Jeremy Clarkson's prostate cancer treatment has thrust a lesser-known targeted therapy into the spotlight after a 10-year study found focal therapy may control the disease as effectively as surgery or radiotherapy while sharply reducing the risk of life-altering side effects.
The former Top Gear presenter revealed last year that he had been diagnosed with prostate cancer and underwent focal therapy, a minimally invasive treatment that destroys only cancerous areas of the prostate instead of removing or damaging the entire gland.
The new research, led by Imperial College London researchers, followed nearly 3,500 men treated through the NHS over 10 years and found that only two patients died from prostate cancer during the follow-up period.
Researchers said the outcomes were comparable to conventional treatments, but with less than half the risk of complications such as urinary incontinence and erectile dysfunction.
A Targeted Treatment That Could Change Prostate Cancer Care
Focal therapy works by precisely targeting tumors within the prostate while leaving healthy tissue intact. Doctors typically use techniques such as high-intensity focused ultrasound (HIFU) or cryotherapy, which freezes cancer cells, to destroy the affected areas.
Unlike radical prostatectomy, which removes the entire prostate, or radiotherapy, which exposes the gland to radiation, focal therapy aims to preserve more of the organ's normal function.
For many patients, that difference could mean avoiding some of the most feared consequences of prostate cancer treatment.
"Side effects can be devastating, and this is the first long-term study that shows many men could avoid them without increasing the risk their cancer could return," Amy Rylance, the director of Prostate Cancer UK said.
In the US, the American Cancer Society estimates that about 333,830 men in the United States will be diagnosed with prostate cancer in 2026, while approximately 36,320 will die from the disease.
About 1 in 8 men in the US will be diagnosed with prostate cancer during their lifetime, but the risk varies significantly depending on factors including age, family history, race and ethnicity.
Black men face a higher risk of developing prostate cancer and are more likely to die from the disease compared with men of other racial and ethnic groups.
Prostate cancer is the second-leading cause of cancer death among American men, behind only lung cancer. About 1 in 44 men will die from the disease.
Why Isn't Everyone Getting Focal Therapy?
Despite growing interest in focal therapy as a less invasive option for prostate cancer treatment, the approach is still not widely available to every patient who may qualify.
In the United States, adoption has been increasing but remains uneven. A survey of 264 urologists found that about 43% reported using focal therapies, up from 24% in a 2019 survey, suggesting that more specialists are beginning to incorporate the treatment into their practices.
Still, focal therapy has not yet become a routine option across the country. One reason is that questions remain about its long-term effectiveness compared with established treatments such as radical prostatectomy and radiation therapy.
One reason for the limited use has been uncertainty over whether treating only part of the prostate could allow cancer to return or spread. Regulators have previously called for stronger long-term evidence before recommending widespread adoption.
The new 10-year findings address one of the biggest concerns surrounding focal therapy: whether it can provide lasting cancer control.
Prof. Hashim Ahmed, a consultant urologist at Imperial College London and a senior author of the study, said the findings showed focal therapy provides "excellent long-term cancer control across a broad range of patients" and strengthens the case for expanding access.
However, experts caution that more randomized clinical trials are still needed to directly compare focal therapy with surgery and radiotherapy.
Who Can Receive Focal Therapy?
Focal therapy is not suitable for every prostate cancer patient.
The treatment is generally considered for men with localized prostate cancer where tumors are confined to specific areas of the prostate. It is not typically offered to patients whose cancer has spread outside the prostate or appears in multiple areas throughout the gland.
Doctors use imaging, including MRI scans, and biopsy results to determine whether a patient is an appropriate candidate.
Because prostate cancer varies widely between individuals, specialists say treatment decisions must continue to be personalized rather than based solely on age or diagnosis.
Could Focal Therapy Help Change the Future of Prostate Cancer Screening?
Beyond offering a potential alternative to surgery and radiation, researchers believe focal therapy could influence the ongoing debate over prostate cancer screening in the United States.
Prostate-specific antigen (PSA) testing can identify cancers that may grow slowly and never threaten a man's life, yet some patients diagnosed with prostate cancer may still undergo aggressive treatments that can lead to lasting complications, including urinary incontinence and erectile dysfunction.
This concern has shaped screening recommendations and contributed to debate among medical organizations about when and how often men should be tested.
The possibility of using more targeted treatments, such as focal therapy, could change that conversation by offering some men a way to treat clinically significant cancers while reducing the risk of the long-term side effects associated with whole-gland treatments.
However, experts caution that focal therapy is not a replacement for screening or a solution for every prostate cancer diagnosis. More research is still needed to determine which patients benefit most and how the approach compares with established treatments over the long term.
