Cryotherapy for Prostate Cancer
What is cryotherapy for prostate cancer?
Cryotherapy uses very cold temperatures to “freeze” prostate tissue and kill cancer cells. It is also called cryosurgery. Cryotherapy can be done to the entire prostate gland or to certain areas (called focal cryotherapy). The cold temperatures can also damage healthy tissue in the area. Your provider takes steps to protect the healthy tissue in the area and lessen the risk of side effects.
Cryotherapy is less invasive than other treatments. The treatment time is shorter, you spend less time in the hospital, and there is less bleeding and pain than other treatment options. It is an option for men who cannot have surgery or radiation, or if the cancer has come back after radiation.
Who can have cryotherapy to treat their prostate cancer?
Cryotherapy can be used to treat prostate cancer that has not spread to other areas of the body (non-metastatic). It is most often used for early-stage or low-risk cancers. It may be a good option for men who cannot have surgery or radiation therapy, or if the cancer has come back after radiation treatment.
How is cryotherapy given?
Cryotherapy is done in the hospital. You are given anesthesia (general or local anesthesia) so you will not feel the procedure.
An ultrasound probe is placed in the rectum. The probe is used to see what areas need to be treated and to monitor the procedure. A catheter is placed in the urethra (the tube that drains urine from the bladder). This catheter is filled with warm water to protect the urethra from freezing during the procedure. Thin needles are placed into the prostate gland through the perineum (the skin between the scrotum and anus). The ultrasound probe is used to guide where these needles are placed. A very cold gas (Argon gas) is put into the needles to freeze the tissue.
After the procedure, you will have a catheter in place to drain your urine for a few weeks. You may go home the same day or stay in the hospital overnight. You will be told how to care for yourself, such as treating your soreness or pain, what activities you can and cannot do, and when to call your healthcare provider.
What are the possible side effects of cryotherapy for prostate cancer?
While freezing prostate tissue, healthy tissue in the area can be damaged by the cold temperature. This type of damage can cause:
- Nerve damage that leads to erectile dysfunction (not being able to get an erection).
- In rare cases, a fistula (hole or connection) from the rectum to the bladder or urethra.
- Urinary incontinence (not being able to hold your urine), which is most common when cryotherapy is used after radiation.
Other risks include: infection, bleeding, pain, frequent or difficult urination, blood in the urine, needing to move bowels often, or swelling in the scrotum or penis.
If cryotherapy is part of your treatment plan for prostate cancer, talk with your provider about any questions you may have.
References
American Cancer Society. Cryotherapy for prostate cancer. https://www.cancer.org/cancer/prostate-cancer/treating/cryosurgery.html
Gestaut, M. M., Cai, W., Vyas, S., Patel, B. J., Hasan, S. A., MunozMaldonado, Y., … Swanson, G. (2017). Low-Dose-Rate Brachytherapy Versus Cryotherapy in Low- and Intermediate-Risk Prostate Cancer. International Journal of Radiation Oncology*Biology*Physics, 98(1), 101–107.
Johns Hopkins Medicine. Cryotherapy for prostate cancer. https://www.hopkinsmedicine.org/health/conditions-and-diseases/prostate-cancer/cryotherapy-for-prostate-cancer
Jung, J. H., Risk, M. C., Goldfarb, R., Reddy, B., Coles, B., & Dahm, P. (2018). Primary cryotherapy for localised or locally advanced prostate cancer. Cochrane Database of Systematic Reviews, (5).
Mayo Clinic. Cryotherapy for prostate cancer. https://www.mayoclinic.org/tests-procedures/cryotherapy-for-prostate-cancer/about/pac-20384740
Shah, T. T., Peters, M., Eldred-Evans, D., Miah, S., Yap, T., Faure-Walker, N. A., … Ahmed, H. U. (2019). Early-Medium-Term Outcomes of Primary Focal Cryotherapy to Treat Nonmetastatic Clinically Significant Prostate Cancer from a Prospective Multicentre Registry. European Urology, 76(1), 98–105.