Survey says most prostate cancer patients never hear of focal therapy

A new survey from The Focal Therapy Clinic says 93% of men had never heard of focal therapy before a prostate cancer diagnosis, even as a 10-year NHS study led by Imperial College London found the treatment can control cancer as well as surgery or radiotherapy with fewer sexual and continence side effects. Campaigners say limited NHS access and weak patient awareness are leaving many men without a treatment option they may prefer.

Why it matters: - Focal therapy may give suitable prostate cancer patients cancer control comparable to surgery or radiotherapy with a lower risk of erectile dysfunction and incontinence. - The survey suggests many men never learn about the option before choosing treatment, even though sexual function is a major concern at diagnosis. - Limited NHS availability means access still depends heavily on where a patient lives.

What happened: - Imperial College London published a 10-year NHS study today showing focal therapy delivers cancer control as good as surgery or radiotherapy, with less than half the risk of life-changing side effects such as erectile dysfunction and incontinence. - The Focal Therapy Clinic surveyed 253 prostate cancer patients treated with focal therapy. - The survey found 93% of men had never heard of focal therapy before diagnosis. - Only 5% said focal therapy was offered at diagnosis. - Many patients instead were offered surgery, hormone therapy or radiotherapy.

The details: - 84% of patients said they were worried about erectile dysfunction before treatment. - 67% said they often or regularly thought about erectile dysfunction. - 29% said they thought about erectile dysfunction constantly. - 82% were worried about the quality of their sex life. - 61% frequently thought about how treatment might affect sex life. - 71% worried about lower libido. - 40% thought about lower libido often or constantly. - 55% of patients reported concerns about mental health before treatment. - 54% said they had little or no real knowledge of prostate cancer before diagnosis. - 45% did not know prostate cancer can appear without symptoms. - 20% were unaware of PSA testing. - 32% had no knowledge of treatment options before diagnosis. - Nearly two-thirds, or 64%, said they found out about focal therapy through independent online research. - Imperial College London data shows the risk of incontinence, erectile dysfunction and rectal problems falls five-fold with focal therapy. - Raj Nigam, senior co-author on the Imperial paper and consultant urologist at The Focal Therapy Clinic, said the study is the largest and longest dataset on focal therapy, with almost 3,500 patients followed over ten years. - Nigam said the data show extremely low metastasis rates, very few prostate cancer deaths and low recurrence rates requiring further radical treatment. - Nigam said carefully selected high-risk patients made up around a quarter of those treated in the study. - Nigam said that broadens the group who could benefit beyond the roughly 20% of patients previously considered eligible. - Focal therapy targets only the cancerous area of the prostate. - Routine NHS access is limited to 10 centres in England.

Between the lines: - The survey points to a communication gap, not just a treatment gap. - Patients appear to be making decisions under heavy fear about sexual function and mental health, while many do not know focal therapy exists. - Campaigners are framing the limited NHS rollout as a postcode lottery. - Nigam argued the new ten-year data removes the main evidence barrier to adding focal therapy to NICE guidance for primary treatment. - NICE has previously cited the lack of ten-year data as the reason not to include focal therapy in the guideline.

What's next: - Campaigners are calling on NICE to review the evidence so focal therapy can be offered to every suitable man. - A guideline change would not happen immediately, but the new study strengthens the case for one. - Clinicians may now be more able to present focal therapy as a safe, established alternative to radical treatment. - The Focal Therapy Clinic says the goal is broader and fairer access for patients who qualify.

The bottom line: - The new evidence may settle whether focal therapy works; the bigger question now is whether patients will actually be told about it and be able to get it.