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Cryotherapy for prostate cancerBy Mayo Clinic staff
Original Article: http://www.mayoclinic.com/health/cryotherapy-for-prostate-cancer/MY01634
Cryotherapy for prostate cancer freezes prostate tissue, causing cancer cells to die. As a minimally invasive procedure, cryotherapy for prostate cancer is sometimes used as an alternative to surgical removal of the prostate gland (prostatectomy).
In the past, cryotherapy for prostate cancer was associated with significantly higher levels of long-term side effects than were other prostate cancer treatments. Advances in the technology of cryotherapy for prostate cancer have reduced these side effects. Most men, however, still experience long-term sexual dysfunction following cryotherapy for prostate cancer.
Cryotherapy for prostate cancer is most often used in men who have early-stage prostate cancer. But cryotherapy for prostate cancer may also be a treatment option in some men whose prostate cancer has returned following other treatments.
Why it's done
Cryotherapy freezes tissue within the prostate gland. After being frozen, the prostate cancer cells die.
Your doctor may recommend cryotherapy for prostate cancer as an option at different times during your cancer treatment and for different reasons, including:
- As the only (primary) treatment for cancer, usually for early-stage cancer that is confined to your prostate
- After other cancer treatment, such as radiation therapy, to stop the growth of prostate cancer that has returned (salvage therapy)
Side effects of cryotherapy for prostate cancer may include:
- Erectile dysfunction
- Pain and swelling of the scrotum and penis
- Frequent urination
- Difficult or painful urination
- Blood in the urine
- Loss of bladder control (urinary incontinence)
- Bleeding or infection in area of procedure
Rarely, cryotherapy may significantly damage tissue and organs near the prostate gland, such as the rectum or bladder.
How you prepare
Your doctor may recommend cleansing your bowels with a fluid solution (enema) to empty your colon before cryotherapy for prostate cancer. You may also need to avoid eating and drinking for a certain period of time before the procedure to avoid anesthesia complications. Ask your doctor for specific instructions.
What you can expect
During cryotherapy for prostate cancer
Cryotherapy for prostate cancer is done in the hospital. You may be given a general anesthetic so that you're unaware during the procedure, or your doctor may numb only the surgical area with a local or regional anesthetic.
Once the anesthetic takes effect, your doctor:
- Places an ultrasound probe in your rectum.
- Places a catheter inside the tube (urethra) that transports urine from your bladder out of your penis. The catheter is filled with a warming solution to keep the urethra from freezing during the procedure.
- Inserts several thin metal probes or needles through the area between the scrotum and the anus (perineum) into the prostate.
- Watches the images generated by the ultrasound probe carefully to ensure correct placement of the needles.
- Releases argon gas to circulate through the probes or needles, cooling them and freezing nearby prostate tissue.
- Carefully controls and monitors the temperature of the needles and the amount of freezing within the prostate gland.
- May place a catheter into your bladder through your lower abdomen (suprapubic catheter) to assist in urinary drainage after cryotherapy.
Cryotherapy for prostate cancer takes around two hours.
After cryotherapy for prostate cancer
You'll likely be able to go home the day of your procedure, or you may spend the night in the hospital. The urinary catheter may need to remain in place for about two weeks to allow for healing.
Cryotherapy for prostate cancer usually results in very little blood loss. You may be sore and bruised where the rods were inserted and have blood in your urine for several days following the procedure. You may also have temporary bladder and bowel function problems. These problems usually resolve over time.
Sexual dysfunction, including impotence, is common in men following cryotherapy. In many, these problems persist long term.
After cryotherapy for prostate cancer, you'll have regular follow-up appointments with your doctor and undergo periodic imaging scans and laboratory testing to see how your cancer has responded to the treatment.
The current method of cryotherapy for prostate cancer — which employs ultrasound guidance, newer technology cryotherapy probes and strict temperature monitoring — has been in use for only several years. The long-term outcomes for this procedure are currently unknown.
- Shelley M, et al. Cryotherapy for localized prostate cancer (Review). The Cochrane Database of Systematic Reviews. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD005010.pub2/abstract. Accessed March 4, 2013.
- Bozzini G, et al. Focal therapy of prostate cancer: Energies and procedures. Urologic Oncology: Seminars and Original Investigations. 2012. In press. Accessed March 5, 2013.
- Pisters LL, et al. Cryotherapy and other ablative techniques for the initial treatment of prostate cancer. http://www.uptodate.com/home. Accessed March 5, 2013.
- Prostate cancer. American Cancer Society. http://www.cancer.org/cancer/prostatecancer/detailedguide/index. Accessed March 4, 2013.
- Cryoablation for prostate cancer. Urology Care Foundation. http://www.urologyhealth.org/urology/index.cfm?article=108. Accessed March 4, 2013.
- Moynihan TJ (expert opinion). Mayo Clinic, Rochester, Minn. March 9, 2013.