The Use of Focal Therapy for Prostate Cancer in the Age of High Resolution and Fusion Imaging

Prostate cancer remains one of the most prevalent malignancies in men, with management strategies evolving rapidly to balance oncological control and preservation of quality of life. Traditionally, treatment has relied on radical approaches such as surgery or radiotherapy, which, while effective, are often associated with significant morbidity, including urinary and sexual dysfunction. In recent years, focal therapy has emerged as a promising paradigm shift—offering organ-preserving alternatives that target only the cancerous lesion while sparing surrounding healthy tissue. Innovative modalities such as laser ablation, high-intensity focused ultrasound (HIFU), cryotherapy, and, more recently, irreversible electroporation, are gaining traction. These technologies hold potential to bridge the gap between active surveillance and radical treatment, aligning with the precision medicine era.

This special issue aims to highlight and critically evaluate the emerging role of focal therapy in prostate cancer management, with a particular focus on novel and underexplored technologies. By gathering contributions from leading experts in urology, oncology, imaging, and biomedical engineering, the issue seeks to foster interdisciplinary dialogue on the efficacy, safety, and applicability of focal therapies. A central goal is to assess how these technologies can be integrated into current clinical pathways—addressing patient selection, imaging guidance, treatment planning, and long-term oncological outcomes. The issue will also explore health economic perspectives, patient-reported quality of life, and the role of artificial intelligence in treatment planning and follow-up. Ultimately, this collection aims to provide a comprehensive reference that informs clinicians, researchers, and policymakers about the potential of focal therapy to redefine standards of care in localized prostate cancer.

This special issue will cover original research, systematic reviews, perspectives, and updates on clinical trials on focal therapy for prostate cancer. Topics of interest include novel ablative modalities (laser therapy, irreversible electroporation, photodynamic therapy, microwave ablation), advances in imaging and targeting, combination strategies, and integration into multidisciplinary care. We particularly welcome contributions addressing patient selection criteria, functional and oncological outcomes, biomarkers, and cost-effectiveness analyses. Studies on real-world implementation, regulatory considerations, and ethical implications of adopting focal therapy are also encouraged. By encompassing both technological innovation and clinical translation, the issue seeks to capture the state of the art and future directions.

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• Brief Research Report
• Case Report
• Classification
• Clinical Trial
• Community Case Study
• Curriculum, Instruction, and Pedagogy
• Data Report
• Editorial
• FAIR² Data
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Article types

This Research Topic accepts the following article types, unless otherwise specified in the Research Topic description:

• Brief Research Report
• Case Report
• Classification
• Clinical Trial
• Community Case Study
• Curriculum, Instruction, and Pedagogy
• Data Report
• Editorial
• FAIR² Data
• General Commentary
• Hypothesis and Theory
• Methods
• Mini Review
• Opinion
• Original Research
• Perspective
• Policy and Practice Reviews
• Policy Brief
• Review
• Study Protocol
• Systematic Review
• Technology and Code

Keywords: prostate cancer, focal therapy, laser therapy, Irreversible electroporation, HIFU, Cryotherapy, Focal laser ablation, FLA

Important note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.