What Happens During a Prostate Tumour Ablation?

Medicine Made Simple Summary

If you’ve been told you have a prostate tumour and surgery is an option, you may also hear about a less-invasive choice called prostate tumour ablation. In this treatment, instead of removing the prostate or using full-blown radiation, doctors apply focused energy (heat, cold, ultrasound or electrical pulses) to destroy tumour cells while leaving most of the prostate intact. It offers a shorter recovery, fewer side-effects on urinary or sexual function, and can be a good option for carefully selected patients.

1. What is prostate tumour ablation?

The prostate is a small gland beneath the bladder that helps produce semen. When cancer cells appear in this gland, traditional treatments include surgery (prostatectomy) or radiation therapy. Tumour ablation is an alternative: a minimally invasive procedure that uses targeted energy to kill cancer-cells in the prostate.

There are two main approaches: focal ablation (treat only the part of the prostate with the tumour) and whole-gland ablation (treat the entire prostate). Focal ablation is often used when the tumour is small and well-localised. Techniques may include high-intensity focused ultrasound (HIFU), cryotherapy (freezing), irreversible electroporation (electrical pulses), or other newer methods.

2. Why might ablation be recommended?

Ablation might be offered when:

• The tumour is low-to-moderate risk, localised and small.
• The patient wants to preserve urinary and sexual function. Studies show focal ablation can have fewer side-effects than radical surgery.
• The patient might not tolerate major surgery or full radiation because of other health issues. 
  It’s important to remember ablation isn’t suitable for every situation. The size, placement, aggressiveness of the tumour and overall health all matter in deciding the best treatment.

3. How does the procedure work in simple terms?

When you go for the ablation procedure, here’s what typically happens:

• Preparing and anaesthesia: You’ll usually be under general anaesthesia or deep sedation. Your surgeon or interventional specialist explains the plan and reviews your scans. 

• Positioning and imaging: You’ll lie in a specific position so the team can access the prostate safely. An imaging probe (often ultrasound via the rectum) is placed to map the prostate and locate the tumour.

• Access and targeting: For needle-based ablation (like cryoablation or irreversible electroporation), thin probes/needles are placed directly into the prostate under imaging guidance. For HIFU or ultrasound-based ablation, a probe near the rectum delivers energy to the tumour area. 
• Ablation of tissue: Depending on the method:

• Cryoablation freezes the tumour tissue.
• HIFU uses heat from sound waves to destroy tumour cells.
• Irreversible electroporation uses electrical pulses to rupture cell membranes. 

• Monitoring and finishing: The team monitors nearby structures like the urethra, bladder, nerves to minimise collateral damage. Once complete, the probes are removed, any catheters placed if necessary, and you’re moved to recovery. Recovery may include a catheter in the bladder for short period.

4. What happens afterward and what’s recovery like?

After the procedure:

• You’ll stay in recovery for observation. Most people go home the same-day or after one overnight stay, depending on the procedure and your health.
• You may have a catheter in your bladder for a day or two.
• Some soreness, urinary urgency or mild discomfort is common for a few days.
• You’ll be asked to avoid heavy lifting or strenuous activity for a short period.
  Over the next few weeks and months, the tumour-treated area heals. Follow-up tests (PSA blood test, imaging) will monitor the treatment’s success and check for any leftover or returning disease.

Studies of ablation for prostate cancer have found favourable outcomes: for example, in one study of 150 patients, whole-gland and partial-gland ablation had low rates of major complications and good control of disease in the short-term (median ~32 months follow-up). 

5. What are the advantages and risks?

Advantages

• Less invasive than open surgery.
• Lower risk of urinary incontinence and often better preservation of erectile function compared with radical prostatectomy.
• Shorter recovery time.
• Can be repeated if needed.

Risks and Limitations

• Because it’s newer compared to surgery or radiation, long-term outcomes are still being studied.
• Possibility of recurrence (some patients may require additional treatment later).
• Potential side-effects include urinary retention, urethral stricture, or erectile dysfunction though rates are lower than with more aggressive treatments.
• Not suitable for all tumours — large, high-risk or widely spread cancers may still need surgery or radiation.

6. Questions you should ask your doctor

Before you decide on ablation, here are key questions to ask:

• Is my tumour clearly localised and suitable for ablation rather than surgery or radiation?
• Which type of ablation will you use and why?
• What are the chances of success in my specific case?
• What are the possible side-effects and how many patients experience them?
• What does recovery look like — hospital stay, catheter use, return to normal life?
• How will my urinary and sexual functions be monitored and preserved?
• What follow-up tests will I need and what’s the plan if the cancer recurs?
  Having these conversations helps you understand your options clearly and choose with confidence.

7. How ablation fits into your overall prostate care

Prostate tumour ablation is often part of a comprehensive care plan rather than an isolated treatment. If you are being monitored under active surveillance, ablation could be the next step if the tumour grows. If you are choosing treatment, ablation may offer a middle ground between doing nothing and undergoing full prostate replacement or radiation. Your urologist, oncologist and radiologist will work together to recommend the best plan for you. It’s also essential to keep up with healthy lifestyle measures, regular check-ups and PSA monitoring regardless of the treatment you choose.

8. What to expect for the future

Research is rapidly advancing. Newer technologies like pulsed electrical fields, robotic-assisted probes, and improved imaging help make ablation more accurate and safer. Over time, we expect more long-term data that will further confirm how ablation compares with surgery and radiation.

Conclusion

If you’ve been diagnosed with a prostate tumour and are worried about major surgery or side-effects, ask your doctor: “Could tumour ablation be right for me?” It’s a modern, minimally invasive option that may allow you to treat your cancer while preserving quality of life. Request a consultation with a specialist experienced in prostate ablation. Bring your scan reports, ask the questions listed above, and make sure you’re fully informed about both benefits and risks. Choosing the right treatment today may help you live well and confidently into tomorrow.