Treatment of Locialized Prostate Cancer– Cryotherapy

In the early 1990's, a new treatment for prostate cancer called cryosurgery emerged. Today, this treatment more aptly is referred to as "cryotherapy". The goal of cryotherapy is to eradicate prostate cancer by freezing the prostate gland. After receiving anesthesia, the doctor inserts needles into the prostate gland through the perineum, the area between the scrotum and anus. The needles produce very cold temperatures. Freezing destroys the entire prostate, including any cancerous tissue within it.

Cryotherapy uses ultra-thin needles to produce ice balls of extreme sub-zero temperatures. The doctor uses ultrasound to accurately guide insertion of the needles, precisely control the size and shape of the ice balls and monitor the freezing.

Cryotherapy Selection Criteria
Cryotherapy is an option for prostate cancer patients who want to avoid major surgery or the risks of "watchful waiting." Cryotherapy can treat prostate cancer patients in the intermediate and high risk groups (stage T2c or above) as well as those who have failed previous radiation treatment.

Effectiveness of Cryotherapy
Recent publications showing 10-year data demonstrates safety and durable efficacy of cryotherapy for treating prostate cancer. Morbidity following the procedure is mild in comparison with other treatments, with the exception of sexual function impairment.

Cryotherapy for prostate cancer can be repeated, and it can also be used as a secondary treatment when other primary treatments fail.

Risks of Cryotherapy
The main risk associated with prostate cryotherapy is impotence. This can occur since in order to ensure the destruction of all cancer cells, the goal is to freeze tissue beyond the prostate. In doing so, the nerve bundles associated with erection that lie close to the prostate may be affected.

Cryotherapy Recovery Time
Cryotherapy can be performed under regional or general anesthesia on an outpatient basis, but depending on the patient's circumstances an overnight stay may be required. In most cases, the cryotherapy procedure takes less than two hours. There is minimal pain and discomfort. Patients generally are mobile the same day and can fully return to a normal routine within a few days.

Side Effects of Cryotherapy
In some patients, incontinence, urethral sloughing and scarring, or urethro-rectal fistula may be a side effect following cryotherapy. In most cases the symptoms are resolved in a few weeks. Other possible side effects may include:

• Moderate pelvic pain
• Blood in the urine
• Mild urinary urgency
• Scrotal swelling

These side-effects usually go away within a few weeks. Most men recover their normal bowel and bladder function.