Tuesday, November 29, 2022

How Effective Is Cryotherapy For Prostate Cancer

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What Are The Side Effects Of Cryotherapy

Cryotherapy & Prostate Cancer | Ask a Prostate Expert, Mark Scholz, MD

Most men have blood in their urine for a day or two after the procedure, as well as soreness in the area where the needles were placed. Other side effects may include loss of urinary control, injury to the rectum and loss of sexual function. Freezing damages nerves near the prostate and causes impotence in up to four out of five men who have cryosurgery. Erectile dysfunction is more common after cryosurgery than after radical prostatectomy.

The freezing may also affect the bladder and intestines, which can lead to pain, burning sensations, and the need to empty the bladder and bowels often. Most men recover normal bowel and bladder function over time.

The side effects from cryosurgery tend to be worse when treatment is done in men who already had radiation therapy, as opposed to men who have it as the first form of treatment.

Are There Advantages To Using Cryotherapy For Prostate Cancer

There are few long-term studies on cryotherapy and prostate cancer. Some experts believe, though, that cryotherapy offers several advantages over surgery and radiation. Those advantages may be particularly noticeable in early-stage prostate cancer. For instance, cryotherapy is a less invasive procedure. It can be done using an epidural or spinal instead of general anesthesia. This may benefit older men with prostate cancer. It can also benefit men who have other conditions such as diabetes, heart disease, or lung disease.

Other advantages with cryotherapy include:

  • Shorter hospital stay
  • Shorter recovery period
  • Much less swelling and pain than with standard surgery for prostate cancer

If needed, cryotherapy can be followed with other conventional therapies, such as radiation therapy or surgery.

One recent study followed men with prostate cancer for a period of 10 years. In that study, researchers concluded that cryotherapy might be as effective as radiation and other common treatments for prostate cancer. Cryotherapy, though, wasn’t directly tested against those more established treatments.

Possible Side Effects Of Chemotherapy

Chemo drugs attack cells that are dividing quickly, which is why they work against cancer cells. But other cells in the body, such as those in the bone marrow , the lining of the mouth and intestines, and the hair follicles, also divide quickly. These cells can also be affected by chemo, which can lead to side effects.

The side effects of chemo depend on the type and dose of drugs given and how long they are taken. Some common side effects can include:

These side effects usually go away once treatment is finished. There are often ways to lessen these side effects. For example, drugs can be given to help prevent or reduce nausea and vomiting.

Along with the risks above, some side effects are seen more often with certain chemo drugs. For example:

  • Docetaxel and cabazitaxel sometimes cause severe allergic reactions. Medicines are given before each treatment to help prevent this. These drugs can also damage nerves , which can cause numbness, tingling, or burning sensations in the hands or feet.
  • Mitoxantrone can, very rarely, cause leukemia several years later.
  • Estramustine carries an increased risk of blood clots.

If you notice any side effects while getting chemo report them to your cancer care team so that they can be treated promptly. In some cases, the doses of the chemo drugs may need to be reduced or treatment may need to be delayed or stopped to prevent the effects from getting worse.

Read Also: Define Prostate

What Is Cryotherapy And Why Use It For Prostate Cancer

The origin of Cryotherapy can be traced back to 19th-century London though at that time it was used in experimental basis to treat cancer of different types. It basically involves deployment of extremely cold temperatures to kill cancer affected cells in the human body. Application of liquid nitrogen was done for the first time in 1966. Later, doctors chose argon gas instead of applying liquid nitrogen for Cryotherapy procedure.

The comparatively higher recurrence rate of prostate cancer in the affected lot compelled medical community to look for alternative and more effective treatments than radiation therapy. On an average, 30% to 40% of the victims faced recurrence of the cancer and this is where experts believe the application of Cryotherapy may help. Cryotherapy for prostate cancer may work better in cases where radiation therapy fails to kill enough cancer affected cells in the body. Cryotherapy is a local treatment and so it is used to treat the prostate gland and no other parts of the male body. Cryotherapy treatment for warts has also become commonplace in recent times.

What Happens During Cryotherapy For Prostate Cancer

OA imaging takes control of prostate cryotherapy  Physics ...

Cryotherapy may require a one-day stay in the hospital. It may also be done as an outpatient procedure. Procedures may vary depending on your condition and your healthcare providers practices.

Generally, cryotherapy follows this process:

  • You will be asked to remove any jewelry or other objects that might get in the way during procedure.

  • You will be asked to remove your clothing and will be given a gown to wear.

  • You will be asked to empty your bladder.

  • An IV line will be put in your arm or hand.

  • The doctor may choose regional anesthesia or general anesthesia. You will also get medicine to help you relax and pain medicines.

  • If you get general anesthesia, a breathing tube may be put through your throat into your lungs and you will be connected to a ventilator. This will breathe for you during the procedure.

  • The anesthesiologist will watch your heart rate, blood pressure, breathing, and blood oxygen level during the procedure.

  • You will be placed on your back on the operating table with your legs up in stirrups.

  • The healthcare provider will put a soft, flexible catheter through your penis and into your bladder to drain urine. The catheter will be filled with warm salt solution. It will help keep urine draining even if the prostate gland swells after the treatment. The catheter will also be used to keep the warm saline moving through the urethra to protect it from the cold temperatures used during the procedure.

  • A sterile bandage/dressing will be applied.

  • Read Also: How Are Fiducial Markers Placed In The Prostate

    How Is Cryosurgery For Prostate Cancer Performed

    Cryosurgery for prostate cancer is done under either general or spinal anesthesia. Before the procedure, an ultrasound probe is placed in the rectum to give the surgeon a visual of the prostate. This allows the doctor to monitor the prostate and nearby organs/tissues during surgery.

    Several probes may be placed in the prostate at locations determined before the procedure. These are positioned to avoid the area of the urethra, the tube which passes through the prostate as it carries urine out of the body from the bladder.

    In addition, a warming catheter is inserted into the urethra to keep the urethra warm throughout the procedure. Other probes may be placed in and around the prostate gland in order to monitor the temperature and prevent damage to noncancerous tissue.

    Cryosurgery takes under two hours and is done in two freezing cycles. In between these cycles, the prostate is allowed to warm, either on its own or with the aid of a warmer gas moving through the probe. After the second thaw, a catheter is inserted into the bladder to help with urination during the recovery period. This tube may be inserted through the urethra, or through a small cut in the lower belly. The catheter will remain in place for several days after surgery.

    If I Have Cryoablation And Sometime Later Cancer Is Again Found In My Prostate Can It Be Treated

    Yes. There are multiple options for retreatment if the cancer is still within the confines of the prostate gland. Cryoablation can be repeated any number of times since, unlike radiation, the effect of freezing is not cumulative. Radiation therapy by seeds or external beam can also be given after cryoablation. Surgical removal of the prostate gland is rarely considered after either cryoablation or radiation therapy.

    Also Check: Does Prostate Massage Prevent Prostate Cancer

    How Often Does Impotency Occur After Cryoablation

    Frequently. If preservation of potency is a major concern, then an alternative therapy should be considered. Monotherapy by radiation generally has a lower rate of impotency. Radical prostatectomy with nerve sparing technique also has a lower risk of impotency. Nerve sparing with cryoablation can be done, but is considered experimental at this time.

    Holistic Healingat Sheba Medical Center

    What is cryotherapy when treating prostate cancer? (Robert Donnell, MD)

    Our integrative team implements a patient-orientated approach. To that end, our specialists offer general advice, pain management, dietary guidance, and complementary medical services. You will benefit from efficient access to treatments, procedures, and research all provided under one roof. To promote optimal health and comfort for your whole body, our staff pays attention to all of your needs.

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    Cryotherapy As A Treatment Option

    Cryotherapy, also known as cryosurgery or cryoablation, is a type of treatment used in many types of cancer and other diseases. In patients with prostate cancer, cryotherapy consists of freezing the cancerous cells in the prostate. Most doctors do not use cryosurgery as the first treatment for prostate cancer, the American Cancer Society states on its website, but it can be an option for men with low risk early-stage prostate cancer who cannot have surgery or radiation therapy.

    Cryotherapy is less invasive than radical prostatectomy surgery, and related to smaller loss of blood, shorter hospital stay, shorter recovery period, and less pain.

    During the procedure, a transrectal ultrasound is used to guide several hollow probes through the skin between the anus and scrotum and into the prostate. Then, ice balls are created with very cold gases passed through the needles in order to destroy the prostate. To be sure the prostate is destroyed without too much damage to nearby tissues, the doctor carefully watches the ultrasound images during the procedure. The patient does not feel any pain since the lower half of the body is numbed with a spinal or epidural anesthesia, or the patient is put to sleep under general anesthesia. Physicians also place a catheter in the urethra during the procedure to circulate warm saltwater and prevent it from freezing.

    What Is The Follow

    At 1 to 2 weeks you will have the catheter removed by one of the nursing team. You will have a consultation booked either in person or remote telephone consultation at the 3-month stage although Professor Ahmed will be able to speak to you before this if there are any issues or concerns greatly affecting you. At the 3-months stage we ask that you have a PSA either at the Cromwell Hospital or with your GP and if you have it with your GP to send the result in before the consultation.

    Also Check: Does Enlarged Prostate Affect Ejaculation

    Cancers That Can Be Treated With Cryotherapy

    Prostate cancer, liver metastases, skin cancer, precancerous lesions and tumors of the oral cavity, cancers of the rectum, and skin are some FDA approved cancers that can be managed with cryotherapy.

    • Prostate cancer: Cryosurgical treatment is a widely accepted alternative to radical excision in prostate cancers. It is usually recommended as a primary treatment option for early-stage prostate cancer or after other cancer treatments to remove the remaining cancer cells.

    In prostate cancer, several hollow probes are inserted into the prostate under the guidance of transrectal ultrasound . Extremely cold gases are passed through these needles to destroy the prostate cells without damaging the surrounding tissues.

    • Liver cancer: Cryosurgery has been used for several years for the treatment of liver cancer. Although cryotherapy is not a permanent cure, its main goal is to improve the survival rates.

    Cryotherapy is recommended in case of a primary tumour or metastatic liver tumour, or if the liver cancer is unresectable or not responding to other treatment modalities.

    • Retinoblastoma: Cryotherapy is effective in treating small tumours located in front of the eye. the procedure may have to be done 2 to 3 times, with a gap of a month between the treatments.
    • Early-stage skin cancers: Early-stage, small skin cancer can be easily managed with cryosurgery. In most cases, it is combined with preliminary curettage.

    Is Cryotherapy Used Instead Of Surgery Or Radiotherapy For The Treatment Of Prostate Cancer

    HIFU and Cryotherapy

    In patients who are advised to have an active form of treatment because the cancer would otherwise progress or grow if they didnt have treatment can have cryotherapy provided the cancer is limited to one or two areas within the prostate. It is also important that the prostate cancer has not shown any signs of distant spread or what is called metastases. The vast majority of patients who were diagnosed with prostate cancer that has shown no sign of spread are offered whole-gland radical radiotherapy or prostatectomy surgery which involves removing the entire prostate. These treatments are very effective and are known to improve cancer control and survival in the long term but that cancer control and survival in the long term in the majority of cases is a small benefit over monitoring the cancer.

    Cryotherapy treatment for prostate cancer is therefore an alternative in those patients that are eligible, instead of whole-gland radical surgery or radiotherapy. It is not for every single patient who is diagnosed with prostate cancer and the detailed eligibility criteria are discussed below although a detailed discussion of your circumstances is very important with an expert in focal therapy. Doctors who do not carry out focal therapy can sometimes mistakenly state patients under their care are no eligible when they so always ask to speak to or see a focal cryotherapy specialist.

    Also Check: How To Find The Prostate Gland Externally

    Having Cryotherapy For Prostate Cancer

    Cryotherapy is usually given under a general anaesthetic. This means you will be asleep during the treatment. If you cannot have a general anaesthetic, you will have spinal anaesthetic. This will numb the lower half of your body, so you will not be able to feel anything. You may also be given a sedative to make you feel relaxed and sleepy.

    Cryotherapy destroys cancer cells by freezing them with a special gas. A doctor gently passes thin needles through the skin behind the scrotum . The doctor also uses an ultrasound probe through the back passage . This helps them get a good view of the prostate and make sure the needles are going into the right place. The gas is then passed through the needles into the area of the prostate where the cancer is.

    Cryotherapy can be used to treat the whole prostate when there might be cancer in more than one area, so that all areas of cancer are treated.

    But it may also be used if you only need treatment to one small area of cancer in the prostate. Doctors call this focal therapy. It takes less time than whole-prostate treatment. It may also cause fewer side effects, because less of the healthy tissue is damaged.

    If you have had this treatment for early prostate cancer you can usually have radiotherapy or surgery if the cancer comes back.

    Recovery After Targeted Focal Cryotherapy Prostate Cancer Treatment

    Qualified patients undergoing targeted focal cryotherapy prostate cancer treatment are typically treated in about two hours and are able to go home the same day. The majority of our patients resume their daily activities within 24 hours. In our 12 years of conducting this procedure, none of our patients has developed any prostate cancer treatment side effects such as urinary incontinence or rectal injury . And nearly 80 percent of our patients recovered the level of sexual activity they had before the operation within three to six months after treatment. A structured follow-up schedule and specialized counseling in diet and lifestyle complement this approach.

    Also Check: What Is Perineural Invasion In Prostate Cancer

    Is Cryotherapy Used Instead Of Active Surveillance For Prostate Cancer

    Patients who have prostate cancer which has not spread and is low risk or a small amount of medium risk cancer are suitable for active surveillance. This involves monitoring the prostate cancer with regular PSA blood tests, clinical exam, MRI scans and sometimes biopsy. The strategy of active surveillance is very safe for these patients. This is because low-risk prostate cancer in the majority doesnt grow or spread and medium risk prostate cancer grows very slowly when it is a small amount. So, generally, we would not advise any kind of active treatment as an alternative to active surveillance for patients who have proven low-risk prostate cancer on a high quality multiparametric MRI and image fusion targeted and systematic prostate biopsy. Patients who have medium risk prostate cancer have the option of active surveillance or focal cryotherapy or focal HIFU, or if they wish, surgery or radiotherapy to treat the entire prostate. The choice is up to the individual patient in discussion with his doctors.

    How Effective Is Cryotherapy In The Treatment Of Prostate Cancer

    Prostate Cancer: Cryosurgery for Localized Disease

    Despite the best efforts of both radiation oncologists and urologic surgeons, sometimes prostate cancer recurs. For those rare cases, cryoablation of the prostate gland may be used.

    During cryotherapy treatment, the surgeon uses ultrasound to guide the placement of thin needles into the area being treated. Argon gas is used to form ice at the end of the needles. Cancer cells are more sensitive to cold than regular cells, so the freezing destroys the cancer cells.

    Read Also: Household Items For Prostate Massage

    Cryotherapy Treatment For Prostate Cancer

    The common diagnosis of prostate cancer in men has led to in-depth research and the development of a variety of treatment options. Treatments vary by the severity of the diagnosis and the specific needs of the patient. Cryotherapy treatment for prostate cancer is a non-surgical treatment that can provide treatment to some patients diagnosed with prostate cancer.

    As a urologists office in Miami, we feel that providing information on prostate cancer treatments can help individuals make informed decisions about their future. As prostate cancer is one of the most commonly diagnosed cancers in men, we always recommend regular prostate exams for early detection and treatment.

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