Search IconSearch
January 2, 2024/Cancer/Surgical Oncology

Exploring Focal Therapies for Prostate Cancer (Podcast)

Patient factors and cancer characteristics are key to deciding between focal therapies and whole gland treatment


Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

Cancer therapies treat the entire prostate. But for a subset of patients, minimally invasive focal therapies that leave part of the prostate untreated may be an option. “[The key is] finding men who are intermediate risk, who based on imaging and based on biopsies have cancer localized to one small part of their prostate,” says Zeyad Schwen, MD, a urologic oncologist at Cleveland Clinic.

In a recent episode of Cleveland Clinic’s Cancer Advances podcast, Dr. Schwen discusses focal therapy for prostate cancer. He covers:

  • The difference between traditional treatments and focal therapies
  • Factors that make a patient a good candidate for focal therapy
  • Focal procedures, including Nanoknife, high-intensity focused ultrasound and cryotherapy
  • Risk of recurrence and salvage therapies
  • Clinical trials devoted to focal therapies


Click the podcast player above to listen to the episode now, or read on for a short edited excerpt.

Check out more Cancer Advances episodes at my.clevelandclinic.org/podcasts/cancer-advances or wherever you get your podcasts.

Excerpt from the podcast:

Podcast host Dale Shepard, MD, PhD: Let’s talk a little bit about what these procedures are, what these focal therapies are. Tell us a little bit about Nanoknife.

Dr. Schwen: This is a newer technology, a newer energy of what we call electroporation. What we do is we deliver high voltage current across the prostate tissue, usually in the form of a needle that disrupts the cell membrane of the cancer cell and then causes cell death. And so, they call it electroporation.

Essentially, it creates pores in the cell membrane, and then as a result, the cell dies. And what’s good about Nanoknife, which is the term that people use, is that it can be directed in a focal way, but also it reduces the collateral damage of the normal tissue around it. So, it has less collateral damage than some of the other energies that we have.

Another advantage of [Nanoknife] is that we can deliver it to other parts of the prostate that were
difficult to reach with other focal therapies, like the anterior prostate. The top of the prostate
traditionally was difficult to reach with some of our other focal therapies like HIFU, which is an
ultrasound ablation, and a lot of these have to be directed through the rectum. So, reaching the top of
the prostate is sometimes more challenging, and sometimes the urethra is in the way. The Nanoknife is another type of energy that allows us to deliver that energy to a focal part of the prostate at the top
that would be difficult to reach with HIFU.

Related Articles

Fluorescent imaging during small bowel surgery
April 11, 2024/Cancer/Surgical Oncology
Fluorescence Imaging Augments Surgical Inspection and Palpation for Small Bowel Carcinoid Tumors

Study demonstrates superior visualization of occult primary lesions

microwave ablation of liver tumor
150-Watt, Single-Antenna Microwave Ablation System Demonstrates Safety and Efficacy

New device offers greater tumor control for malignant liver lesions

23-CNR-4274323-CQD-pagets disease of the breast
October 30, 2023/Cancer/Surgical Oncology
Paget’s Disease of the Breast a Little Understood Form of DCIS

Rare cancer presents as unresolved changes of the nipple

breast cancer
October 6, 2023/Cancer/Surgical Oncology
Surgical De-Escalation for Benign High-Risk Breast Lesions

Are we ready for ‘observation’ of lesions found on core needle biopsy?

March 11, 2022/Cancer/Surgical Oncology
Hybrid Resection of a Fast-Growing Dumbbell Schwannoma: A Case Study

Two-day procedure prevents neurologic compromise for octogenarian

Liposarcoma biopsy under microscopy zoom in different ranges
March 10, 2022/Cancer/Surgical Oncology
Sarcoma Nestled Between Esophagus, Trachea and Aortic Arch: A Case Study

Preoperative chemotherapy enables successful surgical resection

3d illustration of a cross-section of a diseased skin with melanoma that enters the bloodstream and lymphatic tract
February 24, 2022/Cancer/Surgical Oncology
New Model Based on CD8 T Cells May Distinguish ICI Responders from Non-Responders in Melanoma

Study finds high levels of a CD8 T-cell subpopulation to be predictive of ICI resistance

Cross section of human breast cross section. 3d illustration
February 10, 2022/Cancer/Surgical Oncology
Bioimpedance Spectroscopy May Be Best Tool for Preventing Breast Cancer-Related Chronic Lymphedema

Low-strength electrical current identifies at-risk patients with greater accuracy than tape measurement