Cryosurgery for Prostate Cancer
Cryosurgery for prostate cancer, also referred to as cryotherapy, involves inserting one or more ultrathin cryoneedles (also called cryoprobes) into the prostate and circulating argon gas to the tumor. The surgeon uses ultrasound or MRI to guide the needles to monitor the freezing of the cells and to limit the damage to healthy tissue. The needles may be put into the tumor through the skin or during surgery. After cryosurgery, the frozen tissue thaws and is absorbed by the body.
Cryosurgery for prostate cancer is currently indicated for men who have low-risk prostate cancer as an alternative to prostatectomy or radiation, in patients who are high risk for surgery, and in patients who have not responded to radiation therapy. It is less well established than prostatectomy and radiation therapy. The long-term outcomes are not yet known. Cryosurgery for prostate cancer has two advantages has over prostatectomy. The cryosurgery procedure can be repeated, and it can be used to treat men who are unable to undergo surgery or radiation therapy because of their age or medical problems.
Side Effects of Cryosurgery for Prostate Cancer
The most common side effect from cryosurgery for prostate cancer is erectile dysfunction, which is as high as 80 to 90 percent. Several studies report erectile dysfunction to be nearly 90 percent one year after the procedure was performed. (Han, Hubosky, Polascik) An experimental procedure called focal cryoablation may be helpful in reducing the chances of erectile dysfunction. (Singh 2010)
Swelling in the perineum area where the needles are inserted may also occur and is usually temporary. Urinary incontinence rates range from 2 to 7 percent, urethral fistula 0 to 2 percent, and rectal pain about 2.6 percent. Urethral sloughing, in which dead tissue left over from damage to the urethra from the freezing processes and passes through the urethra, occurs in about 2 to 6 percent of patients. (Han, Hubosky, Polascik)