Cryosurgery

What is Cryosurgery for Prostate Cancer?

Cryosurgery is a treatment that freezes the prostate gland to kill cancer cells. This procedure is also called hemi-gland cryoablation, cryotherapy for prostate cancer, or prostate freezing treatment. The prostate rests under the bladder in males. It produces semen and helps direct urine out of the body.

Benefits of Cryosurgery for Prostate Cancer

There are several prostate cryotherapy benefits.

These benefits include:

• Less invasive procedure — Cryosurgery is less invasive than other procedures such as removing the prostate gland or the testicles.
• Shorter recovery time — A patient recovering from cryotherapy will typically recover much faster than many other types of prostate cancer treatments. The hospital stay is also often shorter.
• Reduced side effects — cryotherapy for prostate cancer lowers the risk for incontinence and erectile dysfunction.
• Reduced pain — There is usually less pain and less blood loss with cryosurgery for prostate cancer.

Why You Would Need Cryosurgery

Your doctor may recommend freezing prostate cancer treatment based on the size of your prostate, the development of the cancer, and your general health.

Common reasons for cryosurgery for prostate cancer:

• Your general health makes radiation treatment risky.
• The cancer has not spread to other parts of your body.
• Your cancer has not responded to other treatments.
• Your doctor wants to treat symptoms of prostate cancer.

Potential Risks and Disadvantages

There are risks and disadvantages of cryotherapy for prostate cancer.

Potential risks include:

• Uncontrollable bladder
• Infection
• Erectile dysfunction
• Scrotum pain
• Scrotum swelling
• Pain in the penis
• Swelling in the penis
• Bloody urine
• Bleeding

Some risks, such as an injured scrotum or blocked urethra, are rare.

Criteria

Certain factors might qualify or disqualify someone for cryotherapy prostate cancer treatment.

Criteria that might qualify you for treatment:

• As an initial treatment for prostate cancer.
• For reoccurring prostate cancer.
• You did not respond to other prostate cancer treatments.
• Your general health makes more invasive procedures risky.

Criteria that might disqualify you for treatment:

• You have a condition that prevents your doctor from monitoring your prostate with an ultrasound probe during the treatment.
• The tumor is too large to safely treat with cryotherapy.
• You had rectal cancer surgery in the past.
• You had anal cancer surgery in the past.

How to Prepare Before Surgery

The specific pre-surgery preparations will depend on your health, lifestyle, and medical history.

Common preparations for prostate cryotherapy prostate cancer treatment:

• Explanation — Your doctor will explain the procedure, the benefits, the risks, and what to expect before, during, and after treatment.
• Paperwork — You will be asked to sign consent forms for the procedure.
• Medical Review — Your doctor will review your general health, medical history, and perform a physical exam. You may also take blood tests. We recommend that you inform your doctor of any health issues or symptoms you may currently experience.
• Allergies — Let your doctor know if you are allergic or sensitive to any medications, anesthesia, latex, or other common medical products.
• Medications — Your doctor will review your current medication use and any history of medications. Inform your doctor of any blood thinning medication you may take.
• Lifestyle — Your doctor will usually ask about exercise, nutrition, and lifestyle habits such as smoking. Reducing or stopping any tobacco use is recommended for better treatment outcomes.
• Colon preparation — Your doctor will prescribe a laxative or enema to clear your colon for cryosurgery treatment.
• Sedative — You may receive medication to sedate you before the procedure.

What Happens During the Procedure

You can expect to stay in the hospital for a few hours or up to one full day. Sometimes Cryotherapy is performed as an outpatient procedure. Procedures differ based on your health, condition, and your doctor.

The procedure usually involves three main stages:

1. Preparing your body
2. Inserting medical instruments and delivering gas
3. Removing medical instruments

Preparing Your Body

During Cryosurgery for prostate cancer, you can generally expect your doctor to ask you to remove all jewelry, change into a hospital gown, and use the bathroom. An IV line will be placed in your hand or arm. You will receive anesthesia and a sedative to help you relax and feel less pain during the treatment.

If you receive general anesthesia, your doctor may connect you to a ventilator to help you breathe. Medical specialists will monitor your vital signs, such as your heart rate, breathing, and blood pressure.

Your medical team will position you on the operating table on your back. Your legs will rest on stirrups. Your doctor will insert a catheter into your penis and a transrectal ultrasound into your anus. The ultrasound allows the medical team to monitor your prostate during the procedure.

Inserting Medical Instruments and Delivering Gas

Next, your doctor will insert small needles called cryoprobes into the small area of skin between your scrotum and anus. Gas is directed through the needle to freeze prostate tissue.

Your doctor may cycle freezing gas and helium through the needle to complete the procedure. The helium is heated gas that prevents prolonged cold temperatures from damaging your prostate.

Removing Medical Instruments

Once the cancer is treated, your doctor will remove the needles and ultrasound. If you used a breathing tube, the tube will also be removed. Your doctor will apply a sterilized bandage or dressing to your treatment area. The catheter remains attached while you recover.

What Happens After Cryotherapy

After prostate cryotherapy, you will be taken to a recovery room and monitored. As soon as you are stable, you will be moved to a hospital room. Your doctor will give you pain medicine as needed while you recover. Over the course of a few hours, you will gradually start to drink liquids and eat solid foods.

Your doctor may prescribe antibiotics to prevent infection. You will likely take short walks in the hospital the same day. During your recovery in the hospital, you may notice blood in your urine and swelling in your penis or scrotum. This is expected. You may also feel pain, a burning sensation in your stomach, and the urge to use the bathroom.

Your catheter will remain inserted for 1-3 weeks until you fully heal. Your doctor will schedule a follow up appointment to check on your progress and remove the catheter.

Post-Surgery At-Home Care

Your doctor will explain how to care for yourself at home and what activities to avoid until you fully recover.

Common at home care tips:

• Keep your treatment area clean and dry.
• Avoid driving yourself until cleared by your doctor.
• Avoid strenuous exercise or activities until cleared by your doctor.
• Follow your doctor’s suggested bathing instructions.
• Expect your insertion site to feel uncomfortable for a few days.
• Take pain medication to reduce discomfort.
• Inform your doctor if you experience any swelling, pain, changes to your urine, ability to urinate, fever, drainage, or redness.

You can also expect to schedule a series of follow-up appointments to monitor your progress. Your catheter will be removed 1-3 weeks after your prostate cryosurgery.

Prognosis

The success rate of cryotherapy for prostate cancer is very optimistic. Research suggests positive outcomes for biochemical progression-free survival (BPFS), cancer-specific survival, and overall survival.