10-Year Study Finds Focal Therapy Controls Prostate Cancer with Five-Fold Lower Side-Effect Risk

Jul 18

3 min read

Pelvic MRI scans in coronal and sagittal views showing the uterus and bladder, with colored alignment lines on a black background.

A major new UK study has delivered encouraging long-term evidence that focal therapy can effectively treat prostate cancer while dramatically reducing the life-changing side effects often associated with traditional whole-gland treatments.Researchers from Imperial College London and Imperial College Healthcare NHS Trust followed 3,477 men treated with focal therapy across 14 UK hospitals between 2004 and 2024. The results, published in the journal European Urology, show excellent cancer control at 10 years with significantly fewer complications than radical prostatectomy (surgery) or radiotherapy.

What Is Focal Therapy?

Focal therapy is a minimally invasive approach that targets and destroys only the cancerous areas of the prostate, rather than treating or removing the entire gland. It uses energy sources such as:

High-intensity focused ultrasound (HIFU) — which heats and destroys cancer cells
Cryotherapy — which freezes the targeted tissue

By sparing healthy prostate tissue, nerves, and surrounding structures (including those responsible for urinary control and sexual function), focal therapy aims to maintain quality of life while still addressing clinically significant cancer.

Diagram of prostate cancer treatments: cryotherapy, laser ablation, electroporation and ultrasound near bladder and rectum. — Diagram illustrating different focal therapy techniques for prostate cancer, including HIFU, cryotherapy, laser ablation, and irreversible electroporation.

Landmark 10-Year Findings

The study included many men with intermediate- or high-risk prostate cancer (nine in ten participants), who would traditionally require active treatment rather than monitoring.Key results at 10 years:

Only two men (roughly 0.06%) died from prostate cancer
Prostate cancer mortality was approximately 0.1%
Just 3% experienced cancer spreading beyond the prostate
Cancer control rates were comparable to those seen after radical surgery or radiotherapy

One in three men needed additional treatment during follow-up, but many successfully received repeat focal therapy. Among those who had a second focal procedure, only about one in ten later required surgery or radiotherapy.Most importantly, the risk of significant side effects — including urinary incontinence, erectile dysfunction, and rectal problems — was five times lower than with traditional whole-gland treatments.

Comparison chart of radical surgery, radical radiotherapy, and focal therapy with side effect and survival percentages. — Comparison of side-effect rates across radical surgery, radical radiotherapy, and focal therapy (illustrative data from clinical sources).

Expert Perspectives

Dr Alexander Light, NIHR Doctoral Fellow and Urology Registrar at Imperial College, described the results as “really encouraging,” noting that many men with more aggressive disease — who might previously have been told focal therapy wasn’t suitable — benefited significantly.

Professor Hashim Ahmed, Chair of Urology at Imperial College London, called it “the largest and longest running study demonstrating that focal therapy delivers excellent long-term cancer control across a broad range of patients.” He highlighted that focal therapy could become more widely available with proper support.

Dr Taimur Shah emphasised the need to update NICE clinical guidelines so focal therapy is routinely offered as a first-line option for suitable men.

Patient advocate Paul Sayer, founder of Prost8 UK and a focal therapy patient himself, said: “For too long, many men have believed they had to choose between curing their cancer and preserving the quality of their lives. This study shows that, for many patients, that simply isn’t true.”

Why This Matters

Prostate cancer is the most common cancer in UK men, with over 60,000 new diagnoses each year. Experts estimate that half to two-thirds of men with localised disease (up to 15,000 annually) could be suitable for focal therapy. Currently, only around 1,000 men receive it each year due to limited awareness, access, and variation in clinical pathways.The UK Government has committed up to £2.8 million in capital funding to expand focal therapy services, alongside support for prostate cancer screening trials.

Is Focal Therapy Right for Everyone?

Focal therapy is best suited for men with localised prostate cancer that can be clearly identified on MRI and confirmed by biopsy, particularly those with intermediate-risk disease. Low-risk cases are often managed with active surveillance instead.It is not appropriate for men whose cancer has spread beyond the prostate or who have multiple significant tumours throughout the gland.

The Bottom Line

This 10-year study provides some of the strongest long-term evidence yet that focal therapy can deliver cancer outcomes comparable to traditional treatments while substantially protecting quality of life. For many men facing a prostate cancer diagnosis, it offers a compelling middle path — effective treatment without the full burden of side effects.Men concerned about prostate cancer or considering treatment options should discuss focal therapy with their urologist and ask about referral to a specialist centre offering the procedure. As access improves and guidelines evolve, this targeted approach may become a standard option for thousands more patients across the UK.