If you've been diagnosed with localised prostate cancer, you might be weighing up your treatment options. ProFocal is a new focal therapy that uses laser ablation to target cancer cells in the prostate. It's designed to treat only the affected area, leaving the rest of your prostate untouched. Think of it as precision work rather than a blanket approach.
How does laser ablation with ProFocal work?
ProFocal uses a special needle with a laser fibre at its tip. The needle is inserted through the perineum, the area between your scrotum and back passage, in much the same way a transperineal prostate biopsy is done. The laser fibre delivers controlled energy to destroy cancer cells in the targeted area.
What makes this treatment different is the built-in cooling system. It surrounds the laser fibre and moderates the temperature while the treatment is happening. This helps protect the healthy tissue around the tumour. Only the cancer is treated. The rest of your prostate stays intact.
Who is laser ablation suitable for?
Not everyone with prostate cancer will be a candidate for ProFocal. It's best suited to men with intermediate-risk, localised prostate cancer. Your tumour needs to be visible on an MRI scan and confined to one area of the prostate.
The advantage of focal therapy like this is clear. Because the treatment is limited to the cancer itself, you're less likely to experience the side effects that come with treating the whole gland. That matters when you're thinking about your quality of life after treatment.
What happens during the procedure?
The ProFocal procedure typically takes just over an hour. You'll be under general anaesthetic, so you won't feel anything while it's happening. The laser ablation is carried out with real-time imaging guidance to make sure the right area is being treated.
Most patients go home the same day once they've recovered from the anaesthetic and passed urine without difficulty. It's a day-case procedure in most cases, which means less disruption to your routine.
What are the potential side effects of laser ablation?
As with any medical procedure, there are some side effects to be aware of. You might notice mild bleeding in your urine for a short time afterwards. Some men experience discomfort or bruising around the perineum where the needle was inserted. Temporary urinary symptoms can also occur.
There's a small chance of weaker erections after treatment, though the risk is lower than with whole-gland treatments. The risk of infection is low. If you have any concerns about side effects, it's worth discussing them during your consultation so you know what to expect.
What follow-up is needed after laser ablation?
Follow-up is an important part of your care. You'll need an MRI scan several months after the procedure to check how well the treatment has worked. You'll also have another prostate biopsy to confirm that the tumour has been successfully ablated.
If any cancer cells remain, a repeat laser ablation can be considered. Alternatively, your consultant may recommend a different type of treatment. The good news is that focal therapy doesn't close the door on other options if they're needed later.
Where can you access ProFocal treatment?
ProFocal was developed by Dr Celi Varol at Medlogical Innovations in Australia. It's currently being assessed within the NHS at Guy's Hospital in London under a strict clinical protocol. This is the first centre in Europe to use laser ablation for prostate cancer in this way, and I'm part of the team led by Mr Rick Popert.
The technology isn't yet available in the private sector in the UK, but that may change if it receives formal approval. In the meantime, eligible patients can access it through the NHS pathway at Guy's Hospital.
Is laser ablation the right choice for you?
ProFocal offers a targeted, minimally invasive option for men with suitable localised prostate cancer. It preserves healthy tissue and aims to reduce the side effects that can affect your daily life. But it's not right for everyone, and your individual situation matters.
If you'd like to find out whether laser ablation with ProFocal could be a good fit for you, I'd encourage you to get in touch. We can discuss your diagnosis, your MRI findings and what your options look like. You can book a consultation to talk through your next steps in a way that feels right for you.