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Cryotherapy For Prostate Cancer Side Effects

Prostate Cryotherapy Treatment Recovery

Cryotherapy & Prostate Cancer | Ask a Prostate Expert, Mark Scholz, MD

Patients will normally be able to return home within a day or two of the procedure. For the first week or two, patients will utilize a catheter. Recovery times vary by patient. The catheter, generally, is removed after the first two weeks, with the patient being able to return to most daily activities after one month of recovery.

After a month, strenuous exercise and exertion should still be avoided unless otherwise told by your specialist. It is important to complete post-procedure checkups with your specialist to evaluate your recovery.

What Are The Side Effects

Like all treatments, cryotherapy can cause side effects. These will affect each man differently and you may not get all of them.

The most common side effects of cryotherapy are erection and urinary problems.

Many of the side effects of cryotherapy are caused by healthy tissues being frozen and damaged. Side effects are more likely if you have already had radiotherapy or brachytherapy to your prostate. This is because they may have already damaged the area around your prostate.

Focal cryotherapy can cause the same side effects as whole-prostate cryotherapy. But some research suggests focal cryotherapy may cause less severe side effects, because a smaller area of the prostate is damaged than with whole-prostate cryotherapy.

Ask your doctor or nurse for more information about your risk of side effects. They may be able to show you results of treatments they’ve carried out and put you in touch with other men who’ve had cryotherapy.

The most common long-term side effect of cryotherapy is difficulty getting or keeping an erection . More than three quarters of men cant get an erection after whole-prostate cryotherapy. This is because the treatment can damage the nerves that control erections. Studies suggest that more men get their erections back after focal cryotherapy, because less healthy tissue is damaged than with whole-prostate cryotherapy.

Some men find these problems improve with time, but not all men get their erections back. There are treatments that can help.

Cryoablation In Clinical Practice

The original indication for cryoablation of the prostate was for salvage therapy in prostate cancer patients who had recurred after either external beam radiotherapy or brachytherapy. However, now prostate cryotherapy is also indicated for primary treatment of prostate cancer. As described in the Prostate Cancer section of this site, Dr. Engel does not feel cryotherapy to be appropriate for all cases of prostate cancer. A typical patient is an older patient, particularly one with voiding symptoms that prohibit the safe application of radiation. Other indications would include lower risk cancers, and in patients with morbidities that would make surgery exceedingly risky.

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What Are The Risks Of Cryotherapy For Prostate Cancer Treatment

Whether cryotherapy is effective in eliminating prostate cancer hasn’t been proven. Experts say that sometimes the freezing liquid fails to kill all of the cancer cells. As a result, there is a chance that prostate cancer will come back.

Also, the potential side effects of cryotherapy for prostate cancer are undesirable for some men. These side effects may include:

  • Injury to the urethra and bladder
  • Serious infections as a result of the injury
  • Obstruction or blockage of the urethra

In addition, the risks of cryotherapy are similar to other prostate cancer treatments. They include:

What Is Cryotherapy And Why Use It For Prostate Cancer

HIFU and Cryotherapy

The origin of Cryotherapy can be traced back to 19th-century London though at that time it was used in experimental basis to treat cancer of different types. It basically involves deployment of extremely cold temperatures to kill cancer affected cells in the human body. Application of liquid nitrogen was done for the first time in 1966. Later, doctors chose argon gas instead of applying liquid nitrogen for Cryotherapy procedure.

The comparatively higher recurrence rate of prostate cancer in the affected lot compelled medical community to look for alternative and more effective treatments than radiation therapy. On an average, 30% to 40% of the victims faced recurrence of the cancer and this is where experts believe the application of Cryotherapy may help. Cryotherapy for prostate cancer may work better in cases where radiation therapy fails to kill enough cancer affected cells in the body. Cryotherapy is a local treatment and so it is used to treat the prostate gland and no other parts of the male body. Cryotherapy treatment for warts has also become commonplace in recent times.

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What Are The Risks Of Cryotherapy For Prostate Cancer

As with any procedure, complications can occur. The risk of permanent erectile dysfunction is very high with cryotherapy. This makes it a better choice for men who arent as concerned about ED after treatment. Some other possible complications may include:

  • Bleeding and/or blood in the urine

  • Soreness or swelling in the region where the needles are put into the body

  • Infection

  • Swelling around the penis or scrotum

  • Freezing may affect the bladder and intestines, which can lead to pain and burning sensations

  • Urge to empty the bladder and bowels more often

  • Urinary incontinence is rare, but this may be more common if the man has had radiation therapy in the past

  • An abnormal connection between the rectum and bladder or urethra is a rare complication

There may be other risks depending on your condition. Be sure to discuss any concerns with your healthcare provider before the procedure.

Cryotherapy Procedure Side Effects For Prostate Cancer

Prostate cancer is one major form of cancer that claims plenty of lives worldwide every year. Despite the advancements in radiation therapy, its recurrence rate has made the medical community worried. That is a reason they now opt for alternative therapies like Cryotherapy. It is a procedure in which very cold gaseous solutions or liquids are inserted to eradicate cancerous cells in the prostate gland. It is a less invasive procedure and so blood loss and risk of infection is also minimized. The recovery period is also shorter than that of radiation therapy. However, not every victim of prostate cancer may be deemed suitable candidate for this treatment. Cases of early diagnosis of prostate cancer are thought to be better suited for it. Doctors also analyze several health factors and medical history before suggesting it. Moreover, extensive controlled studies should be carried out before recommending it on a wide scale for treating cases of Prostate Cancer.

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Cryotherapy For Local Control

Among patients undergoing repeat biopsy 3-24 months after treatment with a standard 5-probe cryotherapy system, 7.7-25% have been found to have residual malignancy of the glands, and 42-71% have been found to have focal areas of viable benign epithelium. Numerous disease- and treatment-related factors have been shown to predict rates of local control.

In one series, for example, the likelihood of positive biopsy findings was 9% in subjects with clinical stage T1 or T2 disease, compared with 21% in those with T3 disease. Persistent or recurrent cancer is more likely among tumors located in the prostatic apex or the seminal vesicles than those located in the midgland or the base.

A pooled analysis stratified patients into the following risk groups :

  • Low risk – PSA level of 10 ng/mL or lower, Gleason score of 6 or less, and clinical stage T1 or T2a disease

  • Intermediate risk – PSA level higher than 10 ng/mL, Gleason score of 7 or more, or clinical stage T2b disease or higher

  • High risk – The presence of 2 or 3 of these adverse risk factors

The distribution of patients among low-, intermediate-, and high-risk groups was 25%, 34%, and 41%, respectively. The positive biopsy rate in the series was 18% overall: 12% among low- and intermediate-risk patients and 24% among high-risk patients.

What Is The Follow

Prostate Cancer: Cryosurgery for Localized Disease

At 1 to 2 weeks you will have the catheter removed by one of the nursing team. You will have a consultation booked either in person or remote telephone consultation at the 3-month stage although Professor Ahmed will be able to speak to you before this if there are any issues or concerns greatly affecting you. At the 3-months stage we ask that you have a PSA either at the Cromwell Hospital or with your GP and if you have it with your GP to send the result in before the consultation.

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Where Can I Learn More

To learn more about cryotherapy, to view a video of doctors, patients and their spouses. The video is provided by Healthtronics and is not affiliated with ZERO The End of Prostate Cancer. This video is provided as an educational resource not an endorsement of treatment.

To learn more about localized disease, go to our Localized Cancer section.

Focal Cryotherapy Versuswhole Prostate Cryotherapy

Focal cryotherapy

Usually, focal cryotherapy has fewer side effects than treatments that treat the whole prostate, like surgery or radiation therapy . This is because the treatment is only directed at a specific part of the prostate. Of the men whoâve had focal cryotherapy, around half will have erection problems and may need to use tablets or other aids.

Whole prostate cryotherapy

With whole prostate cryotherapy, which targets the entire prostate, there are increased side effects.

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What Happens During Cryotherapy For Prostate Cancer

Cryotherapy may require a one-day stay in the hospital. It may also be done as an outpatient procedure. Procedures may vary depending on your condition and your healthcare providers practices.

Generally, cryotherapy follows this process:

  • You will be asked to remove any jewelry or other objects that might get in the way during procedure.

  • You will be asked to remove your clothing and will be given a gown to wear.

  • You will be asked to empty your bladder.

  • An IV line will be put in your arm or hand.

  • The doctor may choose regional anesthesia or general anesthesia. You will also get medicine to help you relax and pain medicines.

  • If you get general anesthesia, a breathing tube may be put through your throat into your lungs and you will be connected to a ventilator. This will breathe for you during the procedure.

  • The anesthesiologist will watch your heart rate, blood pressure, breathing, and blood oxygen level during the procedure.

  • You will be placed on your back on the operating table with your legs up in stirrups.

  • The healthcare provider will put a soft, flexible catheter through your penis and into your bladder to drain urine. The catheter will be filled with warm salt solution. It will help keep urine draining even if the prostate gland swells after the treatment. The catheter will also be used to keep the warm saline moving through the urethra to protect it from the cold temperatures used during the procedure.

  • A sterile bandage/dressing will be applied.

  • Prostate Cancer Cryotherapy: Incontinence Side Effects

    Cryosurgery &  Cryotherapy

    Compared with other types of prostate cancer treatments, cryotherapy entails a relatively low risk of incontinence side effects. Cryotherapy is a relatively new prostate cancer treatment, and researchers dispute the exact numbers of patients in cryosurgery clinical trials who experience incontinence. Generally, 5 percent of patients who undergo prostate cryotherapy as primary therapy and 10% of patients who undergo treatment as salvage therapy will experience incontinence. There are also different types of incontinence: some men may experience no control over the flow of urine while others may experience minimal leakage. Each clinical trial has a different set of standards to assess incontinence.

    After Prostate Cancer Cryosurgery Immediately following the cryotherapy procedure and after the removal of the catheter, many men will experience urinary side effects which are not the same as incontinence. Urinary side effects may include irritation, frequency, pain, and minor leakage from which most men will recover without medical intervention as their bodies continue to heal from the procedure.

    Treatments for Incontinence after Prostate Cancer Treatment Speak with your doctor if incontinence symptoms are affecting participation in everyday life. There are a number of incontinence products and treatments available including:

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    Benefits Of Using Cryotherapy For Prostate Cancer Treatment

    It is not without compelling reasons that the oncologists and experts are opting for Cryotherapy for prostate cancer. The inherent advantages of this procedure are:

    • Cancer experts believe that application of Cryotherapy is more effective in dealing with early-stage prostate cancer.
    • Since this is a less invasive procedure, it can be done through a small incision without using general anesthesia. This can be better for elderly men affected by prostate cancer.
    • It involves less blood loss.
    • The hospital stay period and recovery period are shorter.
    • The swelling and pain is less compared to what people have to face after undergoing standard surgery.
    • In some cases, Cryotherapy can be combined with radiation therapy.

    Who Should Consider Cryotherapy

    Cryotherapy is an option for men with localized or locally advanced prostate cancer, where the tumor has only extended out of one side of the prostate . It may be used as an alternative to surgery, particularly for men who do not qualify for surgery for various reasons. Use of cryotherapy is approved for all grades of localized prostate cancer, from low and intermediate risk to high risk.

    This treatment can be used alongside other standard treatments for localized prostate cancer. Cryotherapy is also an option for men who experience a recurrence following radiation therapy .

    There is some evidence that cryotherapy may be a cheaper option that other treatments for localized prostate cancer.

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    Prostate Cancer Cryotherapy: Common Side Effects

    Prostate cancer cryotherapy freezes the entire prostate gland through a minimally invasive procedure involving ultrathin cryoneedles. Side effects usually occur due to damage of the surrounding tissue during the procedure. The severity and occurrence of side effects are largely affected by the relative health of a patient as well as whether cryosurgery is a primary or salvage treatment option. The advent of the minimally-invasive ultrathin cryoneedles and more precise imaging techniques has greatly decreased the occurrence of many side effects, with the exception of impotence.

    After undergoing prostate cancer cryotherapy, some patients may experience the following side effects:

    Swelling in the Genital Area after Cryosurgery The entry of the needles through perineum causes irritation and inflammation. Many physicians will recommend using ice packs on the affected area or beginning a regimen of over-the-counter anti-inflammatory drug.

    Scrotal Edema A more severe complication, scrotal edema occurs when fluid collects in the scrotum. Proper evaluation must be performed by a doctor so that proper course of treatment may be chosen.

    Irritation during Urination Many men will experience itching or burning while urinating after undergoing prostate cryosurgery. Symptoms usually will dissipate in a few days. Some men will also experience urgency. Speak with your physician if symptoms worsen after a few days.

    Side Effects Of Cryotherapy

    What is cryotherapy when treating prostate cancer? (Robert Donnell, MD)

    As with all treatments for prostate cancer, cryotherapy can cause a number of different side effects. These will affect each man differently and you may not experience all or any of them. After undergoing prostate cancer cryotherapy, some patients may experience the following side effects:

    Hematuria : Many men will experience blood in the urine after undergoing prostate cryotherapy. There are two types of hematuria, gross and microscopic. Gross hematuria is visible to the naked eye. Blood in the urine should only last a few weeks following treatment. However if bleeding lasts for more than just a few weeks or worsens contact your doctor.

    Swelling in the genital area: The entry of the needles through the perineum causes both irritation and inflammation. Many physicians will recommend using ice packs on the affected area or beginning a regimen of over-the-counter anti-inflammatory drug to alleviate swelling.

    Erectile dysfunction: Freezing often damages the nerves near the prostate that control erections. Erectile dysfunction is more common after cryotherapy than after radical prostatectomy. Your doctor may prescribe medications such as viagra to help address any issues with sexual function.

    Urinary incontinence: This is generally rare in men who have had cryotherapy as their first treatment for prostate cancer, but it is more common in men who have already had radiation therapy.

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    Who Is A Good Candidate For Prostate Cancer Cryotherapy

    Men with early-stage prostate cancer can often benefit from cryotherapy. Doctors also recommend it for patients whose radiation treatments were unsuccessful or if the cancer has come back.

    Unfortunately, cryotherapy isnt for everyone. It may not work for men with large prostates. In those cases, hormone therapy could shrink the gland and make these patients eligible candidates. You should discuss this with your doctor.

    What About The Cryotherapy Side Effects

    Truth be told, no therapy for cancer is without the risk of side effects and the same is true about Cryotherapy. Based on cases, Cryotherapy side effects can be mild to moderate. There are some drawbacks that have been pointed out by a section of experts. These are:

    • It is yet to be clinically proven on a large scale basis that the application of this procedure actually eliminates all cancer cells. In some instances, it has failed to eradicate cancer affected cells in the recipients body. As a result, prostate cancer has recurred.
    • Some victims can be affected by injury to the urethra.
    • Impotence risk cannot be ruled out.
    • Some patients have also faced urinary incontinence.

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    How Effective Is Cryotherapy For Prostate Cancer

    As a newly developed treatment option, cryotherapy is mainly used for specific purposes. Generally, it is not used as the first treatment method unless the patient has been diagnosed with early stages of prostate cancer and cannot receive surgical treatment.

    Cryotherapy can be an effective treatment method for:

    • Patients whose cancer has not spread outside of the prostate
    • Patients who arent well enough to receive radiation or surgery
    • Symptom treatment
    • For treating patients who have not had successful results with radiation treatment


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