The treatment, known as focal therapy, targets cancer cells within the prostate while leaving surrounding healthy tissue intact. Doctors say this approach can significantly reduce the risk of common side effects associated with surgery and radiotherapy, including erectile dysfunction and incontinence.
Focal therapy was introduced in the UK in 2006. Experts estimate that up to 15,000 men each year could benefit from it, yet it remains available only in a limited number of NHS centres, primarily in London.
Around 60,000 men are diagnosed with prostate cancer annually in the UK. However, clinicians say many patients are not informed about focal therapy as a potential option when discussing treatment plans.
There are three main types of focal therapy used in the UK. High intensity focused ultrasound, known as HIFU, uses sound waves to generate heat and destroy cancer cells. Cryotherapy involves freezing cancerous tissue using extremely cold temperatures delivered through fine needles. The third technique, NanoKnife, also known as irreversible electroporation, uses electrical pulses to destroy tumour cells without heat.
NanoKnife has been authorised for use in the UK under special arrangements by the National Institute for Health and Care Excellence. Despite this, it is routinely offered in only a small number of NHS hospitals, although it is also available privately.
Lord Cameron of Chipping Norton revealed last year that he had been diagnosed with prostate cancer and chose to undergo focal therapy privately.
Professor Hashim Ahmed, chair of urology at Imperial College London, who helped introduce focal therapy in the UK, said patients should be made aware of all available treatment options. He argued that in some cases doctors continue to recommend whole gland removal or radiotherapy without discussing focal therapy.
He explained that prostate tumours are often small and that removing the entire gland may not always be necessary. According to him, newer technologies such as NanoKnife offer effective treatment while reducing damage to surrounding tissues.
Ahmed also highlighted clinical evidence suggesting strong outcomes. A US study involving patients treated with NanoKnife found that the majority preserved erectile function and urinary continence. By contrast, surgery to remove the prostate is associated with a higher rate of these side effects.
A separate study conducted by researchers at Imperial College London examined more than 500 cases in England and found that salvage focal therapy for cancer that had returned after radiotherapy was as effective as surgery, with fewer complications reported among patients who underwent the less invasive treatment.
Supporters of wider adoption say focal therapy should be made available across the country so patients can make fully informed decisions in consultation with their doctors. They argue that expanding access would not replace existing treatments but would provide additional options tailored to individual cases.
As awareness grows, campaigners are calling for greater transparency and consistency in how prostate cancer treatments are offered within the NHS, ensuring that all eligible patients are informed about focal therapy alongside traditional approaches.
