What is Prostate Cryoablation, and Would It Work for Me?

If you’re a man who has been told he has prostate cancer, we get that it’s frightening. You probably have a lot of questions, and Dr. Bevan-Thomas will discuss all of your options with you in detail. In the meantime, this article should address some of your questions.

WHAT IS CRYOABLATION?

Cryoablation (also called cryotherapy or cryosurgery) is a process that freezes cancerous cells in the prostate and cuts off their blood supply. The procedure involves cycles (usually two) of freezing and thawing of the prostate with cooling and warming agents passed through tiny probes into the prostate. Each cryoprobe is a small needle that forms an “ice ball” around the probe, which immediately destroys all of the tissue within the ice (including the cancer).

(But don’t worry about those ice balls. Fortunately, the ice stays local within the prostate and does not affect the family jewels!)

After treatment, your immune system clears out the frozen cells and leaves scar tissue behind.

Cryoablation is less invasive than other prostate procedures, but full-prostate ablation has a high risk of erectile dysfunction. In some cases, Dr. B-T will recommend a focal (partial) ablation. Focal ablation treats only the tumor cells and leaves the rest of the prostate tissue intact. Think of the needle probes as little snipers taking aim at the cancerous cells on your prostate.

When focal cryoablation is possible, you are more likely to retain your sexual and urinary function.

AM I A CANDIDATE FOR CRYOABLATION?

You may be. Dr. B-T will sit down with you and explain your options in detail.

Patients that could benefit from choosing prostate cryoablation include:

Men with prostate cancer that hasn’t spread to other regions of the body.
Men who are less concerned about sexual function (whole-prostate cryoablation).
Men who have had unsuccessful radiation therapy. In this scenario, the procedure is called salvage cryoablation. Cryoablation is the only FDA-approved treatment for men whose cancer has come back after radiation therapy. But salvage cryoablation is for men who have a recurrence only within the prostate. It is not suitable for patients whose cancer has spread to the lymph nodes or bones.
Dr. Bevan-Thomas will have an extensive discussion with you about your situation and treatment option risks and benefits.

DOES PROSTATE SIZE MATTER?

As usual when it comes to prostate treatment, size matters. Because the ice can only travel so far, the best-sized prostates are those that are the size of a clementine or smaller. Dr. Bevan-Thomas will always determine the size of your prostate either with an MRI or with an ultrasound in the office. Sometimes, it is possible to shrink the prostate down with medication to get it to the optimal size for cryoablation.

WHAT CAN I EXPECT DURING A CRYOABLATION PROCEDURE?

The procedure is usually done as an outpatient with general anesthesia. Most patients go home the same day with a suprapubic tube. (This is a tube that goes through the lower abdomen directly into the bladder.) Dr. Bevan-Thomas will discuss this with you beforehand. Expect your ablation to take one to two hours.

WHAT HAPPENS AFTER THE CRYOABLATION PROCEDURE?

The prostate will swell after the procedure, and it takes a few days for this to resolve. Normally, patients are taught how to plug the tube in about five days so they can try to urinate through the urine channel again. If the voiding trial is successful, the patient comes to the office and the suprapubic tube is removed. (This is not a painful process because we are removing this from the belly and not the penis and urine channel.)

WHAT ARE THE BENEFITS OF CRYOABLATION?

Cryoablation is less invasive than other options, such as robotic prostatectomy. You can expect to have less bleeding, a shorter hospital stay, less pain, and a faster recovery. Cryoablation can also be repeated if you need it down the road.

WHAT ARE THE RISKS AND SIDE EFFECTS OF CRYOABLATION?

As with any medical procedure, there are risks to cryoablation. The most common include:

Bleeding or blood in your urine.
Swelling and bruising in the groin.
Urgency or slowing of urination.
Scarring and narrowing of the urethra.
Rarely, a fistula (an abnormal connection between your bladder and rectum or urethra and bladder).

WHY CHOOSE DR. BEVAN-THOMAS?

Dr. Bevan-Thomas is a cryoablation expert and consultant for Endocare and has been educating other physicians around the country about how to perform cryoablation since 2004. He is often asked to fly to different cities and help other surgeons perfect their cryoablation technique to improve their results. He provides both primary and salvage cryotherapy.

Dr. B-T is also committed to thoroughly informing his patients about their diagnoses and treatment options. Because he offers more than one option for prostate cancer, he will help you make the best decision for your particular cancer. Treatment options include cryoablation, active surveillance, robotic surgery, and radiation therapy (through a consultation with a radiation oncologist).

Make an appointment today to talk with Dr. Bevan-Thomas about the best way to treat your prostate cancer.