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Prostate Cancer
Treatment Guide™

Experts in Treating Prostate Cancer
Treatment
Description
Prostate Cancer
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Prostate Cancer
Treatments
Prostate Cancer
Survival Rates
Prostate Cancer
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Cryosurgery &
Cryotherapy

Prostate Cryotherapy

Also called cryosurgery, this minimally invasive procedure uses needles to apply freezing gases to the prostate. Prostate Cryotherapy

Also called cryosurgery, this minimally invasive procedure uses needles to apply freezing gases to the prostate.

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Cryosurgery Patients

Cryosurgery is used for patients with localized cancer, external radiation recurrent cancer, Gleason scores under 6, or PSA levels under 10. Cryosurgery Patients

Cryosurgery is used for patients with localized cancer, external radiation recurrent cancer, Gleason scores under 6, or PSA levels under 10.

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Minimally Invasive Surgery

Cryosurgery takes about 2 hours with a possible overnight admission. Minimally Invasive
Surgery

Cryosurgery takes about 2 hours with a possible overnight admission.

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Cryosurgery
Survival Rates

Long-term clinical results are limited but promising. Cryosurgery
Survival Rates

Long-term clinical results are limited but promising.

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Cryosurgery
Side Effects

Side effects may include moderate pelvic pain, blood in urine, scrotal swelling, mild urinary urgency, and impotence. Cryosurgery
Side Effects

Side effects may include moderate pelvic pain, blood in urine, scrotal swelling, mild urinary urgency, and impotence.

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Prostate News

Click here for the latest news on Cryosurgery & Cryotherapy.Prostate News

Click here for the latest news on Cryosurgery & Cryotherapy.

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Cryosurgery &
Cryotherapy Videos

Click here to view Cryosurgery & Cryotherapy procedures. Cryosurgery &
Cryotherapy Videos

Click here to view Cryosurgery & Cryotherapy procedures.

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Cryosurgery &
Cryotherapy Experience


Click here to share your Cryosurgery & Cryotherapy experiences.Cryosurgery &
Cryotherapy Experience

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Brachytherapy

Chemotherapy

Hormone
Therapy

Radiation
Therapy

Prostatectomy

Robotic Prostatectomy

Watchful
Waiting

Complementary
and
Alternative Medicine

High Intensity
Focused
Ultrasound (HIFU)

Emerging Technologies

 

Cryotherapy and Prostate Cancer

Patients who chose to undergo cryotherapy as their prostate cancer treatment will be in the hospital for one or two days. The planning of the minimally invasive surgery is done as part of the procedure. The patient is placed under general anesthesia. The entire procedure will take two or three hours. The patient is placed in the exaggerated dorsal lithotomy position. This position means that his legs are placed in stirrups, lifted to a 90 degree angle, and opened, and that his perineum is placed just over the edge of the operating table. The dorsal lithotomy position gives the doctor a clear view of the minimally invasive site. The patient is shaved and cleaned from the perineum to the or navel. The surgeon will then insert a catheter to distend the bladder.

The surgeon will use the transrectal ultrasound to obtain a picture of the prostate gland and surrounding organs. A transperineal needle template that will guide the cryoneedles is attached to a stabilizing device and gently fixed against the skin of the perineum. The TRUS will use aiming grid software to guide the needles as well and the template’s holes correspond with this image.

The needles are inserted into three or four horizontal layers with two to five needles per layer. The number of cryoneedles depends on the size of the patient’s prostate gland and the extent of his prostate cancer. In prostate cryotherapy, the third generation needles have made it possible to treat the prostatic capsule and the seminal vesicles. As many as five thermocouples will be inserted into the midgland of the prostate, the urinary sphincter, and each neurovascular bundle. The thermocouple in the urinary sphincter is usually kept above 15 degrees Celsius. The ones in the midgland and the neurovascular bundles are there to ensure the temperature of the prostate gland reaches negative 40 degrees Celsius. Because the neurovascular bundles are destroyed by this temperature, cryotherapy may have a higher incidence of impotence.

After the needles have been positioned, the catheter is removed and the doctor examines the urethra with a cystoscopy for any misplacement. The doctor will reposition needles if necessary. After this inspection, a warming catheter is inserted into the urethra. A warm saline solution is circulated through the bladder, which is kept nearly full to protect it from the tip of the warming device. Throughout the minimally invasive surgery, the urethra and bladder are kept at 43 degrees Celsius.

Argon gas is circulated through the tips of the cryoneedles. The freezing gas creates ice balls on the tips of the needles. Ice crystals form inside of or around the cells and the pH level changes. These actions are what make cryotherapy a viable prostate cancer treatment. Freezing also may activate an anti-tumor response of the body, which occurs when the body recognizes the tumor as an invading agent and attacks the disease itself. The freeze cycle lasts about 10 minutes or until the temperature reaches negative 40 degrees Celsius. There are two types of thawing processes. One is passive: the doctor allows the relative temperature of the body to return the prostate gland to normal temperature. The other is active: the doctor circulates helium gas through the cryoneedles. The helium speeds up the thawing process. Some researchers believe however that the passive thaw process is more effective is destroying the tumor, though slower for the doctor. Patients should not be afraid to speak frankly with their doctors about which procedure they would prefer.

The freeze-thaw cycle is repeated once or twice, depending on the policy of the center. After the procedure, the warming catheter is left in place for at least another five minutes to reduce the risk of urethral sloughing. When the warming catheter is removed, a urinary catheter is inserted in its place. The new catheter will be removed in 2 or 3 days. Patients are usually discharged the same day of the procedure. Doctors will prescribe antibiotics and an alpha-blocker which will relax the neck of bladder and decrease the severity of urinary side effects. Patients can also take pain-medication to combat the soreness of the perineum.

 
 
 

 
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