Some prostate cancer patients good candidates for cryoablation

Dear Doctors: Why don’t we hear more about cryoablation as a treatment for prostate cancer? It appears to be much easier than major surgery, so it seems like it would be a good option. What does the procedure entail? I am also interested in knowing about the advantages and disadvantages.

Dear Reader: Prostate cancer is the second-most-common type of cancer in men. Only skin cancers occur more often. This type of cancer arises in the prostate gland, which is about the size and shape of a walnut and is located beneath the bladder.

Because the prostate sits amid a complex network of nerves and structures that contribute to both sexual and urinary function, removing tumors in this type of cancer can be challenging. Depending on size and specific location of the cancer and whether it has spread, prostate cancer treatment can result in urinary incontinence and loss of sexual function.

Therapies may consist of one or more approaches, including surgery, radiation, chemotherapy, hormone therapy or immunotherapy. Cryoablation, also known as cryotherapy, can also be an option in certain cases. This is a procedure in which abnormal tissues are subjected to extremely cold temperatures, which destroys the cells.

Cryotherapy is performed under either regional or general anesthesia. It may be an outpatient procedure, or it can sometimes require an overnight hospital stay. Guided by ultrasound imagery, the physician inserts thin, hollow needles, known as cryoprobes, into a specific region of the prostate gland. The cryoprobes infuse freezing gas into the cells of the prostate gland, which kills them.

There are two forms of cryotherapy for prostate cancer. One type, known as whole-prostate cryotherapy, treats the entire gland. This kills both the cancer cells and the healthy tissues. Freezing the tissues of the prostate gland often damages the nearby nerves that control erections. As a result, erectile dysfunction occurs more often after whole-prostate cryotherapy than when the gland is surgically removed.