Focal One: Focal Therapy for Prostate Cancer
The bipolar radical prostatectomy and radiation, with its potential impact on the patient’s quality of life, is no longer the only option for a large number of prostate cancer cases. Focal therapy, such as high-intensity focused ultrasound (HIFU), offers the possibility of effectively treating low- to intermediate-risk cancers, mainly small tumors confined to one area of the prostate, without jeopardizing the patients’ continence and erectile function.
In a first for the whole of SE Europe, Athens Medical Group has been implementing focal therapy for prostate cancer for several years with excellent success, thanks to the supply of the Focal One® HIFU (High-intensity Focused Ultrasound) Robotic System.
The advantages of focal therapy and the capabilities of the Focal One system:
- What is focal therapy?
Prostate cancer is categorized based on its risk. Very low-risk cancer is not life-threatening for 10 to 15 years and therefore, active monitoring is recommended. Accordingly, high-risk and life-threatening cancer is traditionally treated with radical removal of the prostate gland (prostatectomy), which is now performed robotically to minimize trauma to the area, and radiation. The question that preoccupied the scientific community was how aggressively we treat low- to intermediate-risk cancers, which also do not directly threaten the patient’s life? Radical treatment (prostatectomy) always carries risks regarding the quality of life of patients (incontinence, erectile dysfunction). The answer came in the form of focal HIFU treatment, which is aimed at men whose cancer is localized, that is, has not spread beyond the walls of the prostate. Essentially, HIFU is used to heat-kill cancer cells without damaging the surrounding structures that control a man’s continence and erectile function.
- Focal One technology: What makes it so innovative?
Focal One is the latest generation of high-intensity focused ultrasound (HIFU) systems, which combine high-resolution magnetic resonance imaging with biopsy results and real-time ultrasound images – a unique collaboration between radiology, histopathology and urology. Utilizing data from Fusion Biopsy (i.e. a biopsy that has been focused on points indicated by multiparametric MRI of the prostate), the system uses high-frequency sound waves that are directed at the cancerous tissue via an ultrasound probe inserted into the rectum. These waves heat the targeted tissue to 85 degrees and destroy it, leaving the surrounding structures intact, including nerves, blood vessels and muscle tissue, all vital for urinary continence and erectile function. With Focal One, the urologist can customize the procedure for each patient and each clinic.
- In which cases is focal therapy indicated?
So far, focal therapy is applied to three categories of patients:
- Patients over 70 years of age, whose lives are not threatened by localized prostate cancer.
- Patients who are unable to undergo the long hours of anesthesia required for robotic prostatectomy. With Focal One, anesthesia time is significantly shorter and in a more comfortable position, while there is also the possibility of epidural or spinal anesthesia.
- Patients who have undergone radiation in the past and now have a recurrence of prostate cancer. As radical prostatectomy carries a very high risk of complications in patients who have undergone radiation, Focal One is an ideal choice.
- What kind of results have you seen with this technology so far?
Since December 2018, when the operation of Focal One at the Athens Medical Group began, patients who have undergone this specific procedure have had complete success and progress. The majority of them are patients with prostate cancer recurrence after radiation or other health problems (cardiological, etc.), as well as patients with limited disease and age over 70 years. The operation was performed under spinal anesthesia, lasted approximately one and a half hours, and the patients were discharged home the next day. After the operation, multiparametric MRI, which is the ideal examination for imaging of the prostate, immediately demonstrated the elimination of the cancer, while after two months the patients had zero PSA (<0.02).
Correspondingly encouraging results are observed internationally and published in studies, indicating that focal therapy will soon be the treatment of choice for the treatment of prostate cancer.
