What focal therapy is
Traditional treatment for localized prostate cancer treats the whole gland with surgery or radiation. These treatments work well, but they can affect urinary control and sexual function. Focal therapy treats only the area of the prostate that contains significant cancer, as seen on MRI and confirmed by biopsy, and leaves the rest of the gland in place. The goal is cancer control with fewer side effects, in exchange for close follow-up.
How Vanquish works
The Vanquish Water Vapor Ablation System, made by Francis Medical, delivers heated sterile water vapor (steam) through a thin needle passed through the urethra. The procedure uses cystoscopy and transrectal ultrasound, with the patient's prior MRI images displayed for targeting. The vapor releases its heat into the targeted tissue and ablates it, while the natural boundaries of the prostate help contain the treatment. According to Francis Medical, the system can reach lesions anywhere in the prostate, including the apex, the anterior gland and the transition zone, which are hard to treat with some other focal therapies.
Regulatory and study status
In the United States, the FDA has cleared Vanquish as a tool for the thermal ablation of targeted prostate tissue through the urethra (510(k) K252388). The FDA has not evaluated Vanquish for the treatment of prostate cancer or for long-term cancer outcomes. Its use in prostate cancer is being studied in VAPOR 2 (NCT05683691), a multicenter study of men with localized, intermediate-risk (Grade Group 2) prostate cancer. The study is ongoing, with follow-up planned through 2029. Initial reported results are encouraging, but long-term cancer-control data are not yet available.
Who may be a candidate
Focal therapy is generally considered only for men with localized cancer that is visible on MRI, confirmed by targeted biopsy, and of favorable or intermediate risk. It is not a treatment for advanced or metastatic disease. Men choosing focal therapy need ongoing PSA tests, MRI and repeat biopsies, and some will later need additional or whole-gland treatment.
Making the decision
Dr. Neal Patel reviews focal therapy alongside active surveillance, robotic prostatectomy and radiation, so you can weigh cancer control, side effects and follow-up. Related pages: Elevated PSA and Advanced prostate cancer therapies. Sources: Francis Medical; ClinicalTrials.gov NCT05683691. Call 678-344-8900.
Preparing for your visit with Dr. Neal Patel
Bring a list of your current medications and supplements, any prior urine, blood or PSA results, and the reports (or discs) from recent imaging. If you can, arrive with a comfortably full bladder, because a urine sample and a bladder scan are often part of the first visit. Write down your main questions so nothing is missed. A family member is welcome to join you. If you prefer Spanish or Korean, let the office know when you book so language support is ready.
Your chart is reviewed before you arrive, and insurance requirements for likely imaging or procedures are checked up front so approvals can move sooner. Before you leave, your orders, prescriptions and follow-up plan are reviewed with you, and you receive education materials tailored to your condition.
At the end of the visit you will receive a written summary in your preferred language that explains what was found, what was ordered and what happens next. Your primary care physician or referring doctor receives a clear update letter with findings, plan and next steps, so everyone caring for you stays informed. Appointments are available at the Johns Creek, Cumming, Decatur and Braselton offices; call 678-344-8900.
Reviewed by Dr. Neal Patel, MD, board-certified urologist. This page is general information and not a substitute for medical advice.