Cryotherapy for Prostate and Kidney Cancer
Cryotherapy for Prostate and Kidney Cancer is a new, yet well established approach to the treatment of these malignancies. It is also one of the most minimally invasive approaches available. Both involve placing needles through the skin into the target organ under either ultrasound or CAT scan guidance, and freezing the tumor using Argon gas. In the case of the prostate, the entire gland is frozen; for the kidney, only the tumor and a small amount of surroundin tissue is frozen. The therapy involves very little discomfort, and can be performed as outpatient surgery in the hospital or as an overnight observational stay. Cryotherapy is FDA approved, approved by all insurances, and has an excellent safety and side-effect profile.
Prostate Cancer
Cryotherapy for prostate cancer is used both for primary(first time) treatment and as salvage therapy for patients who have recurrence cancer after radiation therapy. Cryotherapy used to have a bad reputation in terms of side effects prior to the new Argon/ Helium technology introduced 6 years ago. It now has fewer side effects than any of the other available therapies. It is very well tolerated, and the success rate at 5 years has been shown in several studies to be equal to that of external beam radiation. It involves placing needles through the skin between the legs under ultrasound guidance into the prostate, and freezing and thawing the prostate for two cycles. General or spinal anesthesia is used. The patient is discharged the same day with a urinary catheter, which is generally worn for 5 days, then removed in the office. Side effects that are common are mild rectal soreness immediately after the procedure, temporary scrotal swelling, mild blood in the urine and occasional urinary retention. Impotence, at least for the first 9 months after the procedure, is common. Rare side effects include incontinence, urethral stricture, infection, and rectourethral fistula. After treatment, the patient is monitored for success of treatment and for recurrence of cancer by checking the PSA every 3 months for at least the first year, then less frequently after.
Kidney Cancer
Cryotherapy is now being used to freeze, and thus kill, small kidney tumors. This is done laparoscopically in many centers; we are now doing it with local anesthsia and with CAT scan guidance. Little to no discomfort is involved. The Cryoprobe needles are placed through the skin in the back into the tumor under CAT scan guidance. The tumor is then frozen and thawed twice. The patient is kept overnight for observation. Risks include bleeding, infection, and damage to adjacent organs of other kidney structures.