Focal therapy for prostate cancer in Ireland: addressing the national objective and subjective needs

Focal therapy has been approved by both NICE and EAU for localised prostate cancer treatment as part of a prospective registry; however, it is not yet available in Ireland. This study aims to assess the proportion of patients with prostate cancer who are suitable for this treatment and to assess attitudes amongst specialists in Ireland.

All patients with a new prostate cancer diagnosis in a tertiary-referral unit within a 12-month period had their radiological and clinicopathological parameters examined by an expert in the delivery of focal therapy to assess their suitability for treatment. Secondly, a questionnaire addressing current knowledge and attitudes was sent to all consultant urologists and trainees nationally.

Two hundred seven patients were seen in a prostate cancer diagnosis clinic in 2023. Following exclusions, of the 191 patients with clinically localised disease, 50% (n = 96: 8% GG1; 71% GG2, 16% GG3, 3% GG4) are technically suitable and 27% (n = 52: 6% GG1; 69% GG2, 19% GG3, 6% GG4) are ideal candidates for focal therapy. 23/28 trainees and 25/72 consultants responded to the survey (48%). Ninety-four percent routinely deal with prostate cancer diagnoses; however, almost 90% do not inform patients focal therapy is a treatment option. Forty-four percent of trainees and half of consultant prostatectomists are interested in learning focal treatment.

Although there is a lack of exposure amongst Irish urologists, there is considerable interest in introducing focal therapy nationally. Up to half of patients with new prostate cancer diagnoses may be suitable for treatment highlighting the potential for developing this service in Ireland.