Putting The Deep Freeze On Prostate Cancer

Studies have shown that 65% of men receiving a prostate cancer diagnosis are over the age of 65. Many of these patients are unable to undergo surgery or radiation treatment due to advanced age or other medical conditions. Cryotherapy (also known as cryosurgery or cryoablation) is proving to be a viable option for these men. Recent research at Crittenton Hospital in Rochester, MI, showed that more than 86% of all prostate cryoablation patients in their study experienced a successful treatment. In addition, the success rates of primary cryotherapy for prostate cancer are at least equivalent to that of conventional invasive radical surgery and radiation treatments.

In order to freeze the prostate and destroy cancer cells with
cryotherapy, multiple needles are inserted into the prostate
through the perineum (the area between the anus and scrotum).

Cryotherapy is used to freeze the entire prostate and destroy the cancer cells within it. The treatment is less invasive than surgery, involving only a small incision and insertion of a cryoprobe through the skin.
Additional advantages of cryotherapy over other treatment options include:
  • Outpatient procedure
  • Requires less anesthesia
  • No post-op urethral catheter is required
  • Minimal post-op pain
  • Can treat localized recurrent prostate cancer
  • Future segmental gland treatment
“Cryotherapy can also be used to treat men who cannot have surgery or radiation therapy due to their age or other medical problems,” said Alliance Urology Specialists physician Sigmund Tannenbaum, M.D., F.A.C.S.

Because it is effective only in small areas, cryotherapy is not used to treat prostate cancer that has spread outside the gland, or to distant parts of the body.

While cryotherapy has been well received with patients, cryosurgery for the prostate gland can have side effects including obstructed urine flow,  incontinence, impotence, or injury to the rectum. Side effects are usually temporary, but impotence is more common with cryotherapy than with surgery or radiation.

Argon gas is circulated through the cryoablation needles, creating lethally cold iceballs that freeze the prostate and the cancer cells in it.
The Cryotherapy Procedure
Cryotherapy is typically performed when the prostate volume is 50 grams or less in size. If the prostate is larger, the patient may be placed on hormone therapy to block production of male hormones, causing the prostate to shrink.

During the minimally invasive cryotherapy procedure, multiple cryoablation needles are inserted into the prostate through the perineum (the area between the anus and scrotum) while the patient is under anesthesia. An ultrasound probe is inserted into the rectum in order for the urologist to view the prostate and the entire freezing process during the procedure.

Because the urethra passes through the prostate gland, a warming catheter is used to protect it from freezing. Thermal sensor needles monitor the temperature within and around the prostate to ensure that the prostate is being frozen to temperatures less than -40° C while the adjacent areas of the rectum and other organs remain unfrozen. This safeguard dramatically lowers the chance of incontinence, rectal fistulae or other side effects.

When the cryoablation needles and temperature sensors are in place, a freezing agent, argon gas, is circulated through the cryoablation needles to create temperatures of -40° C or colder. This creates a lethally cold iceball that freezes the prostate and the cancer cells in it. The thawing process, which is what actually ruptures and kills the cancer cells in the prostate gland, is initiated. This freeze-thaw process is repeated to ensure all cancerous cells are destroyed and to help prevent future prostate cancer recurrence. The dead tissue is reabsorbed or remains in the body as harmless scar tissue.

When the freeze-thaw process is finished, the warming catheter is removed and a urinary catheter is inserted to help with any temporary urinary incontinence. The urinary catheter is typically removed after two or three days unless incontinence persists.

For more information about cryotherapy, contact Alliance Urology Specialists at 336-274-1114.

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