Cryotherapy is an effective, minimally invasive procedure for treating prostate cancer. It involves destroying cancer cells by freezing them.
Depending on the extent of the cancer, cryotherapy is usually done on the whole prostate gland. But in some cases, nerve-sparing cryotherapy can be done to protect sexual function. Cryotherapy is also an effective “salvage” treatment when cancer recurs after radiation therapy.
Cryotherapy typically takes 1.5 hours and can be done under either spinal or general anesthesia.
During the procedure:
- Thin needles are inserted through the skin
- Ultrasound imaging and temperature probes precisely target the cancerous tissue
- Harmless argon gas is then circulated inside the probe
- The gas generates temperatures cold enough to freeze the cancer cells
- A special warming catheter is used to protect the urethra
After the procedure, icepacks are applied to the scrotum and perineum for the first day. Patients go home with a catheter which remains in place for about one week.
Patients may experience:
- Swelling or bruising around scrotum and perineum for up to two weeks
- Urinary retention, which can be relieved by the short-term use of a catheter
- Some discomfort sitting for up to two weeks
Side effects are rare, but can include a fistula (an opening between the urethra and the rectum) and incontinence.
Cryotherapy is so precise, surgeons are often able to avoid nerves in the prostate gland that are responsible for causing an erection.
With nerve-sparing cryotherapy, a small portion of the prostate gland is not frozen in order to avoid the nerves responsible for sexual function. Of those men who do lose erections after the procedure, 50% will regain their erections within 3 years.
(Nerve-sparing cryotherapy is typically not possible for someone whose cancer has spread throughout the prostate or has evidence of cancer near the nerves.)
Salvage cryotherapy is the term used when cryotherapy is used when cancer reappears after radiation therapy.
Radiation therapy – including both external and internal methods – is a common treatment for prostate cancer. But if the prostate cancer recurs, salvage cryotherapy is considered by many as the best therapy. It has a cure rate similar to salvage radical surgery – with fewer side effects and a faster recovery.
A major benefit of cryotherapy is that it can be done on an outpatient basis: about half of all patients go home the same day, and half the next day.
Other benefits include:
- Favorable success rates: the reported cure rate is similar to surgery and brachytherapy
- A quick recovery: Patients typically return to normal activities in about 10 days
- Minimal pain: While most people take anti-inflammatory medications for several days, but narcotic pain medications are typically not needed
- A lower risk of the side effects associated with surgery and radiation, including incontinence, irritable bladder and bowels, and blood loss
- Cryotherapy can also be repeated if prostate cancer should recur at a later time.
Most men with prostate cancer are good candidates for cryotherapy. Men who may not be good candidates include:
- Many whose cancer has spread beyond the prostate gland
- Men whose prostate glands so large, the urinary flow is blocked
- Elderly men who don’t want to undergo a surgical procedure
For many man, cryotherapy is not an option simply because it is not available in their areas. Yet cryotherapy is an effective treatment that was approved by the FDA in 2000.
While many men with prostate cancer are good candidates for cryotherapy, this treatment is not widely available because of the special training required.
At Swedish, we have the experience and expertise to safely and effectively perform cryotherapy – as well as teach other surgeons how to do it.
In fact, Swedish is one of the few places in the Northwest where you can receive cryotherapy from a highly experienced surgeon who is a regional instructor in the technology.
Find a Physician at Swedish who is an expert in cryotherapy.
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