How You Can Give Prostate Cancer the ‘Cold Treatment’

Cryotherapy: outpatient procedure, less potential side effects

man in 50s

Here’s a less-known, but effective prostate cancer treatment: freeze the cancer cells.

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Using cold temperatures on prostate tissue to kill cancer cells – or what’s called cryotherapy – offers an excellent option for some prostate cancer patients, experts say.

It not only works very well for the right cases, but the risk of complications is low.

“It is minimally invasive and incision-free,” says urologist David Levy, MD, who practices at the Cleveland Clinic Beachwood Family Health Center. “In fact, we don’t remove the prostate — it simply turns into scar tissue while preserving normal urinary function,” he says.

Who is a good candidate?

Men with early-stage prostate cancer can often benefit from cryotherapy. Doctors also recommend it for patients whose radiation treatments were unsuccessful.

However, cryotherapy won’t work for everyone. It may not work well for men with larger prostates, but in those cases, hormone therapy may shrink the gland and make these patients eligible candidates.

How it works

Here is what happens during this outpatient procedure, performed under general anesthesia:

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  1. A doctor inserts six to eight tiny needles through the skin between the anus and scrotum into the prostate using ultrasound guidance to ensure correct placement.
  2. Argon gas supercools the needles and freezes the prostate tissue, killing it and the cancer. After surgery, patients are sent home with a catheter. Within a day or two, they can do some mildly physical tasks, like mowing the lawn.
  3. Within a week, patients come for a follow-up visit, and their catheter removed.
  4. Five weeks later, your doctor retests your PSA with the target being less than 0.4 ng/ml.

Less potential side effects

With any prostate cancer treatment, potential side effects include urinary incontinence, erectile dysfunction and altered bowel function, as well as others related to hormone therapy.

However, during cryotherapy, the millimeter precision with which your doctor places the needles helps minimize these side effects.

When compared with radiation therapy, cryotherapy results in lower risks of altered bowel and bladder function. It has a significantly lower risk of urinary incontinence compared with current surgical approaches for prostate cancer.

Traditionally, the risk of erectile dysfunction has been higher with cryotherapy compared to surgery or radiation, but newer techniques with nerve-sparing cryotherapy are showing improved results.

Know your options

“When it comes to prostate cancer, one of my biggest concerns is the overtreatment of those who don’t necessarily need it,” Dr. Levy says.

Patients for whom radiation didn’t work often end up on hormone therapy, and 15 percent of these men experience side effects from the hormone shots.

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“They likely make up the largest population of prostate cancer patients with potentially curable disease who could benefit from this therapy at this time,” Dr. Levy says.

While many who are diagnosed do need surgery, there are many options that can provide the same outcome. “That’s why it is so important for people to learn as much as they can,” Dr. Levy says.

He suggests talking to your doctor about all the options and asking a lot of questions before pursuing treatment.

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