PROSTATE
CANCER CRYOTHERAPY
Technological Advances
Prostate Cancer Cryotherapy
History and
Advances in the Field
From 19th-Century Sub-Zero Temperature Conceptualization
to 20th-Century Prostate Cancer Treatment Application
Cryotherapy,
also known as Cryo, Cryosurgery,
and Cryoablation,
provides prostate cancer patients with a minimally
invasive procedure, and recently published 10
year data proves its efficacy. Cryotherapy
can trace its roots back to as early as 2500 B.C.
when low temperatures were used to stop bleeding
and swelling, and 19th-century London when ice-salt
mixtures were applied to breast and cervical cancers.
It is clear that Cryotherapy,
as a concept, has evolved from relative antecedent
experiments. It wasn’t until 1966 that modern
cryotherapy began with the advent of probes cooled
by liquid nitrogen in closed circulation. In the
late 1960s and early 1970s, the transurethral
cryoablation of benign prostatic hyperplastic
tissue marked one of the first applications, which
was closely followed by the ablation treatment
of prostate cancer through an open, fully invasive
perineal approach.
As a result of trial and error in 1974 using a single digitally guided cryoprobe, the minimally invasive transperineal approach was introduced. Compared to other radical surgical procedures of the time, Cryosurgical treatments achieved more effective tissue ablation, and severe complications were reduced. Early acceptance of the modality was impeded by the inability to accurately monitor cryoprobe placement and iceball formation. Technological advances have enabled the acceptance of cryotherapy as a minimally invasive treatment for prostate cancer in the field of urology. These advances include the use of real-time transrectal ultrasound (TRUS) for monitoring probe placement and freezing, the simultaneous use of multiple cryoprobes, and the standard use of urethral warming catheters
Technological Improvements and Advanced Thinking Suggest an Encouraging Future for Cryotherapy
Recent technological developments for cryosurgical
ablation as prostate cancer treatment options
include the development of 17-gauge 3rd generation
cryotherapy
needles based on argon and helium gases. With
ultra-thin needles and the use of the transrectal
ultrasound for guidance and warming catheter,
surgeons are now able to use direct transperineal
insertion, avoid the need for tract dilation,
and create a precise iceball that destroys the
prostatic tissue.
According to American Urological Association
polls, between 1997 and 2001 a constant 2% of
urologists performed cryosurgery as a treatment
for prostate cancer with an average annual number
of procedures performed by urologists increasing
from 4 to 24. Today, cryotherapy is being used
with substantially greater frequency and with
ten-year survival rates comparable to other primary
therapies of surgery and radiation, this prostate
cancer treatment option is quickly becoming universally
accepted and supported.
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