Focal Therapy and Combination Treatments in Prostate Cancer

Focal therapy and combination treatments are reshaping prostate cancer management, offering new hope for precision and patient outcomes.

Managing prostate cancer increasingly demands strategies that balance oncologic control with preservation of sexual and urinary function. These developments represent a milestone in innovations in urology, reflecting technological advances across targeted ablation techniques. Focal therapies such as HIFU, cryoablation and irreversible electroporation now provide minimally invasive options that achieve effective disease eradication while minimizing collateral tissue damage.

Building on this approach, image-guided navigation is transforming procedural accuracy by integrating advanced MRI and fusion biopsy data into treatment planning. This synergy enables urologists to localize cancerous lesions precisely and tailor energy delivery, thereby reducing side effects and improving functional outcomes, as demonstrated by the efficacy of image-guided navigation.

While focal therapies continue to evolve, systemic management of metastatic hormone-sensitive prostate cancer (mHSPC) is also undergoing a paradigm shift. The addition of darolutamide to androgen deprivation therapy demonstrated significant survival benefits and an acceptable safety profile in the ARANOTE trial on darolutamide efficacy, leading to its regulatory endorsement.

Global registry analyses reveal that early aggressive combination strategies are becoming standard for mHSPC. An international study on mHSPC treatment trends shows rising use of novel hormonal agents upfront, correlating with improved overall survival and patient-reported quality of life.

As these technologies become more accessible, their integration into standard practice could redefine patient outcomes in prostate cancer care.

Key Takeaways:

• Focal therapies offer minimally invasive cancer control while preserving quality of life.
• FDA-approved image-guided platforms are enhancing precision in prostate cancer treatment.
• Combining darolutamide with ADT significantly improves survival outcomes in mHSPC.
• Early integration of novel hormonal agents is shifting mHSPC treatment paradigms.