I suspect most of my blog readers do not take personal time to explore research articles on topics like prostate cancer (PCa), multiparametric MRI (mpMRI), men’s health and other topics. One reason why I post blogs is to bring scientific study results to my readers. I draw from well-respected journals that use strong peer review of manuscripts before they are accepted for inclusion. Their authors are affiliated with top academic/research centers, which makes a strong impact on their target medical audiences.

One such journal is Prostate Cancer and Prostatic Diseases (PCAN). It has a solid reputation among urologists, radiologists, oncologists and other clinicians or researchers. PCAN’s spring 2025 edition carries a comprehensive review of four focal therapy methods for treating PCa. The title opens with the expression, “New Kids on the Block,”^[i] but in fact specifically reviews MRgFUS (MR-guided Focused Ultrasound), TULSA, Focal Laser Ablation, and histotripsy for focal therapy. (Note: Histotripsy is not yet approved in the U.S. to treat PCa, only liver cancer). One of the authors is my esteemed Dutch colleague Professor Dr. Jurgen Futterer, which gives me confidence in the caliber of work that went into writing this article.

The article begins by acknowledging the problem of whole-gland PCa approaches which can have significant lingering treatment-related side effects. To address this challenge, focal therapy has emerged as “a promising alternative for intermediate-risk PCa” because it precisely destroys PCa tumors while sparing healthy tissue.

To make their case, the authors conducted an exhaustive search of published focal therapy studies and clinical trials. They amalgamated the data to present their findings on the effectiveness and feasibility of the four focal technologies.

Our Sperling Prostate Center stands out from others because we offer all three focal therapies approved by the FDA for PCa: MRgFUS, TULSA and Focal Laser Ablation. Each is performed and verified under real time MRI guidance.

Here are direct quotes from the article^[ii]:

• “MRgFUS (Exablate) utilizes transrectal high-intensity focused ultrasound under MRI guidance to selectively ablate cancerous tissue, demonstrating positive outcomes in oncologic control and preservation of urinary and sexual function.” (Our Center was chosen as one of the study sites when this approach was under investigation to earn FDA clearance.)
• “TULSA employs transurethral delivery of high-intensity ultrasound energy under MRI guidance, showing promising results for whole gland treatment.” (Our Center uses it for focal treatment only.)
• “Focal Laser Ablation benefits from precise ablation, indicating effectiveness in tumor destruction while preserving quality-of-life.” (We are a leading pioneer and developer of Focal Laser Ablation.)

As the article points out, focal treatment allows for personalization. We customize treatment to each patient’s disease, overall health, and lifestyle preferences. It is an advantage for us to be able to provide the flexibility of three different choices, since the accuracy of our diagnostics means we generate a best fit treatment strategy in conference with each individual. After all, each treatment has particular strengths that may apply to variables such as tumor location, extent, and Grade Group.

While the authors acknowledge that ongoing research must be done to continue to establish long term data, the overall tone of the article is one of praise for the promise these approaches offer for qualified patients. Focal therapy has achieved the ability to control a patient’s PCa, minimize side effect risks, and leave all future treatment options open. We’ve come a long way, something both doctors and patients can have pride and gratitude for.

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.

References

[i] Ghai, S., Ni, T.T., Pavlovich, C.P. et al. New kids on the block: MRI guided transrectal focused US, TULSA, focal laser ablation, histotripsy – a comprehensive review. Prostate Cancer Prostatic Dis (2025).
https://doi.org/10.1038/s41391-025-00956-x
[ii]Ibid.