What Is Cryotherapy and How Can It Help Treat Prostate Cancer?

Cryotherapy involves freezing all or part of your prostate with very cold temperatures, generally under −40ºC (also −40ºF). Surgeons achieve this by inserting several metal probes between your anus and scrotum and into your prostate. The probes pump cold gas through to your prostate until it reaches the targeted temperature.

Extreme cold kills cancer cells in several ways. At a microscopic level:

• It creates ice between cells, drying out the space between them.
• It shrinks cells.
• It creates ice inside cells, causing the cells to die.
• The immediate freezing and thawing change the pH of the cells.
• It creates swelling and inflammation that cuts the blood supply to cancer cells.

Cryotherapy isn’t currently a standard treatment for prostate cancer. Researchers continue to look into when it may be most useful. It may be an option for you if your cancer is contained to your prostate.

A doctor may recommend cryotherapy:

• if you have cancer that has returned after radiation therapy
• as an alternative to radiation therapy or surgery if you’re not eligible for these treatments

Researchers are still trying to learn how effective cryotherapy is compared with other prostate cancer treatments. Studies have found promising results, but according to a 2022 study, long-term data is still lacking.

Another 2022 study refers to cryotherapy as a treatment in a “transition phase.” There’s enough research for it to no longer be experimental but not enough for it to be established.

In a 2022 review of studies, researchers analyzed the outcomes of cryotherapy in 11,228 people with low- or intermediate-risk prostate cancer. The overall survival rate ranged from 61.3% to 99.1%. There was no difference in outcomes in people who received it as a first-line or a second-line treatment.

A 2020 study found that cryotherapy achieved similar results to radical prostatectomy, which is surgery to remove your prostate. But cryotherapy had better functional outcomes. The study involved people with low- and intermediate-risk prostate cancer.

According to the 2022 review, the most commonly reported side effects were:

• erectile dysfunction (ED) in 3.7% to 88.0% of people
• urinary retention in 4.1% to 18.0% of people
• urinary incontinence in 1.6% to 18.0% of people
• lower urinary tract or bladder infection in 3.0% to 16.7% of people

Less than 1% of men develop an abnormal connection between their anus and bladder called a fistula that needs surgery to repair.

Here what’s you can expect before, during, and after your procedure.

Preparation

A medical team may give you a laxative or enema to empty your bowels before your procedure. A doctor will likely tell you to stop eating the night before if you’re receiving general anesthetic.

Procedure

Here’s a general idea of what will happen during your procedure.

1. You’ll likely receive general anesthetic through an intravenous (IV) line so that you’ll be asleep during your procedure. If you can’t have general anesthetic, they may give you anesthetic through your spine.
2. The surgeon will insert a catheter into the tip of your penis through to your bladder. They’ll fill it with warm liquid to protect these areas from damage.
3. They’ll insert an ultrasound probe into your anus so that they can see where to insert needles.
4. They’ll insert thin needles through the area between your anus and penis and into your prostate.
5. Freezing gas will be passed through the needles to cool your prostate. Your surgeon will administer the gas in several cycles to allow your prostate to warm up between each.
6. They’ll remove the needles and insert another tube into your penis to drain your bladder.

After the procedure

You’ll likely be able to go home on the same day as your treatment. Some people need to stay overnight. You may have some pain or discomfort that you can manage with pain relievers.

You may need a catheter for a couple of weeks to promote healing. You may also have some soreness or bruising as well as blood in your urine for several days.

You may also have urinary problems or trouble emptying your bowels. But these symptoms should get better over time.

It’s important to follow the surgeon’s postsurgery instructions. Attend all your scheduled follow-ups to make sure all signs of the cancer are gone to give yourself the best chance of having a good outcome.

According to the National Cancer Institute, there are eight standard treatments for prostate cancer:

• active surveillance
• surgery
• radiation therapy
• hormone therapy
• chemotherapy
• targeted therapy
• immunotherapy
• bisphosphonate therapy

Active surveillance

A doctor may recommend active surveillance if you’re older or they don’t expect your prostate cancer to grow quickly. It involves monitoring the cancer for changes while not actively treating it.

Active surveillance helps prevent complications associated with other treatments but comes with the risk of letting the cancer progress.

Surgery

Surgery is an option if you’re in good overall health and the cancer is contained to your prostate or surrounding area. The most common surgery is a radical prostatectomy. That’s where the prostate and surrounding tissue are removed.

Surgery is more invasive than cryotherapy. But it has a lower risk of serious complications such as ED and urinary problems. Surgery also has a higher cancer-specific survival rate.

Radiation therapy

Radiation therapy uses high-energy waves to destroy cancer cells. It can be an effective treatment but increases your risk of bladder and gastrointestinal cancer. It can also cause side effects such as ED and urinary problems.

Doctors often combine radiation therapy with other treatments such as hormone therapy or surgery.

Other therapies

• Hormone therapy: Hormone therapy involves lowering male hormones that cancer cells need to grow.
• Chemotherapy: Chemotherapy is a chemical drug therapy doctors administer through an IV line or orally. It can cause many side effects due to damage to healthy cells throughout your body.
• Targeted therapy: Targeted therapy is a drug therapy that uses drugs to specifically attack cancer cells. It avoids many of the complications associated with chemotherapy.
• Immunotherapy: Immunotherapy is a drug therapy that stimulates your immune system to attack cancer cells.
• Bisphosphonate therapy: Bisphosphonates are medications used to lower the risk of bone loss in men on hormone therapy.

Cryotherapy is a treatment option for prostate cancer that involves freezing cancer cells with very cold temperatures. Researchers are still trying to understand how effective cryotherapy is compared with other treatments such as radiation therapy and surgery.

A doctor may recommend cryotherapy if you don’t respond to other treatments or if you don’t make a good candidate for surgery or radiation therapy.