Overview
Cryotherapy as a prostate cancer treatment is gaining favor
among patients and doctors. It is also called cryoablation,
cryosurgery, or just "cryo." It uses freezing to destroy
prostate cancer without the risks of major surgery or radiation.
Advances in technology and methods protect surrounding healthy
structures during the procedure.
While the
patient is anesthetized (local or general), the doctor uses
ultrasound guidance to insert 6-8 slender cryoprobes through the
skin into precise locations in the prostate. Since the urethra
passes through the gland, a warming catheter protects the
urethra from freezing. Thermal sensors track temperatures around
the prostate to avoid damaging the bladder and rectum.
When all is
ready, liquid argon gas is circulated within the probes,
freezing the prostate tissue to -40° C. Then helium gas replaces
the argon to thaw the tissue. The freeze/thaw cycle is repeated
once more. The cancer tumor and its blood supply have now been
destroyed. The dead tissue is re-absorbed or remains in the body
as scar tissue and poses no other health threat. The in-hospital
procedure takes about two hours; patients either go home the
same day or spend one night in the hospital.
While many
patients resume normal activity in less than a week, some
patients may experience temporary bruising and swelling. A
urinary catheter is left in place for 1-3 weeks of internal
healing, and then removed.
Less than
1% of patients report incontinence following cryosurgery. Since
the nerve bundles that control erection are adjacent to the
prostate, most patients will be impotent if the entire gland is
frozen. However, qualified patients may be candidates for
potency-sparing cryotherapy.
Cryotherapy
offers several advantages. There is no major surgery or
radiation. Recovery is rapid and most patients return to their
normal lifestyle quickly. Unlike radiation, cryotherapy is
repeatable if prostate-confined cancer recurs. It is the only
Medicare approved treatment if prostate-confined cancer recurs
after radiation therapy (external beam or brachytherapy).
Long-term
statistics show that cryosurgery is at least as effective as
radical prostatectomy and radiation for low-risk cancers, and
has better success rates than surgery and radiation for moderate
to high risk cancers (up to stage T3 tumors).
Cryoablation for prostate cancer is Medicare approved for both
first-time occurrence and post-radiation recurrence.
Cryotherapy
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