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How Cryosurgery Can Eliminate Prostate Cancer
By James Culp
The two major treatment options for men with prostate cancer, radiation and surgery, are tried-and-true, having proved their effectiveness over the years in thousands of patients. Radical prostate removal surgery in particular, despite possible extreme side effects such as impotence, has saved countless lives.
However, a newer surgical procedure is making some headway into the scene. Cryosurgery has been around for years as a treatment for skin cancer, but has recently been refined to be used on other cancers as well, including prostate. It is only recommended when the prostate is still completely confined to the prostate gland, and has not been in use long enough to reliably judge its longterm treatment effectiveness. In this article we'll examine the process of cryosurgery and its implications.
First, a few months before the treatment, hormone therapy is used to bring a halt to androgen (male hormonal) activity. This shrinks the prostate gland along with the cancer, making it more likely that the cryosurgery will reliably freeze all of the prostate tissue. After hormonal treatment, a picture is needed of the prostate gland.
To do this, an ultrasound
probe is inserted into the rectum. Ultrasound gives an image of internal soft tissues, being most well-known for its use in pregnant women to see the unborn fetus. The doctor will be able to see exactly where the prostate is located and how large it is, and can begin the surgery.
This consists of the insertion of very thin, very long needles through the perineum (the area between the testicles and anus) and into the gland. Then, cold nitrogen is pumped through the needles, freezing the prostate tissue and effectively killing the prostate and cells. This is what can lead to some of the more severe side effects.
Impotence being the number one concern. Studies have shown that the chance of impotence is about the same as for other prostate treatment (Urology, Dec 1993 Vol 42 N 6). Unfortunately, to make sure the is thoroughly destroyed, it may be necessary to kill surrounding tissue as well. This is what can lead to impotence.
The entire procedure only lasts a few hours, and the patient usually goes home in a day or two. A catheter will remain attached for several days to several weeks, but can return to their normal activity rate very quickly. Some men may notice blood in the urine, and the most common post-procedure side effect is irritation on the perineum from the needle insertion. Most of these will go away in a few days.
While the effectiveness of cryosurgery is not well established, it can be an excellent middle ground for those who do not wish to risk watchful waiting but are not very excited about going into full surgery for prostate removal and long hospital stays.
James Culp is a prostate cancer survivor and runs a free newsletter tracking the latest developments in disease of the prostate, especially prostate cancer. His newsletter can be subscribed to at http://www.prostaide.org
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