Cryotherapy for Prostate Cancer

What is Cryotherapy?

Cryotherapy (or cryosurgery) is the destruction of diseased cells by freezing and can be used to treat prostate cancer. This is achieved using nitrogen or argon gases cooled to very low temperatures, which are administered to the prostate through metal tubes. The procedure can be carried out under local or general anesthetic. Cryotherapy is an ablative technique, a group of therapies that also include high intensity focused ultrasound and photodynamic therapy.

When is Cryotherapy for Prostate Cancer done?

At present cryotherapy is not a routine treatment for prostate cancer in most European countries and other treatments such as surgery, chemotherapy, radiotherapy or hormone therapy are preferred. This is because cryotherapy has a lower success rate and generally results in greater side-effects such as loss of bladder control and impotence. However, The American Urological Association recently stated that cryotherapy may have a use, particularly in cases where the disease is confined to the prostate.

Cryotherapy and Focal Therapy

In recent years there has been increased screening for prostate cancer by measurement of PSA (prostate specific antigen) levels in the blood, so allowing early detection of the disease. As a result, clinicians are seeing more patients with so called intermediate-risk prostate cancer i.e. disease that has not yet spread beyond the prostate.

In cases of intermediate-risk prostate cancer, the choice is whether to treat radically or take a ‘wait and see’ surveillance approach. Both of these have drawbacks; radical surgery (prostate removal) has side effects such as genitourinary or rectal dysfunction. However the surveillance approach carries the risk of the disease progressing. Both approaches therefore, can cause considerable psychological burden on the patient.

Focal therapy aims to take a midway course between the radical and surveillance approaches by killing the tumor tissue and only a small margin of normal tissue. By preserving as much of the healthy tissue as possible, side effects can be minimized. Some oncologists believe that cryotherapy has potential here, however, it can be difficult to identify which areas of the prostate are affected and hence where to target the therapy.