Cryoablation

Cryotherapy or cryoablation of the prostate involves the destruction of prostate tissue and cancer cells by freezing. Patients who choose cryoablation undergo an outpatient procedure in the operating room where needles are placed into the prostate. These needles are then used to freeze the prostate while measures are taken to warm the urethra to minimize damage to the urinary tract.

While cryotherapy has been used for many years to treat prostate cancer, it previously was associated with a high complication rate. However, improved technology has greatly reduced the risk of these complications today. The major use of cryotherapy has been for patients who have been initially treated with radiation therapy and then have a cancer relapse. However, some men are choosing to have cryotherapy as their initial primary therapy as well. Unfortunately, long-term results are currently lacking for the primary treatment of prostate cancer with cryoablation, so it is considered somewhat more experimental than radiation or surgery for prostate cancer treatment.

There are no established guidelines on how to monitor prostate cancer after cryotherapy or how to determine if cancer is recurrent based on PSA. Side effects may include urinary problems, such as leakage, fistula formation, rectal or perineal pain and erectile problems.

Advantages: It is minimally invasive and does not involve radiation exposure or surgical risk. Repeat treatments are possible with cryotherapy.

Disadvantages: In comparison to surgery or radiation, fewer data are available regarding cancer control for cryotherapy as a primary therapy for prostate cancer. Erectile dysfunction is very common after this type of therapy. Defining recurrent cancer after cryotherapy is difficult.