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Cryotherapy Gaining Recognition as a Viable Treatment
for Localized Prostate Cancer
Cryotherapy utilizes a combination of integrated planning software, ultrasound guidance techniques, treatment probes and precision temperature monitors to freeze and destroy localized prostate cancer. The procedure itself – cryosurgery – is a minimally invasive option to treat localized stage T1 through stage T3 cancer cells.
Cryosurgery utilizes ultrasound-guidance to precisely insert cooling probes into the prostate. Circulation of inert argon gas within the probes generates overlapping teardrop-shaped iceballs. A double freeze-thaw cycle insures physical cell death at the time of treatment.
Clinical studies based on ten-year data indicate favorable results compared with other treatments. For example, data related to total gland freeze encompassing a database of 5,000 patients up to a ten-year period indicates 80% to 90% efficacy with resulting incontinence of less than 5%. Approximately 50% of patients regain erectile function within 1 to 4 years. In addition, up to 10-year data encompassing a database of 500 patients shows that partial (focal) freeze results in 80% to 93% efficacy with a return to potency greater than 70% within a year.
Advantages associated with cryosurgery may include less likeliness to cause urinary and bowel toxicities as compared with radiation treatment and protection of healthy tissue from damage. The procedure typically takes an hour and a half to complete, most patients experience little or no pain, and patients often recover fully within days. Cryosurgery avoids major surgery, is often performed as a same-day outpatient procedure and offers a choice of anesthesia (general or spinal). If cancer is limited to a portion of the prostate, a partial (focal) treatment may be possible to preserve potency.
Disadvantages associated with cryosurgery is the occurrence of impotency because of nerve damage during a total gland freeze, although approximately 50% of patients regain erectile function within 24 hours. Urinary incontinence may occur. Less than approximately ½% of patients incur rectal injury (fistula) that may require subsequent surgery to repair.
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