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Cryotherapy for prostate cancer

Cryotherapy uses very cold temperatures to freeze and kill prostate cancer cells. The goal of cryosurgery is to destroy the entire prostate gland and possibly surrounding tissue.

Cryosurgery is generally not used as a first treatment for prostate cancer.

What Happens During Cryotherapy

Before the procedure, you will be given medicine so that you do not feel pain. You may receive:

  • A sedative to make you drowsy and numbing medicine on your perineum. This is the area between the anus and scrotum.
  • Anesthesia. With spinal anesthesia, you will be drowsy but awake, and numb below the waist. With general anesthesia, you will be asleep and pain-free.

First, you will get a catheter that will stay in place for about 3 weeks after the procedure.

Then, the doctor makes small cuts to place several hollow needles into your perineum.

  • Ultrasound is used to guide the needles to the prostate gland.
  • Then, very cold gas passes through the needles, creating ice balls that destroy the prostate gland.
  • Warm salt water will flow through the catheter to keep your urethra (the tube from the bladder to outside the body) from freezing.

Cryosurgery is most often a 2-hour outpatient procedure. Some people may need to stay in the hospital overnight.

When Cryosurgery is Used to Treat Prostate Cancer

This therapy is not as commonly used and is not as well accepted as other treatments for prostate cancer. Doctors do not know for certain how well cryosurgery works over time. There is not enough data to compare it with standard prostatectomy, radiation treatment, or brachytherapy.

It can only treat prostate cancer that has not spread beyond the prostate. Men who cannot have surgery because of their age or other health problems may have cryosurgery instead. It also may be used if cancer comes back after other treatments.

It is generally not helpful for men with very large prostate glands.

Side Effects

Possible short-term side effects of cryotherapy for prostate cancer include:

  • Blood in the urine
  • Trouble passing urine
  • Swelling of the penis or scrotum
  • Problems controlling your bladder (more likely if you have had radiation therapy also)

Possible long-term problems include:

  • Erection problems in nearly all people
  • Damage to the rectum
  • A tube that forms between the rectum and the bladder, called a fistula (this is very rare)
  • Problems with passing or controlling urine.

Alternative Names

Cryosurgery-prostate cancer; Cryoablation-prostate cancer

References

Cryosurgery in Cancer Treatment: Questions and Answers. National Cancer Institutes. www.cancer.gov/about-cancer/treatment/types/surgery/cryosurgery-fact-sheet. Accessed August 31, 2015.

Cryosurgery for Prostate Cancer. American Cancer Society. www.cancer.org/cancer/prostatecancer/detailedguide/prostate-cancer-treating-cryosurgery. Accessed August 31, 2015.

Horwich A, Parker C, de Reijke T, Kataja V; ESMO Guidelines Working Group. Prostate cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2013 Oct;24 Suppl 6:vi106-14. PMID: 23813930 www.ncbi.nlm.nih.gov/pubmed/23813930.

Mohler JL, Kantoff PW, Armstrong AJ, et al. Prostate cancer, version 2.2014. J Natl Compr Canc Netw. 2014. May;12(5):686-718. PMID: 24812137 www.ncbi.nlm.nih.gov/pubmed/24812137.

Review Date 9/13/2015

Updated by: Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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