Cryotherapy for Prostate Cancer Efficacy Side Effects and More
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ncbi.nlm.nih.gov/pmc/articles/PMC8796757/Basourakos SP, et al. (2020). Feasibility of in-office MRI-targeted partial gland cryoablation for prostate cancer: An IDEAL stage 2A study.
sit.bmj.com/content/bmjsit/2/1/e000056.full.pdfChin YF, et al. (2022). Systematic review of focal and salvage cryotherapy for prostate cancer.
ncbi.nlm.nih.gov/pmc/articles/PMC9333556/Cryotherapy for prostate cancer. (2019).
cancer.org/cancer/prostate-cancer/treating/cryosurgery.htmlFujihara A, et al. (2020). Primary focal versus whole-gland cryotherapy for intermediate and high-risk prostate cancer: A propensity score-matched analysis.
auajournals.org/doi/10.1097/JU.0000000000000860.07Jin K, et al. (2020). Cryotherapy shows no inferiority compared with radical prostatectomy for low-risk and intermediate-risk localized prostate cancer: A real-world study from the SEER database.
ncbi.nlm.nih.gov/pmc/articles/PMC7477459/Key statistics for prostate cancer. (2022).
cancer.org/cancer/prostate-cancer/about/key-statistics.htmlLaviana AA, et al. (2015). Utilizing time-driven activity-based costing to understand the short- and long-term costs of treating localized, low-risk prostate cancer.
acsjournals.onlinelibrary.wiley.com/doi/10.1002/cncr.29743Mercader C, et al. (2020). Primary cryotherapy for localized prostate cancer treatment.
pubmed.ncbi.nlm.nih.gov/33191831/Pellegrino A, et al. (2022). Focal therapy for prostate cancer: what is really needed to move from investigational to valid therapeutic alternative? - A narrative review.
ncbi.nlm.nih.gov/pmc/articles/PMC9358522/Prostate Cancer Treatment (PDQ®) - Patient version. (2021).
cancer.gov/types/prostate/patient/prostate-treatment-pdqTay KJ, et al. (2016). Focal cryotherapy for localized prostate cancer.
pubmed.ncbi.nlm.nih.gov/27416635/Trogdon JG, et al. (2019). Total Medicare costs associated with diagnosis and treatment of prostate cancer in elderly men.
jamanetwork.com/journals/jamaoncology/fullarticle/2701720Werneburg GT, et al. (2019). Effects of focal versus total cryotherapy and minimum tumor temperature on patient-reported quality of life as compared to active surveillance in prostate cancer patients.
ncbi.nlm.nih.gov/pmc/articles/PMC5866195/Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available. Current Version Oct 18, 2022 By Daniel Yetman Edited By A. L. Heywood Medically Reviewed By Matt Coward, MD, FACS Copy Edited By Kristin Hitchcock Share this articleMedically reviewed by Matt Coward, MD, FACS — By Daniel Yetman on October 18, 2022
What Is Cryotherapy and How Can It Help Treat Prostate Cancer
Medically reviewed by Matt Coward, MD, FACS — By Daniel Yetman on October 18, 2022Share on PinterestBSIP/UIG Via/Getty ImagesAbout 1 in 8 men will develop prostate cancer in their life. It mostly occurs in men older than the age of 65 years. First-line treatment for prostate cancer often involves waiting to see how the cancer progresses or some combination of surgery and radiation therapy. Cryotherapy isn’t a standard treatment, but a doctor or healthcare professional may recommend it in certain cases. Cryotherapy uses extreme cold to remove cancer cells. It was initially an experimental prostate cancer treatment in the 1960s. Early forms had high rates of complications, but new imaging techniques to guide the treatment have led to improved outcomes in recent years. In this article, we take a deeper look at cryotherapy as treatment for prostate cancer.Language matters
Sex and gender exist on spectrums. This article uses the term “men” to reflect a term that has been historically used to gender people. It’s important to note that not everyone assigned male at birth identifies with the label “man.” While we aim to create content that includes and reflects the diversity of our readers, specificity is key when reporting on research participants and clinical findings. The studies and surveys referenced in this article didn’t include data on, or include, participants who were transgender, nonbinary, gender nonconforming, genderqueer, agender, or genderless.How does cryotherapy for prostate cancer work
Cryotherapy involves freezing all or part of your prostate with very cold temperatures, generally under −40ºC (also −40ºF). Surgeons achieve this by inserting several metal probes between your anus and scrotum and into your prostate. The probes pump cold gas through to your prostate until it reaches the targeted temperature. Extreme cold kills cancer cells in several ways. At a microscopic level:It creates ice between cells, drying out the space between them.It shrinks cells.It creates ice inside cells, causing the cells to die.The immediate freezing and thawing change the pH of the cells.It creates swelling and inflammation that cuts the blood supply to cancer cells.Focal cryotherapy for prostate cancer
Focal cryotherapy is a promising alternative method of treatment. Traditional cryotherapy treats your whole prostate gland. In focal cryotherapy, only the part of your prostate with cancer is frozen. In a 2020 study, researchers found that focal cryotherapy provided similar outcomes as whole-gland therapy but caused fewer complications. The study involved carefully selected men with intermediate- or high risk prostate cancer.When do doctors recommend cryotherapy for prostate cancer
Cryotherapy isn’t currently a standard treatment for prostate cancer. Researchers continue to look into when it may be most useful. It may be an option for you if your cancer is contained to your prostate. A doctor may recommend cryotherapy:if you have cancer that has returned after radiation therapyas an alternative to radiation therapy or surgery if you’re not eligible for these treatmentsHow effective is cryotherapy at treating prostate cancer
Researchers are still trying to learn how effective cryotherapy is compared with other prostate cancer treatments. Studies have found promising results, but according to a 2022 study, long-term data is still lacking. Another 2022 study refers to cryotherapy as a treatment in a “transition phase.” There’s enough research for it to no longer be experimental but not enough for it to be established. In a 2022 review of studies, researchers analyzed the outcomes of cryotherapy in 11,228 people with low- or intermediate-risk prostate cancer. The overall survival rate ranged from 61.3% to 99.1%. There was no difference in outcomes in people who received it as a first-line or a second-line treatment. A 2020 study found that cryotherapy achieved similar results to radical prostatectomy, which is surgery to remove your prostate. But cryotherapy had better functional outcomes. The study involved people with low- and intermediate-risk prostate cancer.What are the risks of cryotherapy for prostate cancer
According to the 2022 review, the most commonly reported side effects were:erectile dysfunction (ED) in 3.7% to 88.0% of peopleurinary retention in 4.1% to 18.0% of peopleurinary incontinence in 1.6% to 18.0% of peoplelower urinary tract or bladder infection in 3.0% to 16.7% of people Less than 1% of men develop an abnormal connection between their anus and bladder called a fistula that needs surgery to repair.What is the procedure for cryotherapy for prostate cancer
Here what’s you can expect before, during, and after your procedure.Preparation
A medical team may give you a laxative or enema to empty your bowels before your procedure. A doctor will likely tell you to stop eating the night before if you’re receiving general anesthetic.Procedure
Here’s a general idea of what will happen during your procedure.You’ll likely receive general anesthetic through an intravenous (IV) line so that you’ll be asleep during your procedure. If you can’t have general anesthetic, they may give you anesthetic through your spine.The surgeon will insert a catheter into the tip of your penis through to your bladder. They’ll fill it with warm liquid to protect these areas from damage.They’ll insert an ultrasound probe into your anus so that they can see where to insert needles.They’ll insert thin needles through the area between your anus and penis and into your prostate.Freezing gas will be passed through the needles to cool your prostate. Your surgeon will administer the gas in several cycles to allow your prostate to warm up between each.They’ll remove the needles and insert another tube into your penis to drain your bladder.After the procedure
You’ll likely be able to go home on the same day as your treatment. Some people need to stay overnight. You may have some pain or discomfort that you can manage with pain relievers.What can I expect during recovery after cryotherapy for prostate cancer
You may need a catheter for a couple of weeks to promote healing. You may also have some soreness or bruising as well as blood in your urine for several days. You may also have urinary problems or trouble emptying your bowels. But these symptoms should get better over time. It’s important to follow the surgeon’s postsurgery instructions. Attend all your scheduled follow-ups to make sure all signs of the cancer are gone to give yourself the best chance of having a good outcome.How does cryotherapy compare with other treatments for prostate cancer
According to the National Cancer Institute, there are eight standard treatments for prostate cancer:active surveillancesurgeryradiation therapyhormone therapychemotherapytargeted therapyimmunotherapybisphosphonate therapyActive surveillance
A doctor may recommend active surveillance if you’re older or they don’t expect your prostate cancer to grow quickly. It involves monitoring the cancer for changes while not actively treating it. Active surveillance helps prevent complications associated with other treatments but comes with the risk of letting the cancer progress.Surgery
Surgery is an option if you’re in good overall health and the cancer is contained to your prostate or surrounding area. The most common surgery is a radical prostatectomy. That’s where the prostate and surrounding tissue are removed. Surgery is more invasive than cryotherapy. But it has a lower risk of serious complications such as ED and urinary problems. Surgery also has a higher cancer-specific survival rate.Radiation therapy
Radiation therapy uses high-energy waves to destroy cancer cells. It can be an effective treatment but increases your risk of bladder and gastrointestinal cancer. It can also cause side effects such as ED and urinary problems. Doctors often combine radiation therapy with other treatments such as hormone therapy or surgery.Other therapies
Hormone therapy: Hormone therapy involves lowering male hormones that cancer cells need to grow.Chemotherapy: Chemotherapy is a chemical drug therapy doctors administer through an IV line or orally. It can cause many side effects due to damage to healthy cells throughout your body.Targeted therapy: Targeted therapy is a drug therapy that uses drugs to specifically attack cancer cells. It avoids many of the complications associated with chemotherapy.Immunotherapy: Immunotherapy is a drug therapy that stimulates your immune system to attack cancer cells.Bisphosphonate therapy: Bisphosphonates are medications used to lower the risk of bone loss in men on hormone therapy.How much does cryotherapy for prostate cancer cost
In a 2015 study, researchers found the average 5-year cost of cryotherapy was in the middle among common treatments.intensity-modulated radiation therapy: $23,565robot-assisted laparoscopic prostatectomy: $16,946high dose brachytherapy (radiation): $11,448cryotherapy: $11,215low dose brachytherapy: $8,978active surveillance: $7,298 Cryotherapy costs more than low dose radiation due to the higher cost of single-use equipment. The higher cost of surgery was largely due to equipment and hospital stay. In a 2020 study, researchers found the median cost for people who received MRI-targeted partial gland cryotherapy under local anesthesia was $4,463.05.Takeaway
Cryotherapy is a treatment option for prostate cancer that involves freezing cancer cells with very cold temperatures. Researchers are still trying to understand how effective cryotherapy is compared with other treatments such as radiation therapy and surgery. A doctor may recommend cryotherapy if you don’t respond to other treatments or if you don’t make a good candidate for surgery or radiation therapy. Last medically reviewed on October 18, 2022How we vetted this article
SourcesHistoryHealthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.Atluri S, et al. (2022). Focal therapy for localized prostate cancer - Current status.ncbi.nlm.nih.gov/pmc/articles/PMC8796757/Basourakos SP, et al. (2020). Feasibility of in-office MRI-targeted partial gland cryoablation for prostate cancer: An IDEAL stage 2A study.
sit.bmj.com/content/bmjsit/2/1/e000056.full.pdfChin YF, et al. (2022). Systematic review of focal and salvage cryotherapy for prostate cancer.
ncbi.nlm.nih.gov/pmc/articles/PMC9333556/Cryotherapy for prostate cancer. (2019).
cancer.org/cancer/prostate-cancer/treating/cryosurgery.htmlFujihara A, et al. (2020). Primary focal versus whole-gland cryotherapy for intermediate and high-risk prostate cancer: A propensity score-matched analysis.
auajournals.org/doi/10.1097/JU.0000000000000860.07Jin K, et al. (2020). Cryotherapy shows no inferiority compared with radical prostatectomy for low-risk and intermediate-risk localized prostate cancer: A real-world study from the SEER database.
ncbi.nlm.nih.gov/pmc/articles/PMC7477459/Key statistics for prostate cancer. (2022).
cancer.org/cancer/prostate-cancer/about/key-statistics.htmlLaviana AA, et al. (2015). Utilizing time-driven activity-based costing to understand the short- and long-term costs of treating localized, low-risk prostate cancer.
acsjournals.onlinelibrary.wiley.com/doi/10.1002/cncr.29743Mercader C, et al. (2020). Primary cryotherapy for localized prostate cancer treatment.
pubmed.ncbi.nlm.nih.gov/33191831/Pellegrino A, et al. (2022). Focal therapy for prostate cancer: what is really needed to move from investigational to valid therapeutic alternative? - A narrative review.
ncbi.nlm.nih.gov/pmc/articles/PMC9358522/Prostate Cancer Treatment (PDQ®) - Patient version. (2021).
cancer.gov/types/prostate/patient/prostate-treatment-pdqTay KJ, et al. (2016). Focal cryotherapy for localized prostate cancer.
pubmed.ncbi.nlm.nih.gov/27416635/Trogdon JG, et al. (2019). Total Medicare costs associated with diagnosis and treatment of prostate cancer in elderly men.
jamanetwork.com/journals/jamaoncology/fullarticle/2701720Werneburg GT, et al. (2019). Effects of focal versus total cryotherapy and minimum tumor temperature on patient-reported quality of life as compared to active surveillance in prostate cancer patients.
ncbi.nlm.nih.gov/pmc/articles/PMC5866195/Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available. Current Version Oct 18, 2022 By Daniel Yetman Edited By A. L. Heywood Medically Reviewed By Matt Coward, MD, FACS Copy Edited By Kristin Hitchcock Share this articleMedically reviewed by Matt Coward, MD, FACS — By Daniel Yetman on October 18, 2022