Cryotherapy for prostate cancer

• How cryotherapy treatment is used
• Having cryotherapy treatment
• Side effects of cryotherapy for prostate cancer
• Other treatment options

In the past, cryotherapy was not used very much in the UK to treat prostate cancer. Research showed that the cancer often came back after treatment. The treatment also had quite severe side effects, with about 8 out of 10 men (80%) not being able to have an erection (impotence) after treatment. But cryosurgery techniques have improved the results of treatment and have helped to reduce side effects. There are still some issues with this treatment and research is continuing.

In 2008, the National Institute for Health and Clinical Excellence (NICE)  issued guidelines for prostate cancer treatment. You can download these guidelines from the NICE website. The guidelines said that cryotherapy should only be used as part of a clinical trial. NICE say that there is not yet enough evidence available on the long term benefits of this treatment or its effects on your quality of life. So your doctor should explain this to you and give you full information about the other treatment options available before you have cryotherapy. We don't know of any trials of cryotherapy for prostate cancer that are currently open in the UK.

Cryotherapy (also called cryosurgery) is a way of killing cancer cells by freezing them. To have cryotherapy, a number of metal probes are put through the skin and into the affected part of the prostate. The probes contain liquid nitrogen or argon, which can freeze and destroy the cancer. You can have this treatment under local anaesthetic or with a general anaesthetic. You will need to have a tube from your bladder to drain your urine. for 1 to 2 weeks after treatment. There is more information about cryotherapy in the prostate cancer research section of CancerHelp UK.

UK Prostate Link can also direct you to more information about cryotherapy for prostate cancer.

Some men have difficulty getting an erection after this treatment. This happened to between 72 and 100 out of every 100 men treated for early prostate cancer, depending on the particular research study.

Between 1 and 19 out of every 100 men had trouble with bladder control afterwards. Some men developed a narrowing of the tube from the bladder (urethra) following cryotherapy. This can be corrected by stretching, but it is a minor operation needing an anaesthetic. Between 4 and 15 out of every 100 men needed to have a TURP operation after cryotherapy, in order to remove more of the prostate and control their urinary symptoms.

1 or 2 men in every 100 treated had damage to their back passage (rectum), making a small hole (called a fistula) develop between their bowel and the tube from the bladder (the urethra).

If you have just been diagnosed with prostate cancer that is completely inside the prostate, the other treatment options are active monitoring (sometimes called watch and wait), radiotherapy or completely removing the prostate with surgery (radical prostatectomy).

If your prostate cancer has come back, another treatment option is more radiotherapy. Whether you can have more radiotherapy depends on the doses originally given to your prostate area. Or surgery to remove the prostate (sometimes called salvage prostatectomy) can be used. Surgery is more difficult after radiotherapy, so complications are more common. 6 out of every 10 men have incontinence of urine after this type of surgery. Impotence happens in virtually all men who have their prostate removed after the cancer has come back.

All these treatment options are only available if the cancer is only in the prostate gland. The treatments can be very successful at getting rid of the cancer but may not be possible for many men. If the cancer has spread anywhere else in the body, these 'local' treatments will not work. But other treatments can help to control the cancer for some time.