Cryotherapy or Cryoblation is a prostate cancer treatment that freezes either a portion of the prostate, or the entire gland, depending on the extent of the cancer. While this option is performed in a hospital or surgery center, it is generally an outpatient procedure unless severe comorbidity issues exist. Cryotherapy is often used when treating a localized tumor in the prostate, early stage cancer that has not penetrated the capsule wall, or for men who have failed radiation therapy.
The procedure itself is performed by placing several thin needles into the prostate through the skin of the perineum (area between the scrotum and the anus). Once in place, argon gas is circulated through the needles causing them to cool to a temperature that freezes all nearby prostate tissue and causes immediate cell death. Depending on the cancer being treated, freezing may be targeted or the entire prostate is frozen in sections.
As a precaution, a catheter filled with a warming solution is inserted into the urethra to keep it from freezing during the procedure. After the treatment, a patient is discharged home and will have a cather remain in place for 4-7 days on average. One of the advantages of cyrotherapy versus radiotherapy, is that the patient does not require hormone therapy which will temporarily reduce his testosterone to castrate levels. Patients experience very little pain other than the irritation of having an urinary catheter in place.
While this is a safe procedure, it is not without side effects. The most common side effect is erectile dysfunction, particularly in men having their entire prostate gland frozen. During this procedure, the neuro-vascular bundle of nerves (that promote erection) can be affected. Other side effects may include localized pain, swelling, urinary frequency or incontinence, temporary changes to bladder or bowel function, painful urination, hematuria, localized bleeding, infection, or rectal fistula ─ an infected tunnel between the skin and the anus.
After cryotherapy, your provider will continue to monitor the prostate to ensure the absence of cancer. The PSA (prostate specific antigen) blood test will be performed at specific intervals starting at three months. In the case of focal targetted cryoablation, the patient will have periodic PSA’s, repeat MRI and possibly future repeat biopsy to confirm the absence of prostate cancer in the prostate