Cryotherapy - Prostate Cancer Charity

Treatment Specialist Nurses 0800 074 8383 prostatecanceruk.org
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• 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.
What might be an advantage for one person
may not be for someone else. Please talk to
your doctor or nurse about your own situation.
What does cryotherapy involve
Each hospital will do things slightly differently,
so ask your doctor or nurse for details of how
they carry out the procedure.
Before having treatment
Your doctor or nurse may ask you to take some
medicine, called a laxative, to help empty your
bowels immediately before treatment. This will
give your doctor a good view of the prostate
gland during treatment using an ultrasound
probe (see below).
During treatment
Cryotherapy is usually done under general
anaesthetic so that you are asleep during the
treatment. It is sometimes done under local
anaesthetic so that you are awake but won’t
feel anything.
A tube, known as a warming catheter, is passed
through your penis into your bladder. Warm
liquid is circulated through the catheter during
the treatment. This is to help prevent the tube
which you pass urine through (your urethra) from
freezing and being damaged during treatment.
An ultrasound probe is inserted into your back
passage. This allows your doctor to see an
image of the prostate gland and make sure the
cryotherapy needles are in the right place. Several
thin needles, known as cryoneedles or cryoprobes,
are then inserted into the prostate gland through
the skin between the testicles and back passage
(perineum). Probes to monitor temperature are also
inserted into and around the prostate gland.
Freezing gasses are passed down the needles,
causing the temperature to drop to about –40 o C.
This freezes and destroys the surrounding tissue.
The prostate gland is then allowed to warm up,
either naturally, or by passing a different gas
through the needles to warm the gland more
quickly. This is called a freeze-thaw cycle. The
process of freezing and thawing is repeated.
There are usually two freeze-thaw cycles but there
may be more if you have a large prostate gland.
The needles and probes are then removed and,
after about 20 minutes, the warming catheter is
also removed. Another tube, used to drain urine,
will be passed into your bladder either through the
penis (urethral catheter) or through a small cut in
your abdomen (suprapubic catheter). This will be
left in for one to two weeks after you go home. The
whole process usually takes around two hours.
Going home after treatment
Most people can go home on the same day
or the following day. It is normal to have some
discomfort, and your doctor or nurse will tell you
which pain-relieving drugs you can take. You will
be given antibiotics to reduce the risk of infection
which you will need to take for a few days after
you go home. If your urine starts to smell strongly
or if you have a temperature, contact your doctor
or nurse. These could be signs of an infection and
you may need more antibiotics.
You will go home with a catheter in place to
avoid any problems passing urine. This will be
left in for one to two weeks. Your nurse will show
you how to care for the catheter before you
leave the hospital. Some treatment centres may
also give you medication called alpha-blockers
to relax the muscle in and around the prostate
to help you pass urine.