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Cryotherapy for prostate cancer

Cryosurgery - prostate cancer; Cryoablation - prostate cancer

Cryotherapy uses very cold temperatures to freeze and kill prostate cancer cells. The goal of cryosurgery is to destroy the entire prostate gland and possibly surrounding tissue.

Cryosurgery is generally not used as a first treatment for prostate cancer.

What Happens During Cryotherapy

Before the procedure, you will be given medicine so that you do not feel pain. You may receive:

  • A sedative to make you drowsy and numbing medicine on your perineum. This is the area between the anus and scrotum.
  • Anesthesia. With spinal anesthesia, you will be drowsy but awake, and numb below the waist. With general anesthesia, you will be asleep and pain-free.

First, you will get a catheter that will stay in place for about 3 weeks after the procedure.

  • During the procedure, the surgeon places needles through the skin of the perineum into the prostate.
  • Ultrasound is used to guide the needles to the prostate gland.
  • Then, very cold gas passes through the needles, creating ice balls that destroy the prostate gland.
  • Warm salt water will flow through the catheter to keep your urethra (the tube from the bladder to outside the body) from freezing.

Cryosurgery is most often a 2-hour outpatient procedure. Some people may need to stay in the hospital overnight.

When Cryosurgery is Used to Treat Prostate Cancer

This therapy is not as commonly used and is not as well accepted as other treatments for prostate cancer. Doctors do not know for certain how well cryosurgery works over time. There is not enough data to compare it with standard prostatectomy, radiation treatment, or brachytherapy.

It can only treat prostate cancer that has not spread beyond the prostate. Men who cannot have surgery because of their age or other health problems may have cryosurgery instead. It also may be used if cancer comes back after other treatments.

It is generally not helpful for men with very large prostate glands.

Side Effects

Possible short-term side effects of cryotherapy for prostate cancer include:

  • Blood in the urine
  • Trouble passing urine
  • Swelling of the penis or scrotum
  • Problems controlling your bladder (more likely if you have had radiation therapy also)

Possible long-term problems include:

  • Erection problems in nearly all men
  • Damage to the rectum
  • A tube that forms between the rectum and the bladder, called a fistula (this is very rare)
  • Problems with passing or controlling urine
  • Scarring of the urethra and difficulty urinating

References

American Cancer Society website. Cryotherapy for prostate cancer. www.cancer.org/cancer/prostate-cancer/treating/cryosurgery.html. Updated August 1, 2019. Accessed December 17, 2019.

Chipollini J, Punnen S. Salvage cryoablation of the prostate. In: Mydlo JH, Godec CJ, eds. Prostate Cancer: Science and Clinical Practice. 2nd ed. Philadelphia, PA: Elsevier; 2016:chap 58.

National Cancer Institute website. Prostate cancer treatment (PDQ) - health professional version. www.cancer.gov/types/prostate/hp/prostate-treatment-pdq. Updated January 29, 2020. Accessed March 24, 2020.

National Comprehensive Cancer Network website. NCCN clinical practice guidelines in oncology (NCCN guidelines): prostate cancer. Version 1.2020. www.nccn.org/professionals/physician_gls/pdf/prostate.pdf. Updated March 16, 2020. Accessed March 24, 2020.

  • Prostate cancer

    Animation

  •  

    Prostate cancer - Animation

    As men get older, they have a lot of new worries to deal with, from hair loss, weight gain, perhaps even erectile dysfunction. In addition, cancer is one of the biggest concerns that older men face, especially prostate cancer, which is the leading cause of cancer death in men over 75. Younger men may not be very familiar with their prostate, the walnut-shaped gland that wraps around the urethra, the tube that carries urine out of the body. But as they get older, the prostate can start to cause problems. Men over the age of 60 are at increased risk for prostate cancer, especially if they're of African descent, they have a father or brother with the disease, or they eat a lot of burgers and processed meats in their daily diet. It can be hard to pinpoint prostate cancer symptoms, because they usually start late in the disease and they can mimic symptoms of a benign, enlarged prostate, which is also more common in older men. Symptoms like a slow urine stream, dribbling, blood in the urine, or straining while urinating can be signs of either condition. An enlarged prostate can also confuse the results of a PSA test, which is used to screen for prostate cancer. So, if your doctor thinks you might have prostate cancer, you may need a biopsy, which is a procedure that removes a small piece of prostate tissue and sends it to the lab to check for cancer. Then a scoring system called the Gleason grade is used to tell how fast your cancer might spread. Your Gleason grade will help decide what treatment you get. Early-stage prostate cancers that haven't spread are often removed with surgery, and then treated with radiation therapy to kill any remaining cancer cells. Prostate cancer surgery may affect your ability to have sex and control urine, so talk about these issues with your doctor before you have the procedure. Because prostate cancer tends to grow very slowly, your doctor may want to just monitor you with PSA tests and biopsies, and avoid treatment unless the cancer starts to spread. Prostate cancer that has spread is usually treated with surgery, chemotherapy, or hormone therapy. If your doctor discovers prostate cancer in its early stages, before it spreads, it's pretty easy to treat, and even cure. Treatments can also slow down prostate cancer that's spread, and extend your survival. Before you have to deal with a prostate cancer diagnosis, ask your doctor for ways to prevent and screen for the disease. Eating a healthy, low-fat diet that's high in healthy omega-3 fatty acids might help lower your risk. There are also drugs called finasteride and dutasteride that are used in some men to prevent prostate cancer. Talk with your doctor about the pros and cons of these drugs, as well as the possible benefits and risks of having your PSA levels tested.

  • Male reproductive anatomy

    Male reproductive anatomy - illustration

    The male reproductive structures include the penis, the scrotum, the testicles (testes), the epididymis, the seminal vesicles, and the prostate.

    Male reproductive anatomy

    illustration

  • Prostate cancer

    Animation

  •  

    Prostate cancer - Animation

    As men get older, they have a lot of new worries to deal with, from hair loss, weight gain, perhaps even erectile dysfunction. In addition, cancer is one of the biggest concerns that older men face, especially prostate cancer, which is the leading cause of cancer death in men over 75. Younger men may not be very familiar with their prostate, the walnut-shaped gland that wraps around the urethra, the tube that carries urine out of the body. But as they get older, the prostate can start to cause problems. Men over the age of 60 are at increased risk for prostate cancer, especially if they're of African descent, they have a father or brother with the disease, or they eat a lot of burgers and processed meats in their daily diet. It can be hard to pinpoint prostate cancer symptoms, because they usually start late in the disease and they can mimic symptoms of a benign, enlarged prostate, which is also more common in older men. Symptoms like a slow urine stream, dribbling, blood in the urine, or straining while urinating can be signs of either condition. An enlarged prostate can also confuse the results of a PSA test, which is used to screen for prostate cancer. So, if your doctor thinks you might have prostate cancer, you may need a biopsy, which is a procedure that removes a small piece of prostate tissue and sends it to the lab to check for cancer. Then a scoring system called the Gleason grade is used to tell how fast your cancer might spread. Your Gleason grade will help decide what treatment you get. Early-stage prostate cancers that haven't spread are often removed with surgery, and then treated with radiation therapy to kill any remaining cancer cells. Prostate cancer surgery may affect your ability to have sex and control urine, so talk about these issues with your doctor before you have the procedure. Because prostate cancer tends to grow very slowly, your doctor may want to just monitor you with PSA tests and biopsies, and avoid treatment unless the cancer starts to spread. Prostate cancer that has spread is usually treated with surgery, chemotherapy, or hormone therapy. If your doctor discovers prostate cancer in its early stages, before it spreads, it's pretty easy to treat, and even cure. Treatments can also slow down prostate cancer that's spread, and extend your survival. Before you have to deal with a prostate cancer diagnosis, ask your doctor for ways to prevent and screen for the disease. Eating a healthy, low-fat diet that's high in healthy omega-3 fatty acids might help lower your risk. There are also drugs called finasteride and dutasteride that are used in some men to prevent prostate cancer. Talk with your doctor about the pros and cons of these drugs, as well as the possible benefits and risks of having your PSA levels tested.

  • Male reproductive anatomy

    Male reproductive anatomy - illustration

    The male reproductive structures include the penis, the scrotum, the testicles (testes), the epididymis, the seminal vesicles, and the prostate.

    Male reproductive anatomy

    illustration

A Closer Look

 
 

Review Date: 9/23/2019

Reviewed By: Sovrin M. Shah, MD, Assistant Professor, Department of Urology, The Icahn School of Medicine at Mount Sinai, New York, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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