In most patients with a localized tumor of the prostate the whole gland must be treated, either by complete removal of the tumor or by radiation therapy. This is necessary, as in 80% of the cases the many tumor foci are spread throughout the whole of the prostate. Such a tumor is called a multifocal tumor.
Cases in which the whole gland is not affected
New, improved diagnostic methods enable early diagnosis and targeted treatment of the few focal tumors. Nowadays, it is possible to detect tumors that have only one focus (unifocal), or tumors that are restricted to one area, for instance, to the lateral lobe of the prostate. Such tumors, detected at an early stage, can be treated with so-called focal therapy.
However, focal therapy is only suited to certain patients; the general state of health plays a role and many criteria must be carefully evaluated. Apart from the prostate cancer being restricted to one or very few tumor foci within the prostate, the Gleason score (which reflects the extent of the tumor and degree of tissue alteration) may not exceed 3+3 or 3+4. The PSA value is also a criterion. Focal therapy can only be considered if the value is below 15 ng/ml. It is also a possibility if you do not wish to have an operation, or if an operation is not suitable for health reasons.