Cryotherapy for early prostate cancer

Cryotherapy destroys cancer cells by freezing them. It is sometimes used to treat early prostate cancers or prostate cancer that has come back.

What is cryotherapy treatment?

Cryotherapy destroys cancer cells by freezing them with a special gas. It is sometimes used to treat early prostate cancer (usually low-risk) or prostate cancer that has come back after radiotherapy or brachytherapy.

Unfortunately, this treatment is not routinely available in all NHS hospitals. It is important to talk to your specialist doctor and nurse first to find out if a treatment is available in your area. Usually you can only have cryotherapy on the NHS as part of a clinical trial.

Some private clinics also offer cryotherapy. This treatment is not suitable for everyone. It depends on where the cancer is in the prostate, and the risk group of the cancer. Your doctor can explain more about this.

When is cryotherapy used?

Cryotherapy can be used to treat the whole prostate when the cancer is in more than one area. It is also used when there is only one small area of cancer in the prostate (focal therapy).

If there are areas of cancer that are growing quickly (high grade) you can have focal treatment to these. Very slow-growing areas of cancer may not be treated. You may have fewer side effects, because less healthy tissue is damaged.

If the cancer comes back after cryotherapy, you may still be able to have treatment with surgery or radiotherapy. You will have your PSA level checked regularly after treatment.

How is cryotherapy given?

You usually have cryotherapy under a general anaesthetic or a spinal anaesthetic. You can usually go home when you have recovered from the anaesthetic.

The doctor passes thin needles through the skin behind the scrotum (perineum). They pass an ultrasound probe into the back passage (rectum), to give a picture of the prostate gland on a screen. This is so the doctor can guide the needles into the right place. They pass the gas, which freezes the cancer cells, through the needles into the area of the prostate gland where the cancer is.

Side effects of cryotherapy for early prostate cancer

Urinary problems

You may have problems passing urine (peeing).

To prevent this, you have a tube (catheter) put into your bladder to drain urine into a bag. It is left in for 2 weeks. You may have some urine leaking from the bladder (incontinence) when it is removed, but this usually improves within a few months.

Doing regular exercises to strengthen your pelvic floor muscles can help to improve your bladder control.

Long-term urinary problems

You may have some pain in your lower tummy or back passage (rectum). You will be given painkillers for this. You may have some bleeding from the back passage, but this is not common.

You may have some swelling, numbness, or tingling around the penis and scrotum. This happens 1 to 2 weeks after cryotherapy. It will slowly improve over a few months.

Pain and bleeding

You may have some pain in your lower tummy or back passage (rectum). You will be given painkillers for this. You may have some bleeding from the back passage, but this is not common.

You may have some swelling, numbness, or tingling around the penis and scrotum. This happens 1 to 2 weeks after cryotherapy. It will slowly improve over a few months.

Erection problems

Cryotherapy can cause problems getting an erection. This is called erectile dysfunction (ED). ED may not happen straight after treatment. It may develop slowly, over 2 to 5 years.

Rectal fistula

Rarely, cryotherapy can damage tissues surrounding the prostate and cause a small hole between the rectum (back passage) and the urethra. This is called a rectal fistula. If you have a rectal fistula, you will need an operation to repair it.

We have more information about fistulas.

Possible benefits and disadvantages of cryotherapy

If you are thinking about having cryotherapy, your doctor can explain the benefits and disadvantages. They will also tell you about the other treatment options available to you.

Doctors still do not know enough about how effective cryotherapy is compared to existing treatments for early prostate cancer. Active surveillance, which involves monitoring the cancer, may be an option.

Side effects, such as erection difficulties and urinary problems may be less of a problem with these treatments. But they may still affect you. If you have already had treatment for prostate cancer, the side effects may be worse.

Some people may prefer to have cryotherapy even though there is not enough evidence about them yet. They may feel there is less risk of certain side effects and want to avoid surgery or radiotherapy. Or, it may be because these treatments can be given in a short hospital stay and recovery is usually quick.

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    This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Senior Medical Editors, Dr Jim Barber, Consultant Clinical Oncologist and Dr Ursula McGovern, Consultant Medical Oncologist.

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