Cryotherapy 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 -40C. 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.