Thousands at Risk Due to Limited Access to Focal Therapy for Prostate Cancer

Thousands of men diagnosed with prostate cancer are at risk of life-changing side effects due to limited access to focal therapy, a treatment recently highlighted by former UK Prime Minister David Cameron. During an announcement on November 29, 2025, Cameron revealed his successful treatment with this targeted approach, which is less invasive than traditional surgical methods and radiotherapy.

Focal therapy is designed to minimize risks associated with prostate cancer treatment, particularly erectile dysfunction and urinary incontinence, which can affect up to 20 percent of men undergoing standard operations. The procedure allows for quicker recovery times and is significantly less expensive, with patients typically discharged within a day and requiring little follow-up care. Despite these advantages, only seven NHS hospitals in London and the South-East currently offer this therapy.

According to the charity Prost8, approximately one-third of men needing immediate treatment—around 17,000 annually—could benefit from focal therapy. Yet, only 600 to 700 men are currently being offered this option each year. Paul Sayer, founder of Prost8 and a prostate cancer survivor himself, criticized the NHS for failing to provide adequate treatment options. He stated, “I speak to men who are terrified and wrongly being led to believe they have only two options—surgery or radiotherapy.”

As focal therapy is relatively new, the National Institute for Health and Care Excellence has urged caution, emphasizing the need for more evidence regarding its effectiveness before widespread adoption within the NHS. The National Screening Committee has also advised against routine screening for all men, despite findings suggesting it could reduce prostate cancer mortality by 13 percent. Instead, screening is recommended only for men with the genetic variants BRCA1 and BRCA2.

In the UK, approximately 63,000 men are diagnosed with prostate cancer each year. Of these, about 10,000 cases are deemed incurable. Another 5,600 men are diagnosed with early-stage disease that requires monitoring. Most remaining patients undergo either surgery to remove the prostate or radiotherapy, which treats the entire organ. In contrast, focal therapy specifically targets the tumor, preserving healthy tissue through methods such as laser ablation, sound waves, cryotherapy, or electrical pulses.

The financial implications of focal therapy are also noteworthy. The equipment necessary for this method is considerably less expensive than standard robotic surgery, costing around £500,000 per unit compared to £1.7 million for robotic systems. Data indicate that focal therapy costs the NHS an average of £5,400 per patient, while traditional surgery can run up to £15,000 and radiotherapy about £10,000.

Professor Hashim Ahmed, chair of urology at Imperial College London, expressed concern over the current capacity for providing focal therapy, stating, “Hospitals offering it cannot cope with demand. We need more hospitals, surgeons, and capacity.” An NHS spokesperson reiterated that current guidance highlights limited evidence concerning the effectiveness of cryotherapy and high-intensity focused ultrasound, advising against their routine availability.

The situation raises critical questions about equitable access to innovative cancer treatments and the need for further investment in healthcare resources to ensure that all patients receive the best possible care.