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Cryoablation (Cryosurgery, Cryotherapy)
from Endocare, Inc. reference Karen Barrie 

 Cryoablation as a prostate cancer treatment is being considered more and more by both patients and doctors. It is also called cryotherapy or cryosurgery, or just “cryo” for short. It uses freezing to destroy prostate tumors. It quickly kills cancer without the risks of major surgery or radioactivity. Though the consequences of collateral damage such as impotence are significant.

 While the patient is anesthetized (local or general) the doctor uses ultrasound guidance to insert 6-8 slender cryoprobes through the skin into accurate locations in the prostate gland. Since the urethra passes through the prostate gland, a warming catheter protects the urethra from freezing. Thermal sensors keep track of the temperature around the prostate to avoid damage to the bladder and rectum.

 When all is ready, liquid argon gas is circulated within the probes, freezing tissue to –40° C. Then helium gas replaces the argon to thaw the tissue. The process is repeated once more. The cancer tumor and its blood supply have now been destroyed. The dead tissue is re-absorbed or remains in the body as harmless scar tissue. The procedure takes about two hours; patients either go home the same day, or spend one night in the hospital.

 While many patients resume normal activity in less than a week, some patients may experience temporary bruising and swelling. A urinary catheter is left in place for 1-3 weeks of internal healing, then removed.

Less than 1% of patients report incontinence following cryosurgery. Since the nerve bundles are adjacent to the prostate gland, most patients will be impotent if the entire prostate is frozen. About 47% regain erectile function over time. However, qualified patients may be candidates for nerve-sparing cryo which preserves potency in up to 80% of cases. Discuss your likely hood of impotence with your doctor, at length.

 Cryoblation has other advantages as well. Recovery is rapid. Most patients return to their normal lifestyle quickly. Unlike radiation, it can be repeated if prostate-confined cancer recurs (comes back). Furthermore, it is the only Medicare approved treatment if prostate-confined cancer recurs after radiation therapy (external beam or brachytherapy).

 Long-term statistics show that cryosurgery is at least as effective as radical prostatectomy and radiation for low-risk cancers, and has better success rates than surgery and radiation for moderate to high risk cancers. Cryo is more effective than external radiation or seeds if the cancer is confined to the prostate gland (up to stage T3 tumors.)

 Cryoablation for prostate cancer is Medicare approved for both first-time occurrence and post-radiation recurrence.

last reviewed August 2005

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