Inclusion Criteria

DISEASE CHARACTERISTICS:

- Histologically confirmed adenocarcinoma of the prostate

- Low-risk disease, as defined by the following criteria:

- Gleason grade total ≤ 7 (patterns 3+4 or 4+3 or less acceptable)

- Localized disease (unilateral or bilateral) (stage T2c, N0, M0 or less)

- Serum PSA ≤ 15 ng/mL

- Prostate volume ≤ 40 cc or maximum anterior-posterior length ≤ 40 mm

- Multi-sequence-MRI and transperineal template 5 mm-spaced biopsies performed within
the past 6 months

- All malignant areas must be treatable by focal ablation so that approximately 50% of
prostate tissue is destroyed and ≥ 1 neurovascular bundle is preserved

- No intraprostatic calcifications making high-intensity focused ultrasound of focal
areas of cancer untreatable

- No metastatic disease

PATIENT CHARACTERISTICS:

- Life expectancy ≥ 5 years

- Must be fit for general or regional anesthesia as assessed by Consultant Anesthetist

- No prior rectal fistula

- No American Society of Anesthesiology grades III-IV

- No latex allergies

- No contraindication to MRI scanning (e.g., severe claustrophobia, permanent cardiac
pacemaker, or metallic implant likely to contribute significant artifact to images)

- No moderate to severe inflammatory bowel disease

PRIOR CONCURRENT THERAPY:

- No androgen suppression treatment within the past 6 months

- No transurethral resection of the prostate or laser prostatectomy within the past 5
years

- No prior treatment (i.e., radiotherapy, brachytherapy, surgery, laser therapy,
chemotherapy, high-intensity focused ultrasound, cryosurgery, thermal therapy, or
microwave therapy) for prostate cancer

- No prior significant rectal surgery preventing insertion of transrectal probe