Cryotherapy is the use of extremely cold temperatures to freeze and destroy cancerous tissue in the prostate.
Even with early intervention and conventional treatment, 30% to 40% of prostate cancers will recur and require further treatment. Some experts consider cryotherapy to be an option for treating recurrent prostate cancer, especially if initial radiation therapy did not kill the cancer cells sufficiently.
How it works
In cryotherapy, the doctor inserts an ultra-thin metal probe or needle into the prostate through an incision between the anus and scrotum. To protect the urethra from the effects of freezing, the doctor introduces warm saline through a catheter.
The surgeon will use visual information generated by ultrasound as a guide during the procedure before injecting an ice-cold liquid, such as liquid nitrogen or, more commonly, argon, through the probe into the prostate. The intense cold temperature freezes the prostate and destroys any cancerous tissue it contains, and the surgeon uses the ultrasound image to identify the tumor tissue, thus preventing damage to normal prostate tissue.
Principles of treatment
No living tissue – healthy or unhealthy – can tolerate extreme cold temperatures. The injection of nitrogen or argon into the prostate rapidly absorbs heat from the gland, and as the heat is drawn out, ice crystals or balls of ice instantly expand out, leading to cell membrane rupture and tissue damage, and eventually cell death.
Once the cancer cells are destroyed, the white blood cells remove the necrotic cells and tissues. Some studies have shown that the immune system is activated during this process and attacks the remaining cancer cells.
Treatment advantages
There are few long-term studies on cryotherapy for prostate cancer. Some experts believe there are several advantages of cryotherapy over surgery and radiation therapy, and these advantages are even more pronounced in early-stage prostate cancer. For example, cryotherapy is a less invasive procedure that allows the surgeon to perform the procedure with epidural or spinal anesthesia without the need for general anesthesia, which is beneficial for older prostate cancer patients. In addition, cryotherapy can be beneficial for prostate cancer patients with other conditions such as diabetes, heart disease or lung disease.
Other benefits of cryotherapy include:
- Less blood loss
- Shorter hospital stay (usually only one or two nights)
- Shorter recovery period
- Less swelling and pain than standard prostate cancer surgery
If necessary, cryotherapy can be followed by other conventional treatments, such as radiation or surgery.
Side effects
The ability of cryotherapy to completely cure prostate cancer has not been proven. Experts say that the freezing fluid sometimes does not kill all of the cancer cells. Therefore, it may still come back after treatment.
In addition, some patients cannot accept the potential side effects of cryotherapy, which include:
- Urethral and bladder damage
- Severe infection due to injury
- Urethral obstruction or blockage
In addition, similar to other therapies, cryotherapy can cause the following problems:
- Erectile dysfunction
- Urinary incontinence
- Recurrence of prostate cancer
There is a paucity of data from long-term studies on cryotherapy for prostate cancer, so there is no definitive answer about who can be considered for cryotherapy. Some experts believe that cryotherapy may be most effective for locally recurrent prostate cancer.