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Cryosurgery (also called cryotherapy or cryoablation) is sometimes used to treat early stage
prostate cancer by freezing it. As with brachytherapy, this may not be a good option for men with
large prostate glands.
In this approach, several hollow probes (needles) are placed through the skin between the anus
and scrotum. The doctor guides them into the prostate using transrectal ultrasound (TRUS).
This type of procedure requires spinal or epidural anesthesia (where the lower half of your body
is numbed) or general anesthesia (where you are asleep).
Very cold gases are then passed through the needles, creating ice balls that destroy the
prostate gland. To be sure the prostate is destroyed without too much damage to nearby
tissues, the doctor carefully watches the ultrasound images during the procedure. Warm
saltwater is circulated through a catheter in the urethra during the procedure to keep it from
freezing. The catheter is kept in place for about 3 weeks afterward to allow the bladder to empty
while you recover.
After the procedure, there will be some bruising and soreness in the area where the probes
were inserted. You might need to stay in the hospital overnight, but many patients leave the
same day.
Cryosurgery is less invasive than radical prostatectomy, so there is usually less blood loss, a
shorter hospital stay, shorter recovery period, and less pain than with surgery. But compared
with surgery or radiation therapy, doctors know much less about the long-term effectiveness of
cryosurgery.
Cryosurgery doesnt appear to be as good as radiation for more advanced prostate tumors. In a
study comparing cryosurgery to radiation therapy for locally advanced prostate cancer (T2c to
T3b tumors), more men in the cryosurgery group had elevated PSA levels (a sign that their
cancers had come back) after 8 years than the men in the radiation group.
Current techniques using ultrasound guidance and precise temperature monitoring have only
been available for a few years.
For this reason, most doctors do not often use cryosurgery as the first treatment for prostate
cancer. It is sometimes recommended if the cancer has come back after other treatments.