In prostate cancer, we offer a treatment approach that prioritizes both cancer control and quality of life through advanced imaging techniques and targeted treatment strategies.
For many years, the main treatment options in prostate cancer were surgery or radiotherapy. Today, focal therapy, which aims to treat only the cancerous lesion in suitable patients, has become an important alternative.
Focal therapy is not suitable for every patient. Proper patient selection is made through advanced prostate MRI, targeted biopsy, and detailed evaluation.
The goal is not only to control the cancer, but also to preserve urinary control and sexual function as much as possible.
Prostate cancer is often a slow-growing disease, but it can lead to serious consequences when not diagnosed early. One in every 8 men is at risk of developing it during their lifetime.
Today, the diagnostic pathway has changed. In cases of elevated PSA, multiparametric prostate MRI is recommended before proceeding directly to biopsy. This helps clarify suspicious lesions and allows biopsy to be completely avoided in approximately one quarter of patients.
Accurate MRI, correct interpretation, and targeted biopsy reduce unnecessary procedures and help determine the correct risk group.
The focal therapy process begins with detailed patient selection. PSA, prostate MRI, biopsy findings, and, if available, PSMA PET results are evaluated together.
In eligible patients, the procedure is performed under general anesthesia. In most cases, a one-night hospital stay is sufficient. After an average one-week catheter period, the patient returns to normal daily life.
The follow-up process is at least as important as the procedure itself. During the first two years, close follow-up is carried out with PSA every three months and prostate MRI once a year.
Fill out the form, and our expert team will contact you as soon as possible.
Prostate cancer is the most common cancer in men. It often does not cause symptoms in the early stages. For this reason, regular PSA testing and urological examination are very important for early diagnosis. When detected early, treatment options are broader and outcomes are more successful.
No. PSA is an important marker, but it is not sufficient on its own to establish a diagnosis. PSA can also be elevated in benign conditions such as prostatitis. In addition, cancer may still be present even when PSA is within normal limits. Therefore, PSA must always be interpreted together with clinical evaluation and imaging.
In the current approach, direct biopsy is not recommended. First, a multiparametric prostate MRI is performed. MRI helps identify suspicious areas, and in some patients, biopsy may not be necessary at all. This approach reduces unnecessary biopsies.
Prostate MRI is one of the most critical steps in the diagnostic process when prostate cancer is suspected. It helps identify suspicious areas accurately. An incorrectly performed or misinterpreted MRI can lead both to unnecessary biopsy and to missing the actual lesion. For this reason, it is important that the scan is performed and interpreted in experienced centers.
A biopsy is the procedure of taking tissue samples from the prostate gland. Today, targeted biopsy directed at suspicious areas seen on MRI is recommended. This increases the likelihood of sampling the cancerous lesion accurately and has largely replaced blind biopsy.
Transrectal biopsy is performed through the rectum and carries a low but real risk of infection. Transperineal biopsy is performed through the area between the anus and the testicles and has a significantly lower risk of infection. Current guidelines recommend the transperineal approach whenever possible.
Targeted biopsy is the direct sampling of suspicious areas seen on MRI. The most commonly used method is fusion biopsy, where MRI and ultrasound images are combined. This method provides higher accuracy compared with conventional random biopsy.
Both are important. However, biopsy is a highly sensitive and multi-step procedure. Accurate interpretation of MRI, correct marking of the lesion, and proper execution of the fusion process all require experience. The device alone is not enough; the experience of the physician performing the procedure is the determining factor.
Focal therapy is the treatment of only the cancerous lesion rather than removing the entire prostate. The goal is to control the cancer while preserving healthy tissue. This approach has been practiced worldwide for approximately 20 years. In suitable patients, it may be an alternative to surgery and radiotherapy. The main aim is both cancer control and preservation of quality of life.
Focal therapy is not suitable for every patient. It is generally considered for patients with cancer limited to a specific region of the prostate and within the intermediate-risk group. Proper patient selection requires advanced prostate MRI, targeted biopsy, and detailed evaluation. On average, only 1 out of every 4 to 5 patients is an appropriate candidate. The decision is always individualized.
In surgery and radiotherapy, the entire prostate is generally targeted. In focal therapy, only the cancerous area is treated. For this reason, the risk of urinary incontinence and sexual dysfunction is generally lower. In addition, the recovery period after treatment is faster. The most important difference is that it is an organ-preserving approach.
Scientific data show that, in appropriate patients, cancer control rates are similar to surgery. In follow-up studies of around 8 years, the recurrence rate is approximately 15%. However, each patient’s risk is different. What matters most is proper patient selection and regular follow-up. Cancer control and quality of life must be evaluated together.
Side effects are lower compared with conventional treatments. The risk of urinary incontinence is approximately 0 to 1%, and the risk of erectile dysfunction is around 5 to 10%. These rates are not the same for every patient; the location of the lesion within the prostate is a key factor. The rarest complication is fistula, and its rate is very low. In experienced centers, risks are reduced even further.
Recurrence does not mean that the treatment has failed. After focal therapy, the same method can be applied again if needed. Surgery or radiotherapy can also be considered when necessary. Focal therapy does not eliminate future treatment options. This flexibility is an important advantage.
Different energy sources are used in focal therapy. The most common methods are HIFU, cryotherapy, and IRE. There is no single “best” method for every patient. The location and size of the lesion, as well as the patient’s anatomical characteristics, are key factors in selection. The most appropriate energy source is determined through personalized evaluation.
Regular follow-up is very important after treatment. During the first two years, PSA testing is generally performed every 3 months. Prostate MRI is recommended once a year. This allows possible recurrence to be detected early. Long-term follow-up is an integral part of treatment.
First 2 years:
Between years 2 and 5: