treatments were excluded). They identified 107 studies; the combined number of patients was 6933. The number of articles on each reported treatment was:

  • High intensity focal ultrasound (HIFU) – 26 articles
  • Focal cryo – 22 articles
  • Irreversible electroporation (IRE) – 14 articles
  • Focal brachytherapy (seed implants) – 11 articles
  • Focal laser ablation (FLA) – 10 articles
  • Photodynamic therapy (TOOKAD) – 8 articles
  • Microwave ablation – 3 articles
  • Partial robotic prostatectomy – 3 articles
  • Bipolar radio frequency ablation (RFA) – 2 articles
  • Prostatic artery embolization (PAE) – 1 article
  • Comparison of 2 or more different methods – 7 articles

In terms of urinary function after focal therapy, pad-free rates ranged from 92.3 – 100%. There was a greater spread in change of erectile function, with rates between 0 – 94.4% (the high end was due to cryo). The authors wrote, “The most common reported complications were hematuria [blood in urine], infections, and urethral strictures [blockage of urine], with rates widely ranging among different treatments.” On the whole, they evaluated focal therapy with curative intent for low-to-intermediate risk PCa to have a better safety profile and fewer functional side effects than whole-gland treatments. Thus, the scholarly research on the part of Italian and Chinese researchers led to a conclusion they hold in common: despite heterogeneous study design and definitions, focal therapy is “a promising treatment for localized PCa…”

The Sperling Prostate Center is recognized as a center of excellence in focal treatment of prostate cancer. We are leading pioneers in three of today’s most advanced focal technologies: Focal Laser Ablation, TULSA-PRO, and Exablate MR-guided Focused Ultrasound. In addition, we incorporate Artificial Intelligence in our MRI detection and diagnostic services.

As far as Italy and China sharing focal therapy’s rosy outlook, let’s add the Sperling Prostate Center to that conviction.

NOTE: This content is solely for purposes of information and does not substitute for diagnostic or medical advice. Talk to your doctor if you are experiencing pelvic pain, or have any other health concerns or questions of a personal medical nature.

[i] Nicoletti R, Alberti A, Castellani D, Yee CH et al. Functional outcomes and safety of focal therapy for prostate cancer: a systematic review on results and patient-reported outcome measures (PROMs). Prostate Cancer Prostatic Dis. 2023 Jul 25.


About Dr. Dan Sperling

Dan Sperling, MD, DABR, is a board certified radiologist who is globally recognized as a leader in multiparametric MRI for the detection and diagnosis of a range of disease conditions. As Medical Director of the Sperling Prostate Center, Sperling Medical Group and Sperling Neurosurgery Associates, he and his team are on the leading edge of significant change in medical practice. He is the co-author of the new patient book Redefining Prostate Cancer, and is a contributing author on over 25 published studies. For more information, contact the Sperling Prostate Center.

You may also be interested in...

WordPress Image Lightbox