Now being performed by urologist Jack Cassell, M.D., cryoablation of the prostate is a new minimally invasive treatment that uses the application of extreme cold (-40 degrees Celsius) in combination with ultrasound to precisely destroy cancer cells in and around the prostate gland.
During cryotherapy, the patient is placed under general or epidural anesthesia. A thin catheter that circulates warm fluid is placed next to the urethra to protect it from freezing. Several cyroprobes are then inserted into the prostate gland and liquid argon is circulated, freezing the entire prostate gland. Throughout the procedure, transrectal ultrasound imaging enables Dr. Cassell to clearly visualize the freezing process to ensure that surrounding tissues are unaffected.
Following cryotherapy, patients go home with a catheter in place for one week to help with urination, and most can resume normal activities immediately after the procedure.
Long-term side effects of cryoablation of the prostate are similar to other therapies. Although impotence occurs in 80 to 90% of patients who undergo the procedure, nearly half regain sexual function as the neurovascular structures regenerate over time.
According to Dr. Cassell, “Cryoablation of the prostate is less invasive and causes less trauma than radical prostatectomy, and studies have shown significant decreases in PSA in blood tests with no evidence of prostate cancer in repeat biopsies of the prostate after cryotherapy.” Although radical prostatectomy and radiation therapy are the gold standard for localized prostate cancer, cryotherapy may be an effective treatment when radiation fails. “For those patients, the advantages of cryotherapy over radical prostatectomy are outstanding,” says Dr. Cassell. Unlike prostate surgery or radiation therapy, cryotherapy can be repeated if prostate cancer returns.