Cryosurgery for Prostate Cancer
Cryosurgery (also called cryotherapy or cryoablation) is sometimes used to treat localized prostate cancer by freezing the cells with a metal probe. During this procedure, warm saltwater is circulated through a catheter in the urethra to keep it from freezing. The probe is placed through a skin incision located between the anus and scrotum and guided into the prostate using transrectal ultrasound. Spinal, epidural or general anesthesia is used during the procedure.
The appearance of prostate tissue in ultrasound images changes when it is frozen. To be sure enough prostate tissue is destroyed without too much damage to nearby tissues, the surgeon carefully watches these images during the procedure. A suprapubic (above the pubic area) catheter is placed through a skin incision on the abdomen into the bladder so that if the prostate swells after the procedure (which usually occurs) it won't block the passage of urine. The catheter is removed 1 to 2 weeks later. After the procedure, there will be some bruising and soreness of the area where the probe was inserted. Patients will likely stay in the hospital for 1 or 2 days following the procedure.
Cryosurgery is less invasive than radical prostatectomy, so there is less blood loss, a shorter hospital stay, shorter recovery period and less pain than radical surgery. But compared with surgery or radiation therapy, doctors know much less about the long-term effectiveness of cryosurgery. Current techniques using ultrasound guidance and precise temperature monitoring only have been available for a few years. Outcomes (treatment results) of long-term (10- to 15-year) follow-up still must be collected and analyzed. For this reason, most doctors do not include cryotherapy among the options they routinely consider for initial treatment of prostate cancer.