Cryotherapy for Prostate Cancer

Overview

Cryotherapy uses very cold temperatures to destroy cancer cells in the prostate gland. In this treatment, doctors pass thin metal needles through the skin and directly into the prostate. These needles carry special gases that freeze the prostate tissue.

Key points about cryotherapy:

Often chosen for early-stage or intermediate-risk prostate cancer.
Sometimes used when cancer comes back after other treatments.
Offers another option if surgery or radiation are not possible.

Treatment Area	Details
Targeted Area	Prostate gland
Who May Benefit	Early-stage patients, intermediate-risk cases
Possible Risks	Long-term sexual side effects, but less than in the past

Technology improvements have made it safer, resulting in fewer long-term problems. Some people may still experience sexual issues. Cryotherapy gives doctors another tool to manage prostate cancer in different situations.

Main Reasons for Selecting Cryotherapy

Doctors use cryotherapy to destroy prostate cancer cells by freezing affected tissue. They may choose this method when the cancer remains within the prostate, especially if surgery or radiation therapy is not a safe choice. In some cases, doctors use cryotherapy as a follow-up treatment if cancer returns after the initial approach, such as prostatectomy or high-intensity focused ultrasound (HIFU).

When Might Doctors Consider Cryotherapy

As an alternative to invasive surgery when patients are not ideal for radical prostatectomy.
If cancer is limited to the prostate and hasn’t spread.
When other options, like radiation therapy or immunotherapy, are not possible.
For patients who want a minimally invasive procedure with shorter recovery times.

Treatment Situation	Is Cryotherapy Recommended?
Localized prostate cancer	Yes
After failed initial treatment	Yes
Previous major rectal or anal surgery	No
Hard to monitor with ultrasound	No
Large tumor close to other organs	No

Researchers are exploring focal therapy, a method where doctors treat only part of the prostate with the most aggressive cancer cells. This approach may help reduce side effects compared to treating the whole prostate. Currently, doctors mostly offer cryotherapy to patients who are not suited for other treatments or who want less invasive care instead of active surveillance.

Possible Complications

Cryotherapy for prostate cancer may cause several side effects. Common issues include erectile dysfunction, pain or swelling in the genital area, blood in the urine, and loss of bladder control. Sometimes, bleeding or infection can occur at the treatment site. Less often, complications such as injury to the rectum or urethral blockage may develop. Other risks may include:

Urinary incontinence
Sexual dysfunction
Fistula (rare)

What You Can Expect

Steps Before the Procedure

Doctors often instruct patients to use a fluid enema to clear the colon. They usually give antibiotics to lower the chance of infection during the process.

During the Procedure

Doctors usually perform cryotherapy for prostate cancer in a hospital setting. Some people receive a general anesthetic, which puts them to sleep, while others might get a regional anesthetic, allowing them to stay conscious but feel no pain in the area being treated. Steps typically include:

The doctor positions an ultrasound probe in the rectum to help guide the treatment.
A warming catheter, filled with warm saline, is inserted into the urethra to prevent freezing during the process.
The doctor inserts several thin needles or probes into the prostate through the perineum (the skin between the scrotum and anus).
The doctor uses real-time ultrasound images to ensure correct probe placement.
A special gas passes through the probes, freezing the prostate tissue.
The temperature and spread of the freezing are closely monitored to protect nearby healthy tissue.
Sometimes, the doctor places a urinary catheter through the lower abdomen into the bladder to help drain urine after the procedure.

Doctors often perform this treatment as an outpatient procedure, though sometimes patients stay overnight in the hospital.

Table: Common Tools Used During Cryotherapy

Tool	Purpose
Ultrasound probe	Guides probe placement
Warming catheter	Keeps the urethra warm and prevents freezing
Metal probes/needles	Delivers freezing gas to prostate tissue
Urinary catheter	Drains urine after the procedure

What Happens After Prostate Cryotherapy

After treatment, most people can go home the same day or might stay in the hospital overnight for monitoring. The urinary catheter may stay in place for up to two weeks to help with healing and allow urine to flow. What patients may experience includes:

Mild soreness or bruising in the area where the probes were inserted.
Blood in the urine for a few days.
Trouble urinating or moving bowels; these problems usually improve over time.

Doctors may prescribe antibiotics to prevent infection. Most people recover quickly and can return to daily activities soon after the procedure.

Outcomes

Patients typically attend regular follow-up appointments after treatment, which may include PSA tests and imaging scans to monitor recovery progress. Doctors monitor the immune system and healing during this recovery period to ensure there are no complications. This lets doctors track how well the therapy works and address any issues quickly.

Prostate Cancer Freezing

Cryotherapy is a treatment that uses extreme cold to target and destroy cancer cells within prostate tissue. Special needles, called cryoprobes, deliver the freezing agent directly to the cancerous area. Argon gas quickly freezes the cells, while helium gas may thaw the tissue.

Doctors often select this method for men with early-stage or local cancer, especially if surgery or radiation is not possible. Some use it as a focal therapy, freezing only the tumor while sparing nearby healthy tissue.

Key Points

Uses argon gas and sometimes liquid nitrogen to create intense cold
Freezing cuts off the cancer cells’ blood supply
The body absorbs dead tissue
Common side effects include erectile dysfunction and urinary issues