Q: What type of patients can have Targeted Focal Therapy (TFT) for prostate cancer?

A: Patients who are diagnosed with early stage prostate cancer with focal disease within the prostate and an average sized prostate.

Q: Do I have to have a Mapping Biopsy to have TFT?

A: If you are considering TFT, you need to have a 3D-mapping biopsy (discuss with your doctor). You should have:

1- Small cancer volume of less than 30% of the total prostate volume.

2- Localized prostate cancer areas, which are confined to the prostate.

3- The cancer is at safe distance from the vital organs, such as the urethra and rectum.

Q: How many patients that have an initial biopsy of the prostate that indicates a low risk prostate cancer are found to have much more extensive disease based on the 3D mapping biopsy?

A: We performed 3D mapping biopsies on more than 150 patients with newly diagnosed focal and low risk disease. Not surprisingly, 65 out of the 150 men (43%) where found to have more extensive or aggressive disease, these men needed more aggressive treatment such as radical surgery or radiation.

Q: What are the complications seen after the mapping biopsy?

A: The mapping biopsy is performed under light sedation, patients are discharged from the hospital the same day and the majority of patients recover within 24 hours. However, few patients (5-10%) experience bleeding in the urine that is usually self-limiting within 24-48 hours. We did not have any cases of infection, however, it is a potential risk for any invasive procedure, even when minimal.

Q: What are the side effects seen after TFT?

A: Typically, patients are treated in 2 hours and sent home the same day. The majority of the patients resume their daily activities within 24 hrs. None of our patients has developed any serious adverse events such as urinary incontinence or rectal injury. The majority (80% of the cases) of the patients recovered the level of sexual activity they had before the operation within 3-6 months.

Q: Is the TFT procedure done anywhere else in the US?

A: Yes, in few private practices around the US, some urologists attempted to treat one side of the prostate and perform extensive biopsy on the other side of the prostate. Our study is the first trial of targeted focal cryotherapy performed at an academic institution and has received approval of the local ethical (IRB) and scientific (PRMC) committees.

 See an example of the different steps from Patient Admission to Follow-up: [ Patient algorithm ]

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