Focal therapies represent an advanced strategy for the localized treatment of prostate cancer. These are precise techniques – such as cryotherapy, HIFU, or TPLA – designed to treat only the diseased portion of the prostate gland, preserving the remaining healthy tissue and functionality.

Focal therapy procedures are minimally or, in some cases, micro-invasive treatments performed under ultrasound or MRI-fusion guidance. They are designed to target only the tumor core (or dominant lesion – Target), sparing the healthy prostate tissue. These techniques aim to balance oncologic effectiveness with a reduction in the side effects commonly associated with radical treatments.

Focal therapies may be considered for specific types of localized prostate cancer (for instance, cancer with low to intermediate aggressiveness – Gleason score 6 or 7 – confined to a clearly defined area). Potential advantages include:

• Minimal hospital stay: often outpatient procedures or short post-operative recovery
• Lower risk of urinary and sexual dysfunction compared to prostatectomy or radiotherapy
• Repeatable in case of local recurrence, with no limitations for future treatments
• Intermediate option between active surveillance and radical therapy

• Cryotherapy
• High-Intensity Focused Ultrasound (HIFU)
• Focused lasers (e.g., Focal Laser Ablation, TPLA) under MRI guidance
• Emerging techniques such as Photodynamic Therapy (PDT) and Irreversible Electroporation (IRE)

According to international consensus, focal therapies are mainly indicated for patients with localized low- to intermediate-risk tumors. This includes those with a Gleason score ≤ 7 (3+3; 3+4; low-volume 4+3), unifocal disease (i.e., lesion limited to the target biopsy zone), or – in selected cases – multifocal disease.

Professor Pierluigi Bove is an internationally recognized expert in focal therapy, with an established scientific and clinical background. He serves as an international consultant and proctor for Galil Medical in prostate and kidney tumor cryoablation procedures. He is also a lecturer and proctor for Elesta Laser for TPLA (Transperineal Prostate Laser Ablation).

2. Are focal therapies safe? What is their success rate?

Focal therapies have a very favorable safety profile: most patients are treated on an outpatient basis or require only a short hospital stay, and can resume daily activities quickly. The risk of serious complications is significantly lower than with radical surgery, and urinary and sexual functions are generally preserved.

Regarding success rates, while clinical data are still evolving, results are encouraging—especially in carefully selected patients with low- or intermediate-risk tumors. In centers of excellence such as those where Prof. Bove practices, focal therapies are performed with advanced technologies (cryoablation probes, high-precision lasers, focused ultrasound) and guided by multiparametric MRI, allowing for highly accurate treatment planning.

The duration of a focal therapy procedure depends on the technique used (laser, HIFU, cryotherapy, etc.) and the size and location of the lesion. On average, prostate-targeted procedures last between 30 and 90 minutes and may be performed with regular hospital admission (although many patients can be discharged the same day or the following morning).

One of the most appreciated benefits of focal therapies is rapid recovery: being minimally invasive, physical impact is low. Most patients can resume everyday activities within 48–72 hours, avoiding strenuous effort during the first week and following personalized clinical instructions.

Post-operative management is also simpler than with traditional surgical approaches: no external surgical incision, little to no pain, and often no need for a catheter—or only for a short time.

Thanks to the selective nature of the treatment, focal therapies offer fast recovery, preserved quality of life, and careful, non-invasive oncological monitoring.

Professor Pierluigi Bove practices at leading healthcare facilities such as Policlinico Tor Vergata in Rome, within the Robotic Urology Unit (UOSD URMI), and at the UPMC Salvator Mundi International Hospital, both equipped with state-of-the-art technologies.
Thanks to his extensive experience and the support of a multidisciplinary team, each patient is followed through every stage: from diagnosis to treatment and post-operative follow-up. To schedule an appointment or request a consultation, you can use the contact form available on the website.