A personalized treatment strategy, defined by a medical team and discussed with the patient.
Prostate cancer treatments
Treatment strategy
The treatment strategy is adapted to each individual case. It depends first and foremost on the characteristics of the cancer affecting the patient: location, grade, and stage. It also depends on the patient’s age and lifestyle, in particular their sexuality. The choice of treatments is discussed by a panel of at least three doctors representing multiple specialties. The proposed treatment is then presented to and discussed with the patient.
Active monitoring
Active monitoring is a personalized approach taken for prostate cancer not requiring immediate treatment. It aims to delay treatment, and the side effects that can accompany it, until such time as it becomes necessary. This strategy involves closely monitoring how the cancer progresses, based on regular examinations such as PSA tests, MRI scans, and biopsies.
Active monitoring is generally recommended for patients with low-risk prostate cancer.
For more information, see www.urofrance.org/publications/fiches-infos-patients
Therapeutic ultrasound (HIFU):
minimally invasive treatment with no incisions and no radiation
minimally invasive treatment with no incisions and no radiation
HIFU treatment of localized prostate cancer by has been studied since the 1990s and has now been used regularly for more than 15 years. It is a minimally invasive, incision-free surgical technique. It involves directing convergent ultrasound waves towards a focal point, where their sudden and intense absorption causes temperature to rise almost immediately (over 70°C/160°F), thereby destroying the cells situated in the target zone without damaging the healthy tissue around it. This energy is delivered through a probe placed in the rectum, which is situated right behind the prostate. Treatment efficacy is monitored in real time via ultrasound. Since 2015, HIFU treatment has been “conformal” thanks to an increase in the number and adaptability of ultrasound sources (Focal One®). Based on tumor size and other factors, the urologist can now adjust the size of the required ablation area to provide more personalized treatment.
The interesting aspect of this approach lies in the high rates of preservation of urinary continence, erection, and quality of life.
Surgery (radical prostatectomy)
In a radical prostatectomy, the prostate gland is removed entirely, along with the seminal vesicles and sometimes the surrounding lymph nodes. Surgery is one of the standard treatments for localized prostate cancer. This surgery is complex and requires general anesthesia. It can be performed as open surgery or by potentially robot-assisted laparoscopy. There are side effects.
For more information, see
www.urofrance.org/publications/fiches-infos-patients
External radiotherapy
For this treatment, the region is irradiated with high-energy rays. These rays (photons, protons) cause lesions to the DNA of the cell nucleus. Treatment is generally given during regular sessions held over several weeks. Hormone therapy is also often associated with this. There are side effects. Digestive, urinary, or sexual symptoms may appear several months after radiotherapy: rectal bleeding, more frequent or irregular stools, cystitis (frequent need to urinate, urgency), burning sensation during urination, or bleeding. Urinary incontinence is rare. Erection difficulties can onset progressively over the following months or years, and are often improved by medical treatments.
For more information, see
www.urofrance.org/publications/fiches-infos-patients
Brachytherapy
This technique consists of placing radioactive seeds into the prostate to irradiate and destroy the cancer cells. This treatment is carried out under general or locoregional anesthetic. There are side effects.
For more information, see
www.urofrance.org/publications/fiches-infos-patients
For more information
HIFU treatments
Focal One® – Robotic focal HIFU treatment
Focal One is a medical device used to treat localized prostate cancer by ultrasound (HIFU), subject to certain criteria.
HIFU treatment: advantages for the patient
Treatment of localized prostate cancer with High-Intensity Focused Ultrasound (HIFU) is considered a minimally invasive procedure, meaning that no incision is made and therefore no scar is left.
HIFU treatment results
In 2024, a published French trial(1) including more than 3300 patients enrolled at 46 sites proved the non-inferiority of HIFU treatment compared with standard surgery, in terms of oncological results at
30 months.