July 17, 2026

expert reaction to study looking at focal therapy (using a heat-based treatment (high intensity focused ultrasound, HIFU) or a freezing-based treatment (cryotherapy)) for prostate cancer

A study published in European Urology looks at focal therapy for the treatment of prostate cancer.

Dr Alastair Lamb, Clinical Reader, Barts Cancer Institute, St Bartholomew’s Hospital, said:

“It’s a registry study.  It shows that focal is safe.  It doesn’t show that it works compared to standard of care radical treatment (prostatectomy and radiotherapy) which have RCTs showing their efficacy in long term survival outcomes.

“It’s an exciting potential treatment for prostate cancer that may well be an integral part of prostate cancer treatment in the future.  Focal therapy doesn’t cure prostate cancer but that may be okay.

“We need randomised trials.  We need better understanding of localised prostate cancer, how it arises, how it grows and how it spreads.

“We eagerly await the results of the PART Trial, the first and only large randomised controlled trial comparing focal versus radical therapy in prostate cancer that needs treatment – until then focal therapy remains a very promising experimental treatment.”

Prof Prabhakar Rajan, Professor of Urology and Robotic Surgery, Barts Cancer Institute, Queen Mary University of London; Consultant Urologist, Barts Health NHS Trust; and Director, healthXY Ltd, said:

“This is an important study that adds to the growing evidence that focal therapy can provide excellent long-term cancer control for carefully selected men with localised prostate cancer.  The reported 10-year cancer outcomes are encouraging and support the potential of gland-preserving treatment to reduce the burden of radical therapy.

“However, these findings should be interpreted with caution.  This is a large observational registry study rather than a randomised controlled trial, so outcomes cannot be directly compared with surgery, radiotherapy or active surveillance.  Around one-third of patients also required further treatment over 10 years in the intention-to-treat analysis, highlighting that focal therapy is often part of an ongoing treatment pathway rather than a one-off cure.

“Importantly, the study does not report long-term urinary, sexual or bowel function.  As preserving quality of life is one of the main reasons patients choose focal therapy, durable functional outcomes are just as important as cancer control.

“Overall, these results provide valuable long-term evidence that focal therapy is a promising option for appropriately selected patients.  The next priority should be high-quality randomised trials, such as the PART trial, with comprehensive assessment of cancer control, quality of life and cost-effectiveness to define the role of focal therapy alongside established treatment options.”

‘Oncological Outcomes Following Focal HIFU and Cryotherapy for Treatment of Nonmetastatic Prostate Cancer in the United Kingdom: An Updated Analysis of 3477 Patients from the Prospective HEAT and ICE Registries’ by Alexander Light et al. was published in European Urology.

DOI: 10.1016/j.eururo.2026.05.007

Declared interests

Dr Alastair Lamb: “ADL is funded Cancer Research UK (RCCASF-Nov24/100001) and UCARE (1120887).  He has also received funding from NIHR HTA (NIHR131233) as co-CI of the TRANSLATE prostate biopsy trial, and the John Black Charitable Foundation as prostate module lead of the QUANTUM Biobank.  He has received educational support from Intuitive Surgical, BXT Accelyon, GlaxoSmithKline, Astellas, Lilly, Astrazenaca and Ipsen. He is a stipendiary BJUI Section Editor for prostate cancer and has received honoraria for reviewing from European Urology and Lancet Oncology.  He has also received consulting fees from AlphaSights. His private practice focusses entirely on treating men with prostate cancer and he acknowledges that any academic article written or talk delivered may increase visibility for potential future patients. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the talk/manuscript.”

Prof Prabhakar Rajan: “Prabhakar Rajan is a director and founder of healthXY Ltd, has received reimbursement for consultancy and advisory boards from Antev Ltd and Medtronic Ltd, speaker fees from Janssen-Cilag Ltd (Johnson & Johnson), and educational support from Angiodynamics UK Ltd, EDAP TMS S.A., HC 21 Healthcare Ltd, Medtronic Ltd, and Janssen-Cilag Ltd (Johnson & Johnson).”