Cold temperature can destroy cancer. This is the basis of cryosurgery--using very cold temperatures to treat tumors. Therefore, cryosurgery of the prostate gland is the technique of freezing prostate tissue. Today, we are interested in using cryoablation of the prostate to treat prostate cancer.
Prostate cancer is the most common cancer affecting males in the United States. There will be about 200,000 new cases of prostate cancer diagnosed this year. Prostate cancer is also the second leading cause of cancer death in males in the United States. It is estimated that 31,400 men will die from prostate cancer this year.
There are many treatments available for prostate cancer. The most common curative therapies are surgery, known as radical prostatectomy, and radiation therapy. If a man chooses radiation therapy, he has a choice of external beam radiation, implantation of radioactive seeds (brachytherapy), or a combination of the two.
Today, patients have another treatment option available to them--cryosurgery. Cryosurgery is an effective primary therapy for prostate cancer. This means it is the initial treatment for the cancer. However, it is also an effective salvage therapy. In other words, if a patient has received either external beam radiation therapy or implantation of radioactive seeds, and the prostate cancer persists or has come back, the patient can then still be treated with cryoablation of the prostate. This salvage role of cryosurgery gives the patient another good chance of being cured of the cancer.
The goal of cryosurgery is to freeze the entire prostate gland, rendering the patient free of disease. New technology allows the urologist to utilize minimally invasive techniques to perform the cryoablation procedure. Small probes are placed into the prostate using percutaneous access--poking them through the skin. No incisions are made.
The blunt tip probe, shown above left, produces a spherical iceball in the prostae, shown above right.
The flat probe, shown above left, produces a hemispherical iceball in the prostate, shown above right.
The entire procedure is followed with ultrasound visualization. This allows the urologist to monitor the formation of the ice ball within the prostate visually and in real time, ensuring greater accuracy and more importantly, leading to a safer procedure with less complications. The better visualization allows the urologist to keep the freezing confined to the prostate, sparing the bladder, rectum and sphincter muscles.
Cryoablation of the prostate can result in disease-free status in a high percentage of patients. After one year, about 67% of patients who have undergone cryosurgery as the primary treatment have an undetectable PSA. When cryosurgery is used as salvage therapy after failed radiation, recurrence free survival ranges from 66.5% to 86% at one year and 53.2% to 74% at two years.
I would like to learn more about the cryosurgery procedure
I would like to learn more about the history of cryosurgery