Cryogenic Prostate Cancer Treatment

Prostate cancer is the most common non-skin cancer in male patients, affecting one in six American men. For some, cryogenics offers a minimally invasive solution to their prostate cancer. This treatment involves freezing the prostate gland, destroying the gland itself as well as the cancer it contains. As with all prostate cancer treatments, cryotherapy has its own unique benefits and risks, so patients should learn all they can about this prostate cancer treatment option.

The Goal of Treatment

• The goal of cryogenic prostate cancer treatment is to totally destroy, or ablate, the prostate gland by freezing the tissue from the inside. During the procedure, the physician will insert tiny needles into the prostate gland through the skin. Needle placement is determined based on ultrasound images of the gland. Argon gas, which is extremely cold, is infused into the gland through the needles. Once the tissue has reached the desired temperature (-40 degrees Fahrenheit), it is warmed using helium. This process is repeated twice to ensure that all of the cells in the tissue are destroyed. The surrounding tissue is kept warm with a warming catheter.

History

• The idea of cryogenic therapy for prostate cancer was introduced in the 1960s when the first liquid nitrogen cryoprobe was developed. These early procedures were performed through the urethra or a perennial incision. These treatments caused a lot of side effects, and the idea was abandoned. In 1974, the idea of infusing the gland with the freezing gas through transperineal needles was introduced, but a lack of good imaging technology contributed to a high risk of complications. When ultrasound imaging and argon gas were introduced into the cryoablation technique in the 1990s, it gained new interest in the medical world.

How It Works

• This procedure works because the infusion of the argon gas causes tiny ice balls to form inside each cell within the gland. These ice balls destroy the tissue at the cellular level. When the tissue is thawed, dead cells are all that remains. Both healthy glandular cells and cancer cells are destroyed. Because the procedure destroys all cells within the prostate gland as well as some surrounding tissue, it works well for localized cancers or cancers that are just reaching the edge of the gland.

Benefits

• Because cryotherapy for prostate cancer is a minimally invasive procedure, it does not require a long hospital stay. Some physicians will keep their patients overnight for observation, but this is not required. Since the treatment requires no incision, cryosurgery causes less pain than other procedures, and many patients are walking within hours of treatment. It causes minimal blood loss, if any at all, and is repeatable if needed. It can also be used as a salvage treatment if other prostate cancer treatments, like radiation, have failed.

Risks

• While cryogenics as a prostate cancer treatment option appears to be effective, it is a relatively new treatment option without long-term survival rate data, according to the Prostate Cancer Treatment Guide. The Prostate Cancer Centre states that cryotherapy has a higher risk of impotence than other popular treatments, because the nerves that cause an erection are usually frozen in the process. This impotence is sometimes temporary or can be treated with erectile dysfunction treatments. Incontinence is also a slight risk, but this is lowered by the warming catheter used during the procedure.