Prostate Cryotherapy

What is prostate cryotherapy (prostate cryoablation)?

Prostate cryotherapy is a treatment for prostate cancer that freezes cancer cells to destroy them. Healthcare providers (usually a surgeon specializing in urology) can use it to treat your entire prostate or just a part. Providers often use it if cancer comes back after radiation treatment, but it’s also an option for some people as their initial treatment. Other names for it include prostate cryoablation and cryosurgery.

Who can get prostate cryotherapy?

Providers use cryotherapy on prostate cancer that hasn’t spread outside your prostate, is slow-growing and has a low risk of spreading in the future. You might be eligible for prostate cryotherapy if:

• You don’t want surgery or radiation.
• Your provider recommends against surgery and radiation.
• The cancer has come back after radiation treatment.
• It might provide pain relief or relief of other symptoms.

How does prostate cryotherapy work?

Prostate cryotherapy works by using argon gas to cool tumor cells to a temperature cold enough to destroy them (-40 degrees Celsius). A provider inserts needles (cryoprobes) directly into the tumor to apply the gas. They use a transrectal ultrasound to help guide the needles and monitor how well an ice ball is developing.

After the ice ball forms, they use helium gas to thaw out the cells. This first freeze-thaw cycle weakens the cells. The provider performs at least one additional freeze-thaw cycle to destroy the cells.

How do I prepare for prostate cryotherapy?

Your provider will give you instructions on how to prepare for the procedure. Following their directions closely can reduce your risk of complications. Before prostate cryotherapy, your provider may ask you to:

• Not eat anything for eight hours before the procedure (fast).
• Take a laxative to clear out your colon.
• Ask someone to drive you home after the procedure.

Tell your provider about all the medications you take, including over-the-counter (OTC) or herbal supplements.

What happens during prostate cryotherapy?

During prostate cryotherapy, a provider will:

• Give you anesthesia. This might be general or local anesthesia.
• Insert a tube (catheter) into your urethra (the tube that your pee flows through to leave your body). Warm saline flows through the catheter to protect your urethra from freezing. It also keeps your urethra open so pee can drain from your body during and after the procedure.
• Insert several needles at precise points. They’ll use imaging (like transurethral ultrasound or MRI) to know exactly where to put the needles.
• Apply argon gas through the needles to freeze the tumor. They’ll monitor the growth of the ice ball over a few minutes.
• Apply helium gas through the needles to thaw the tumor.
• Repeat the freeze-thaw cycle at least one more time.

How long does prostate cryotherapy take?

Prostate cryotherapy usually takes about 45 minutes. You might be at the provider’s office or hospital for two or three hours overall if you’re having an outpatient procedure (one that doesn’t require a hospital stay).

What happens after prostate cryotherapy?

After the procedure, a provider will monitor you and let you know when you can go home. In some cases, you might have to spend the night at the hospital. Your provider will leave the catheter in for a week or two. They might also put you on an antibiotic to prevent infections.

What are the advantages of prostate cryotherapy?

There are many advantages to prostate cryotherapy. Cryotherapy:

• Is minimally invasive.
• Is usually an outpatient procedure.
• Requires minimal anesthesia.
• Has a short recovery period.
• Has a low risk of complications, which can give you a better quality of life afterwards.
• Can be repeated if the first treatment doesn’t completely get rid of the cancer.
• Offers an alternative to surgery and radiation, or an additional treatment option if radiation doesn’t work.

What are the side effects of prostate cryotherapy?

The most common side effects of prostate cryotherapy are erectile dysfunction (difficulty getting an erection) and urinary incontinence (leaking pee). You’re more likely to have these side effects if you’ve had other procedures on your prostate, like radiation. Many people see significant improvement in side effects 12 to 18 months after the procedure.

You might also experience:

• Swelling in your scrotum.
• Pain or burning when you pee.
• Pain in your pelvis or rectum.
• Blood in your pee.
• Urgent need or increased need to pee.

What are the possible complications of prostate cryotherapy?

There’s a small risk of serious complications, including:

• Injury to surrounding tissues, such as your rectum or bladder.
• Fistula (an abnormal opening that connects your urethra and rectum).

What is the recovery time for prostate cryosurgery?

Everyone is different, but the recovery time for prostate cryosurgery is usually about a week. Your provider will remove the catheter in a week or two. Ask your provider when it’s OK to go back to your normal activities.

What is the success rate of cryosurgery for prostate cancer?

Providers measure the success rate of cryosurgery by looking at the amount of time until there’s:

• An increase in prostate-specific antigen (PSA) levels.
• An increase in the size of the tumor.
• A need to change to a different type of treatment.

Using these measures, studies have found that prostate cryotherapy is successful for around 76% to 90% of people three years after their procedure.

How can I take care of myself after prostate cryotherapy?

Ask your provider what activities are safe to do after cryotherapy. Make sure you know how to take care of your catheter and take any medications as prescribed.

When should I call my healthcare provider?

Contact your provider if you have any questions before or after your procedure. Let them know right away if you have signs of infection — like a fever or bloody, cloudy or foul-smelling pee — or if you have pain.

A note from Cleveland Clinic

Prostate cryotherapy is a procedure providers can use to treat cancer — a tool in their toolkit. It can give you an additional option if other treatments aren’t for you. Your provider may recommend it first, or after they’ve tried other tools in their kit. Prostate cryotherapy has come a long way since it was first introduced. But don’t hesitate to ask your provider about the risks and benefits before having the procedure.