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Prostate Cryotherapy Information

Prostate Cryotherapy Page Information
Understanding Prostate Cryotherapy
The Procedure & Video
Advantages & Disadvantages
Conclusion
Frequently Asked Questions
Download (PDF) Patient Brochure


Understanding Prostate Cryotherapy

An exciting new treatment option for prostate cancer treatment is cryosurgery also known as cryotherapy. Because it is minimally invasive, cryotherapy as a prostate cancer treatment is gaining favor among patients and doctors. It also has fewer complications than surgery. Studies show cryotherapy can be an effective alternative to surgery and radiation for appropriate patients, particularly men who develop prostate cancer in their late 60’s or early 70’s.

Cryotherapy is actually not a new concept; this procedure has been explored in various forms over the past few decades. But new cryotherapy techniques and technology are making the procedure much more popular. In recent years, newer technology, including the use of transrectal ultrasound imaging, temperature sensors and cryoablation “needles” versus probes to freeze has made prostate cryotherapy much safer and easier.


The Procedure

Modern prostate cryotherapy is usually in a hospital with the patient under local anesthesia. Using ultrasound guidance, several ultra thin cryoablation needles are placed directly through the patient’s perineum (the place between the scrotum and anus) and into the prostate. The urologist can see each needle entering the prostate with the transrectal ultrasound, and guide the needle to its exact placement. Once the needles are in place, argon gas is released into the needles, where it circulates and plunges the temperature. As the tissue around the needles freeze, the formation and expansion of ice crystals within the cancerous cells cause the cells to rupture and die.

 


Video courtesy of Galil Medical

After approximately 10 minutes, the urologist completes the first freeze cycle and then administers another treatment to help ensure that all cancer cells are killed. To keep the urethra from freezing along with the prostate, a catheter is placed inside the urethra and filled with warming solution. Thermal sensors track temperatures in and around the prostate to avoid damaging the bladder and rectum.

The entire procedure takes one to two hours and most patients undergoing prostatic cryotherapy will have the procedure done as a single day out-patient or spend one night in the hospital. At the conclusion of the procedure, the needles are removed from the patient, no stitches are required. Most patients resume normal activity in less than one week. Some may experience temporary bruising and swelling. Usually, a urinary catheter is left in place for one to three weeks for internal healing, and then removed.

After the procedure, the urologist who performed the procedure will order tests to determine the extent of treatment success. Once known, the information is provided to the doctor, who will give the information to the patient.

There is no special preparation needed to undergo cryotherapy, although some physicians recommend ibuprofen a half-hour before the procedure to relieve minor discomfort. Antibiotics are also given beforehand as a way to guard against infection.


Advantages

Cryotherapy offers several advantages: there is no major surgery or radiation, recovery time is rapid, and most patients return to their normal lifestyle. Unlike radiation, cryotherapy is repeatable if prostate-confined cancer recurs, and it can also be used as a secondary treatment when other primary treatments fail. A recent study (October 2003) showed that 97% of patients treated with new-generation minimally invasive cryotherapy were still cancer-free after twelve months. In longer term study published in May 2002, cryotherapy outcomes using PSA measurement reported the seven year disease-free success statistics were:

  • 92% success for low risk disease
  • 89% success for medium risk disease
  • 89% success for high risk disease

Disadvantages

With cryotherapy, controlling cancer confined to the prostate in about 90 percent of men, the results are encouraging. However, this procedure, as does all procedures, has disadvantages. In some patients, incontinence, urethral scarring, and damage to the rectum may occur. The procedure may not kill all of the cancer cells; this is rare unless the patient has been previously radiated. Other possible side effects include:

  • Severe to moderate pelvic pain
  • Tissue sloughing
  • Impotence
  • Scrotal swelling
  • Blood in urine
  • Mild urinary urgency

In most cases the side effects usually go away within a few weeks, and most men will regain normal bowel and bladder function.


In Brief

Choosing a treatment for prostate cancer isn’t easy. Many physicians feel that this modern technology only recently has the long-term effectiveness to recommend the procedure. Today’s traditional choices include surgery, radiation, hormone therapy and now cryotherapy. At the present time, there are hundreds of urologists and medical centers that have experience with cryotherapy for prostate cancer. With recent longer term data now available, prostate cryotherapy using modern technology may be a treatment choice for you. Ongoing clinical studies are currently being performed on selected patients, including those whose prostate cancer has grown back after failure of radiation therapy or on patients with advanced prostate cancer.


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Frequently Asked Questions

Who gets cryotherapy?

Cryotherapy is an option for prostate cancer patients who want to avoid major surgery. Patients with smaller prostates are better candidates for treatment. Those with larger prostates can undergo therapy to decrease the prostate size prior to cryotherapy.

What are some other uses of this procedure?

Cryotherapy has been used to destroy skin tumors, pre cancerous moles, skin tags and unsightly freckles. It also has been used to destroy a childhood cancer of the retina. In addition to treating prostate cancer, physicians have performed this procedure in patients with kidney, liver, lung and cervical cancer, especially if surgery is not an option.

Will cryotherapy eventually be a treatment option for all types of cancer?

Currently, research is being done to determine the effectiveness of cryotherapy for tumors of the brain, kidney, bone, lung and spine. In addition, researchers are evaluating its usefulness in freezing and shrinking benign breast lumps.

Who is cryotherapy recommended for?

Presently, cryotherapy is recommended for patients who have localized prostate cancer or have recurrence of prostate cancer despite radiation.

Is cryotherapy performed the same way in every patient?

Not exactly. Cryotherapy will vary from patient to patient according to the tumor stage and grade.

What does “tumor grade” mean?

A “tumor grade” is a labeling system telling how quickly a cancer is growing.

What is a prostatectomy?

This is where an attempt is made to surgically remove the entire prostate.

What happens to the prostate after cryotherapy?

Unlike a prostatectomy, cryosurgery attempts to destroy prostate tumor tissue in place, without removing it.

What happens to the tumor and tissue following the procedure?

At this point, the cancer tumor and its blood supply have been destroyed, the dead tissue is reabsorbed or remains in the body as scar tissue and poses no other health threat.

What can one expect at home during the post-operative period?

Scrotal swelling occurs in approximately 25% of patients, and patients are advised to apply ice packs to the scrotum for the first five days after the procedure.

How do you know if cryotherapy is the right treatment for you?

The decision regarding treatment for prostate cancer is a very personal one. It is a cancer that has multiple treatment approaches with different complications and cure rates.

What are the main treatment options for prostate cancer patients?

There are three main approaches to the treatment of prostate cancer, including: surgery, radiation therapy and cryotherapy. The decision of what therapy to choose is based on the extent and type of the cancer, age of the patient, general health of the patient and the preference of the patient.

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Download (PDF) Patient Brochure
Information courtesy of Galil Medical
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