Think of focal therapy like this:

Treating only the diseased part of the prostate, not the entire gland.

In other words, we target the cancer and avoid touching healthy tissues.

This approach is not a new trend.

It is a treatment method that has been used worldwide for more than 20 years and has strong scientific evidence.

Especially in early-stage and suitable patients, it provides a strong alternative to conventional surgery or radiotherapy.

The most important difference:

Patients do not have to disconnect from their daily lives during treatment.

The risk of side effects is lower and the recovery process is much faster.

Is it suitable for every patient? No.

But there are many suitable cases, and for the right patient it is a very valuable option.

No. Today, in selected patients there is another option called focal therapy that can offer significant advantages for the patient.

Focal therapy is a modern approach that precisely targets the cancerous area while preserving healthy tissue.

The aim is not only to treat the cancer.

It is to treat the disease while preserving urinary control, sexual function, and overall quality of life.

Today medicine increasingly focuses on personalized and targeted treatments.

In prostate cancer, focal therapy has become one of the important options on the table.

The biggest fears are usually:

“Will I lose urinary control?”

“Will my sexual life end?”

These fears are very real and completely understandable.

This is exactly where focal therapy becomes important.

Because the goal is not only cancer control, but also preserving the patient’s functional life.

When we treat only the problematic area without removing the entire prostate,

urinary control and sexual functions can often be preserved much better.

For me, success is not only controlling the cancer, but also ensuring that my patient can continue life with confidence after treatment.

Focal therapy is not suitable for everyone.

A very detailed evaluation must be performed first.

Advanced prostate MRI, targeted biopsies and proper patient selection are required.

Only about 1 out of every 4 to 5 prostate cancer patients is suitable for this treatment.

We never say “this must definitely be done” to any patient.

We proceed according to the principle of the right patient and the right treatment.

The most important thing is:

Patients should know their options.

Because in prostate cancer, there is no longer only one path.

Scientific data show the following:

In studies from the United Kingdom where 1200 patients were followed for 8 years,

cancer control rates of focal therapy and prostate surgery were found to be similar.

In both methods, the recurrence rate is approximately 15%.

But the difference is this:

Side effects are much lower with focal therapy.

Cancer control is similar, but quality of life is better.

First of all, it must be clearly stated:

Compared with surgery and radiotherapy, focal therapy has the lowest rate of side effects.

The risk of urinary incontinence is approximately 0–1%

The risk of erectile dysfunction is around 5–10%

These rates may vary from patient to patient.

The rarest complication is fistula.

Its reported rate in the literature is about 0.2%.

With experienced teams and correct patient selection, the risk becomes extremely low.

“What if the cancer returns?”

Let me say this clearly:

This is not the end of the world.

One of the biggest advantages of focal therapy is:

It does not eliminate future treatment options.

If necessary, focal therapy can be repeated.

If necessary, surgery or radiotherapy can still be performed.

Focal therapy provides flexibility for the patient.

We follow patients very closely:

PSA test every 3–6 months

Prostate MRI once per year

According to data from the United Kingdom, 80% of patients who developed recurrence were treated again with focal therapy.

The probability of eventually requiring surgery is only around 2–3%.

This shows one important truth:

Correct patient selection is everything.

Today there are approximately 7–8 different energy sources used for focal therapy.

The most common ones are:

HIFU (heating method)

Cryotherapy (freezing method)

IRE (irreversible electroporation)

Which one is the best?

There is no single best method for everyone.

Factors such as the location of the lesion, its size and the patient’s anatomy are decisive.

Therefore treatment must always be individualized.

Unfortunately, many patients have never even heard of focal therapy.

If suitable patients were aware of this option, preference rates might increase.

Focal therapy requires a very strong infrastructure:

High quality prostate MRI

Targeted biopsy

PSMA PET imaging

Multiple energy sources

An experienced team

The follow-up process is as important as the treatment itself.

The literature shows:

Centers with insufficient experience tend to have worse results.

Therefore patients should choose:

• The right center
• The right team
• The right patient selection
• The right follow-up

There is only one reason why we record these videos:

Patients diagnosed with prostate cancer should know their alternatives.

Because knowledge reduces fear.

Focal therapy is a method that has been used worldwide for many years and provides encouraging results in appropriate patients.

Our aim is not to ignore the cancer.

Our aim is to offer a smarter, more targeted and more humane treatment approach.

If you have been diagnosed with prostate cancer, learn about all your options.

Because the right information leads to the right decision.

Is focal therapy suitable for everyone? No.

But in the right patient it is a very strong option.

The ideal patient is someone with a clearly visible, localized cancer focus on one side of the prostate.

Patients with intermediate-risk cancer such as Gleason 3+4 or 4+3 and a life expectancy of more than 10 years are generally suitable candidates.

Some patients with multiple low-risk lesions on the same side may also be candidates.

In summary:

With proper patient selection, effective treatment is possible without removing the entire prostate.

Medicine has been undergoing a transformation for a long time.

In many cancers today we no longer remove the entire organ, we treat only the cancerous part.

In prostate cancer we have reached the same point.

With advanced MRI technology we can see the location and boundaries of the cancer much more clearly.

This allows us to:

Target only the cancer focus instead of removing the entire prostate.

This is the modern logic behind focal therapy.

If recurrence occurs after 5 or 10 years, is that really a failure?

If the patient has preserved urinary control, sexual function and normal life during that time,

this is actually a major achievement.

Technology is also advancing rapidly.

Even today’s focal therapy devices are far more advanced than those from 10 years ago.

Controlling cancer while preserving function is a very important success.

If recurrence develops and the patient decides to undergo surgery, the most common question is:

Does previous focal therapy make surgery more difficult?

The answer is clear: No.

Studies comparing patients who had focal therapy followed by surgery with those who had surgery directly found no significant difference in functional outcomes.

In other words:

Focal therapy does not negatively affect a potential future surgery.

Today the most commonly used energy source in focal therapy is HIFU.

In HIFU, ultrasound waves are concentrated at a specific point to generate high heat and destroy the cancer tissue in a controlled manner.

One of the most important advantages of this method is that it has been used for many years.

Its effectiveness has been scientifically proven and there are numerous publications in the literature.

Another newer energy source, irreversible electroporation (IRE), is also rapidly spreading worldwide and is increasingly used in clinical practice.

According to current data, the effectiveness of different devices is quite similar.

In devices called robotic, there is actually no procedure performed independently by a robot.

Some manual steps performed by the operator are simply automated.

Although it may appear more practical, automation can sometimes create disadvantages compared with manual control.

Ultimately everything still depends on the experience of the operator.

No matter which device is used, the most important factor determining success is the knowledge and experience of the physician performing the procedure.

Unfortunately, many patients are still not aware of focal therapy as a treatment option.

If properly informed, a significant proportion of suitable patients might prefer this approach.

While focal therapy is rapidly becoming widespread in developed countries, its adoption is still slower in developing regions.

The main reason is clear:

Focal therapy requires a highly advanced infrastructure and significant expertise.

In our approach, we rely on:

• High-quality prostate MRI
• Advanced targeted biopsy techniques
• PSMA PET-CT or PET-MRI imaging
• Multiple energy sources such as HIFU, IRE, and cryotherapy

This allows us to select the most appropriate treatment strategy for each individual patient.

Over the past 5+ years, we have performed focal therapy in more than 250 patients, gaining substantial experience and achieving successful outcomes.

However, treatment alone is not enough.

The follow-up process is equally critical.

Accurate interpretation of post-treatment prostate MRI requires a high level of expertise.

As you can see, focal therapy is a multi-step process where each stage must be optimized.

Scientific literature clearly shows that centers lacking sufficient experience tend to have poorer outcomes.

For this reason, patients should prioritize:

• Proper patient selection
• The right treatment strategy
• An experienced medical team
• A structured and consistent follow-up process

Because in focal therapy, success is not based on a single step —
it is the result of doing every step correctly.