Treatment

Cryotherapy

Cryotherapy is a way of treating prostate cancer that uses freezing and thawing to kill the cancer cells in the prostate gland. It is also sometimes known as cryosurgery or cryoablation.

You may be suitable for cryotherapy if your cancer has not spread outside the prostate gland (localised prostate cancer). It is also sometimes used to treat cancer that is breaking through the capsule of the prostate ( locally advanced prostate cancer).

Cryotherapy is usually used for men whose prostate cancer has come back after treatment with radiotherapy or brachytherapy (recurrant prostate cancer). It is less often offered as a first treatment for prostate cancer. However, it may be an option for men who are unable to have other treatments such as surgery or radiotherapy. For example, men with heart problems (cardiovascular problems) may not be able to have surgery for prostate cancer.

Cryotherapy is newer than some of the other treatments for prostate cancer. We do not know as much about how effective it is in the long term, or the risk of side effects compared with other treatments. Researchers are studying better ways of carrying out cryotherapy. Because of this, it is only available in specialist centres in the UK, or as part of a clinical trial.

What other treatments are available?

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What are the advantages and disadvantages?

The advantages and disadvantages of cryotherapy may depend on whether you are having it as a first treatment for prostate cancer or because the cancer has come back after another treatment. There is a higher risk of side effects if you have already had another treatment for prostate cancer.

Advantages

  • Cryotherapy involves less invasive surgery than some other treatments, with little blood loss.
  • You will only be in hospital for a short time and recovery time is quick.
  • Cryotherapy may be a treatment option if your cancer has come back after radiotherapy or brachytherapy.

Disadvantages

  • Many men who have cryotherapy have long term erectile problems following treatment.
  • There is also a risk of other side effects which could affect your quality of life such as urinary problems and a small risk of bowel problems.
  • We do not know as much about how effective the treatment is in the long term (after 10 or 15 years), compared with other treatments.
  • Cryotherapy is only available in specialist centres in the UK or as part of a clinical trial.

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What does cryotherapy involve?

Each treatment centre will do things slightly differently, so ask your doctor or nurse how they carry out the procedure.

Cryotherapy is carried out under either general or local anaesthetic. The procedure usually takes around two hours.

You will have a tube into your bladder (catheter) to drain urine during the treatment.

Several thin needles are inserted into the prostate gland through the skin between the testicles and back passage (perineum). Freezing gases are passed down the needles, causing the temperature to drop to about -40oC. The prostate gland is then allowed to warm up. This is called a freeze-thaw cycle. There are often two freeze-thaw cycles, but there may be more if you have a large prostate gland.

Most people can go home on the same day or the day after treatment. You will go home with a catheter in place to avoid any problems passing urine. The catheter will be removed after about two weeks.

You will have follow up appointments to monitor your recovery. Your PSA level will be checked about every three months for at least the first year, and every six months after that.

Read our Tool Kit fact sheet online for more information about cryotherapy.

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What are the side effects?

Like all treatments, cryotherapy can cause side effects. Cryotherapy will affect each man differently, and you may not get all of the side effects. There is a greater risk of side effects if you have already had radiotherapy or brachytherapy because these treatments may have damaged the tissues surrounding the prostate gland.

Short term side effects include:

  • blood in the urine (haematuria)
  • difficulty or discomfort passing urine
  • bruising and swelling of the penis, skin around the testicles (scrotum), inner thigh and the area between your testicles and back passage (perineum), or
  • pain and bleeding where the needles were inserted.


The most common long term side effects are problems getting or keeping an erection (erectile dysfunction) and a number of urinary problems.

You can read more about the side effects in our Tool Kit fact sheet, cryotherapy.

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Questions to ask your  doctor or nurse

  • How successful is cryotherapy at treating prostate cancer?
  • What is the risk of side effects?
  • What are my other treatment options?
  • How much experience does the specialist have in carrying out cryotherapy?
  • How often will you check my PSA after the treatment?

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References

You can find a full list of references used to produce this page in our online fact sheet.