I recently attended the Us TOO, prostate cancer support group, meeting at one of our local hospitals. An interesting topic was discussed: cryosurgery. Cryosurgery entails the destruction of tissue, organ or gland using freezing temperatures. A common example of cryosurgery is when a dermatologist freezes a wart on some one's hand to remove it.
Cryosurgery is one method of treating prostate cancer. The process is the following: freezing probes are inserted into the prostate gland under ultrasound guidance. The probes are activated and the temperature of the prostate drops below 20 degrees Celsius. The prostate is thawed towards normal body temperatures. The freeze-thaw cycle is then repeated a second time and it is this process that causes destruction of the prostate cancer. Cryosurgery, also called cryoablation, is performed under anesthesia and is an out-patient procedure.
Cryoablation can be performed for two scenarios. First, is the primary treatment for localized prostate cancer. Second, is to treat men with a recurrence of cancer after they underwent external beam radiation or seed implant (brachytherapy) in the past. The later is also called salvage cryoablation.
Here's an example or salvage cryoablation: A 65 year old male with Gleason 6 prostate cancer was treated with external beam radiation 4 years ago. His original PSA was 6.9 ng/ml and was less than 0.1 ng/ml for 3 years after treatment. His last 3 PSAs have steadily risen to 1.1 ng/ml and his urologist repeated his transrectal ultrasound guided biopsy. This revealed Gleason 6 prostate cancer on the right side of his prostate gland. Essentially, his cancer has returned. His options at this time include hormonal therapy, radical surgery to remove the prostate, cryosurgery or observation. Salvage cryoablation is an excellent option to try and cure his recurrent cancer.
Cryoablation has side effects. These include local pain and swelling of the genitalia, blood in the urine, urinary incontinence and erectile dysfunction. Men are usually sent home with a catheter for at least 24 hours.
But, do we need to treat the entire prostate gland to cure prostate cancer? We'll review this during my next blog entry...
Published On: July 03, 2007