What Is Vanquish Water Vapor Therapy?

Vanquish is a transurethral focal therapy system developed by Francis Medical that uses thermal energy stored in sterile water vapor to precisely ablate cancerous prostate tissue. Unlike whole-gland treatments (surgery or radiation), Vanquish targets only the cancer while preserving surrounding healthy tissue.

The system combines three technologies:

  • Real-time ultrasound imaging visualizes prostate anatomy during treatment.
  • Electromagnetic tracking confirms exact needle placement within the target zone.
  • Standard cystoscopy accesses the prostate transurethrally.

This triple-guidance ensures water vapor is delivered precisely to cancer lesions identified on pre-treatment MRI.

FDA Clearance and Clinical Evidence

Francis Medical received FDA 510(k) clearance on December 2, 2025 for Vanquish water vapor ablation of prostate tissue. This clearance was supported by 12-month data from the VAPOR 2 pivotal study:

91% Clearance of targeted MRI-visible intermediate-risk disease
93% Patient satisfaction rate
2.7% Grade 2+ urinary incontinence
Low Rates of erectile dysfunction

VAPOR 2 Study: 235 patients with intermediate-risk localized prostate cancer across 26 U.S. sites. Enrollment completed February 2025. Patients followed for 5 years; primary completion expected April 2027.

Who Is a Candidate?

Vanquish is designed for men with localized, intermediate-risk prostate cancer. Ideal candidates include:

  • MRI-visible prostate cancer lesions (confirmed on mpMRI).
  • Intermediate-risk disease (PSA 10-20, Gleason 7, or clinical stage T2b-T2c).
  • Desire for focal therapy rather than whole-gland treatment.
  • Interest in preserving sexual and urinary function.
  • Willingness to undergo close post-treatment surveillance.

Not ideal for: High-risk disease, multifocal cancer, or patients preferring definitive whole-gland therapy.

How the Procedure Works

Before the Procedure

  • Multiparametric MRI identifies cancer lesions.
  • MRI-fusion biopsy confirms cancer grade and location.
  • Pre-op labs, urine culture, medical clearance.
  • Stop blood thinners 5-7 days prior.
  • NPO after midnight; arrive 2 hours before.

During the Procedure

  • Outpatient; general or spinal anesthesia.
  • Cystoscope advanced transurethrally to prostate.
  • Real-time ultrasound + electromagnetic tracking guide needle to MRI-identified cancer.
  • Sterile water vapor injected; thermal energy ablates cancer cells.
  • Multiple injections cover entire lesion.
  • Total time: 30-60 minutes.
  • Foley catheter placed temporarily.

Recovery and Aftercare

Immediate Recovery

  • Same-day discharge for most patients.
  • Catheter removed within 24 hours.
  • Minimal to no pain.
  • Blood-tinged urine 1-2 days is normal.
  • Return to activities within 2-3 days.

Long-Term Surveillance

  • PSA every 3 months first year, then every 6 months.
  • Follow-up MRI at 6 and 12 months.
  • Repeat biopsy at 12 months to confirm clearance.
  • Ongoing surveillance per active surveillance protocols.
  • Repeat Vanquish or salvage therapy if recurrence.

Clinical Outcomes from VAPOR 2

  • 91% cancer clearance of targeted lesions at 12 months.
  • 93% patient satisfaction with procedure and outcomes.
  • 2.7% incontinence (vs. 5-15% for surgery).
  • Low ED rates — preserved function in most patients.
  • No serious device-related adverse events.
  • Minimal pain during and after treatment.

Long-Term: 5-year follow-up data expected April 2027.

Vanquish vs. Other Treatments

  • vs. Radical Prostatectomy: Vanquish preserves more function, faster recovery, outpatient. Surgery offers whole-gland removal with definitive pathology.
  • vs. Radiation: Vanquish is single-session, no radiation exposure. Radiation treats whole gland but may have delayed side effects.
  • vs. Active Surveillance: Vanquish treats cancer immediately while preserving function.
  • vs. Other Focal Therapies: Vanquish offers precision guidance with proven 91% clearance in FDA trial.

Why Advanced Urology?

  • Early adoption of FDA-cleared technology — offering latest focal therapy options.
  • Expertise in multiparametric MRI and fusion biopsy — accurate cancer localization.
  • Multidisciplinary prostate cancer team reviewing every case.
  • Comprehensive surveillance program — close monitoring with PSA, MRI, and biopsy.
  • Access to all treatment modalities if Vanquish isn't right for you.

Frequently Asked Questions

Is Vanquish a cure for prostate cancer?

Vanquish ablates targeted cancer lesions with high precision. VAPOR 2 shows 91% clearance at 12 months. Long-term data (5 years) will clarify durability. Close surveillance is essential.

Will I lose sexual function?

Vanquish preserves erectile function by avoiding neurovascular bundles. VAPOR 2 showed low ED rates vs. whole-gland treatments.

How is Vanquish different from Rezum?

Rezum treats BPH (benign enlarged prostate). Vanquish treats prostate CANCER using precision guidance. Different diseases, different applications.

What if cancer comes back?

Surveillance MRI and biopsy detect recurrence. Options include repeat Vanquish, salvage radiation, surgery, or systemic therapy.

Is Vanquish covered by insurance?

Coverage varies with FDA clearance. We work with insurers for authorization. Self-pay options available.

How long does it take?

30-60 minutes. Outpatient with same-day discharge for most patients.

Next Steps

If you have localized, intermediate-risk prostate cancer and want focal therapy that preserves quality of life, our specialists will review your imaging and discuss whether Vanquish is appropriate.

Schedule evaluationEmail our team