Hong Kong Pioneers Multimodal Focal Therapy for Prostate Cancer Treatment

Hong Kong – In a significant medical breakthrough, The Chinese University of Hong Kong (CUHK) has established itself as a pioneer in Asia by introducing and systematically evaluating multimodality focal therapy for prostate cancer treatment. This innovative approach is transforming the landscape of prostate cancer care, offering patients a less invasive alternative to traditional radical surgery while maintaining excellent cancer control outcomes.

 

A Revolutionary "À La Carte" Approach

Unlike conventional treatments that often involve removing the entire prostate gland, focal therapy precisely targets only the cancerous tissue, similar to performing a "lumpectomy" for the prostate. CUHK's pioneering work represents the first systematic introduction of this multimodality approach in Hong Kong, providing patients with personalized treatment options tailored to their specific tumour characteristics.

Since 2019, the medical team at CUHK has successfully treated 102 patients with localized, low-to-intermediate-risk prostate cancer using three advanced focal therapy modalities:

• High-Intensity Focused Ultrasound (HIFU) – utilizing thermal energy from ultrasound waves to destroy cancer cells

• Cryotherapy – freezing and destroying cancer cells through targeted cold application

• Targeted Microwave Ablation (TMA) – delivering precise heat via microwave energy to eliminate tumours

Dramatic Reduction in Treatment Time and Complications

The results from Hong Kong's pioneering programme have been remarkable. Compared to conventional radical prostatectomy, which typically requires 180 to 240 minutes of surgery, focal therapy procedures are significantly shorter:

• HIFU procedures: 119 minutes (approximately 40% time saving)

• TMA procedures: 70 minutes (approximately 60% time saving)

• Cryotherapy procedures: 120.5 minutes (approximately 33% time saving)

Perhaps most impressive is the impact on recovery time. Over 60% of patients were discharged on the same day following focal therapy, compared to the typical 3-5 day hospital stay required after conventional radical surgery. More than 85% of all patients went home within 24 hours post-operation.

 

Preserving Quality of Life

One of the most significant advantages of focal therapy is the preservation of urological function. Traditional radical treatments often carry substantial risks of urinary incontinence and erectile dysfunction, complications that can severely impact quality of life, particularly for patients over 70 years old.

In contrast, patients who received focal therapy experienced:

• Preserved continence and erectile function

• Maintained quality of life

• Significant improvement in urinary symptoms within 12 months

• Minimal post-operative trauma

Dr. Samuel Yee Chi-hang, Clinical Associate Professor at CUHK's Division of Urology, explains: "Compared with conventional surgery, focal therapy can typically be completed in one to two hours, causing fewer side effects than conventional radical treatments. This approach significantly reduces surgical trauma and psychological burden, offering a safe and effective option for low-to-intermediate-risk patients."

 

Impressive Cancer Control Outcomes

The focal therapy programme has demonstrated excellent oncological outcomes. Among the 63 patients who underwent follow-up biopsy between six months and one year after treatment, the recurrence rate was approximately 20%. Importantly, most recurrent cases were classified as insignificant low-risk disease requiring only routine monitoring rather than immediate intervention.

For the small percentage of patients with clinically significant recurrence, multiple treatment options remain available, including repeat focal therapy, robotic radical prostatectomy, or radiotherapy.

 

Precision Medicine in Action

What sets Hong Kong's approach apart is the personalized selection of focal therapy modality based on each patient's unique tumour characteristics. The medical team uses advanced multiparametric MRI and sophisticated biopsy techniques to precisely locate tumours before selecting the most appropriate treatment:

• HIFU is primarily used for posterior tumours (86.4% of HIFU cases)

• Cryotherapy and TMA are preferred for anterior tumours (72.2% and 77.5% respectively)

Dr. Peter Chiu Ka-fung, Associate Professor at CUHK's Division of Urology, emphasizes: "Cancer affects each patient differently, so treatment should be personalised to suit individual conditions and needs. It is estimated that one in seven patients with localized prostate cancer is suitable for focal therapy, meaning whole-gland intervention is not always necessary."

 

Global Recognition and Future Directions

The groundbreaking research has been published in Prostate International, the official journal of the Asia Pacific Prostate Society, marking international recognition of Hong Kong's leadership in this field. Among the three focal therapy modalities, HIFU has already been adopted as a standard treatment by the Hong Kong Hospital Authority.

Professor Anthony Ng Chi-fai, Head of Division of Urology at CUHK, states: "This marks the first systematic introduction of multimodality focal therapy techniques in Hong Kong, with clinical evaluation of their effectiveness in patients with localised, low-to-intermediate-risk primary prostate cancer. The team will further explore and consolidate the potential applications of other focal therapy approaches in patients with higher-risk prostate cancer."

 

Who Can Benefit?

Focal therapy is particularly suitable for patients with:

• Localized, low-to-intermediate-risk prostate cancer

• Tumours confined to a specific region within the prostate

• Concerns about quality of life after treatment

• Medical conditions that make radical surgery challenging

• Desire for organ-preserving treatment options

 

A New Era in Prostate Cancer Treatment

With prostate cancer being the third most common cancer and fourth leading cancer killer among men in Hong Kong, the introduction of focal therapy represents a paradigm shift in treatment philosophy. Rather than treating all prostate cancers with radical whole-gland removal, this precision medicine approach allows doctors to match treatment intensity to disease severity.

The success of Hong Kong's pioneering programme offers hope to countless patients who previously faced a difficult choice between aggressive treatment with significant side effects or anxious watchful waiting. With focal therapy, there's now a middle path that effectively controls cancer while preserving quality of life.

As CUHK continues to refine these techniques and expand their applications, Hong Kong's position as a pioneer in focal therapy for prostate cancer solidifies its reputation as a leader in precision oncology and patient-centered cancer care in Asia.