Focal laser ablation is a new treatment for prostate cancer that involves destroying cancer cells with heat generated from a concentrated beam of light.

Focal therapies are treatments that aim to kill cancer cells while leaving the rest of your organ undamaged.

Although focal laser ablation (FLA) is a promising treatment option for intermediate-risk prostate cancer contained to your prostate, there’s still a limited amount of research comparing it with other types of treatment. Its optimal use remains controversial.

Currently, the use of FLA or other focal therapies isn’t routinely recommended by the American Urological Association and National Comprehensive Cancer Network guidelines due to a lack of supporting evidence.

Read on to learn when doctors may recommend FLA for prostate cancer and what the latest research has found about its effectiveness.

FLA and other focal treatments aim to destroy cancer cells while leaving your healthy tissue intact. FLA uses a laser to generate heat, which destroys cancer cells. In theory, it may help reduce side effects of cancer treatment caused by damage to your healthy tissue.

Only about 15–20% of prostate cancers are isolated to one part of your prostate and have the potential to be treated with focal therapies alone.

FLA is currently considered an experimental option since there’s limited research comparing it with standard treatment options like surgery or radiation therapy.

The results of small studies suggest that focal therapies tend to be safe with a low risk of side effects compared with standard treatment.

To date, most studies examining FLA have small sample sizes and follow-up periods of less than a year.

A clinical trial completed in 2018 monitored 15 people who received FLA for 3 years. None of the participants had serious side effects. Reported side effects included:

Side effectFrequency (out of 15 people)
urinary tract infection1
blood in urine4
weak urine stream1
skin ulceration1
Peyronie disease (painful erections)1
epididymitis (swelling in your testicles)1

More research is needed to fully understand the effectiveness of FLA compared with other prostate cancer treatments.

In one small study, only 17% of a group of 120 men with low- or intermediate-risk early stage prostate cancer needed additional treatment within a year.

Multiple small studies suggest that the success rate of magnetic resonance imaging (MRI)-guided FLA is getting close to the success rate of surgery or radiation therapy.

At least 13 clinical trials examining FLA are currently underway or recruiting candidates. It still may be many years before the results of some of these trials become available. For example, one trial isn’t estimated to be completed until 2038.

FLA usually takes about 1.5–3 hours. The laser raises the temperature of your tissue to greater than 60°C (140°F).

Before the procedure

Before your procedure, your tumor location will be determined with MRI and biopsies. You’ll likely be given antibiotics about 60 minutes before your procedure. You’ll also likely be given a sedative before the procedure starts.

During the procedure

The exact procedure you receive may vary. MRI is often used to give surgeons a real-time image of your prostate.

The laser will be aimed at your prostate in one of two ways:

  • Transrectal approach: The transrectal approach involves inserting laser fibers into your anus.
  • Transperineal approach: The transperineal approach involves placing fibers into the skin between your anus and scrotum.

The laser will likely only be active for 3–4 minutes.

You may feel pressure in your penis or a feeling like you need to have a bowel movement during the procedure.

After the procedure

After the treatment, you’ll have a catheter in your bladder for 1–7 days. Drugs are given to prevent infections and bladder spasms.

You may be instructed to perform an enema on your rectal area on the morning of your biopsy. Some people may find it useful to bring music and headphones to prevent anxiety.

FLA usually doesn’t require a hospital stay. You’ll likely have regular follow-ups at 3-month intervals for the first year.

The cost of focal prostate cancer treatment can depend on factors such as where you live and where your cancer is treated.

FLA isn’t widely available yet, but prostate cancer treatment often costs thousands of dollars. In a 2019 study, researchers found half of people older than 70 years of age in the United States paid more than $14,453 for prostate cancer treatment within 3 years of receiving a diagnosis.

Most insurance providers are unlikely to cover FLA since it’s considered experimental. For example, Anthem BlueCross considers it not medically necessary. Medicare will sometimes cover laser ablation for benign prostatic hyperplasia.

Learn more about the cost of treating metastatic prostate cancer.

Other focal therapies for prostate cancer include:

  • Cryotherapy: Cryotherapy uses intense cold to destroy cancer cells.
  • High-intensity focused ultrasound: High-intensity focused ultrasound uses high-frequency sound waves to heat up cancer cells and kill them.
  • Photodynamic therapy: Photodynamic therapy involves the use of a drug called a photosensitizer that’s injected into your bloodstream to kill the cancer.
  • NanoKnife: NanoKnife uses electricity to kill prostate cancer cells.

FLA is an experimental prostate cancer treatment that uses heat created by a laser to destroy cancer cells. More research is needed to understand how effective FLA is compared with other cancer treatments.

Theoretically, FLA may lead to fewer side effects than standard therapy due to less damage to your healthy tissue. You can find FLA and other prostate cancer clinical trials from the National Cancer Institute’s database.