Focal Therapies

contact

My prostate cancer as of six weeks ago and a Pet Scan has remain within the prostate. I have been asking questions at this forum and its amazing and helpful in my decision making process.

Now I have another what about FOCAL THERAPIES? Im reading some about it so have any gone this direction? Here at my local hospital like VG said follow there protocol's so no mention of any other treatments. Maybe the second opinion is the way.

Contact

MACH1

Focal is for tumors that are located in only one area of the prostate. If you have it in a few different areas they will not do focal. I ended up doing brachytherapy radiation for the entire prostate.

Not sure what your Gleason is but in any case I would recommend a decipher test to see if your cancer is considered fast or slow growing. The results can help you make a decisionastovyour choice of treatment.

Good luck.

swl1956

Focal Therapies can be a great choice for some, but only if you are a good candidate which is a relatively small percentage of Pca patients. I was one of those whom it was offered as an alternative to RP or RT at a center of excellence which had experience and facilities for most types of treatments. I had IRE Nanoknife. The procedure went well and was uneventful other than a temporary bout of urinary retention. (not fun!) Anyhow, it completely killed the tumor within the prostate and with minimal side effects of only no more ejaculate. Unfortunately for me, six months later my PSA was rising quickly. Subsequent tests indicated Pca in the pelvic lymph nodes which resulted in me having RT and ADT. According to my surgeon it likely would not have made any difference of which treatment I chose first. They surmise that micro metastasis had occurred to lymph nodes that was undetectable at the time even with the PSMA PET scans. I do not regret my choice. Now after IMRT and ADT (Orgovyx, Zytiga / Prednisone) my PSA has been undetectable for almost a year. Anyhow, I have conversed with others having Focal Therapies that have had very good outcomes. In my opinion I would only consider it if you've been vetted by a center of excellence that along with standard of care procedures also routinely performs Focal Therapies. The only two I considered were Cryotherapy and IRE.

contact

When the biopsies were taken five areas of the twelve showed cancer. You have answer my question but IM going to run it buy my here in NH. Gleason score was 4+5 which is not good. IM not familiar with a decipher test but will find out. Any further info is helpful.

thanks

Old Salt

With those Gleason scores and multiple areas with cancer, it seems to me that you are NOT a good candidate for any focal therapy.

Wheel

Agree with Old Salt, in addition a Gleason 9 in and of itself is considered advanced and likely more aggressive so at this point in treatment considerations I don’t know whether a Decipher is even warranted. There is no surveillance or watch and wait with Gleason 9. Treatment is needed now and Radiation would include hormone treatment. If it is still within the capsule , surgery would be a good approach if you are still age appropriate, but with Gleason 9, hormone treatment afterwards would still be protocol. Definitely get opinions from both Radiation Oncologist and Surgical Oncologist’s

contact

Its been almost two months since biopsies and about an month from Pet scan. I've kick this around just about long enough so Monday Im seeing the Doc again asking an couple of questions and make a decision.

thanks

MACH1

I'm in total agreement with both Wheel and Old Salt. A Gleason of 9 and multiple areas of tumors tules out focal therapy and no need for Decipher test. Also agree that with whatever modality or multiple modalities you choose ADT would also be involved. I know this is not what you want to hear. Here is a link to last year's annual UCSF patient conference and info on registration for the 2026 conference which takes place in April. I highly recommend watching it and you can pick and choose the subjects of interest. Watching last year's conference greatly influenced my decision for brachytherapy. https://cancer.ucsf.edu/research/programs/prostate/patient-conference

Clevelandguy

Hi,

I agree with the other survivors above, if it was me I would go with more proven treatments like surgery or radiation. 4+5 is nothing to mess around with in my humble non medical opinion.

Dave 3+4

contact

All this information has been well accepted and I thank you. Just recently I joined an support group of those with cancer treatments and in recovery. Heart warming to say the least. A second opinion has been talk about a lot and I believe this also will help me in my decisions of treatments. I know the cancer where it is now needs quick attention and another medical hospital like Dana Farber (recommended) will help.

Ron

Old Salt

Please, do make an appointment with Dana Farber ASAP. The second opinion can wait. You REALLY don't want the cancer to 'escape' the prostate.

BattleStar

https://csn.cancer.org/discussion/330013/focal-therapies

Hello contact, sorry to hear about your cancer. have they mentioned radiation. it can be very effective and yes oncology centers stick with protocols. no thinking outside the box on alternatives. maybe you should be think about a second opinion, after all it is your life at hand. I pray you get resolve and God bless you.