Cryotherapy

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What does “Cryotherapy” mean?
The word Cryotherapy comes from two ancient Greek words. Cryo is the word for cold and therapy is the word for healing. In other words, Cryotherapy means healing by using extreme cold.

What is the procedure like?
After anesthesia is administered, one or more slender needles (cryoprobes) are inserted into or near the tumor. The doctor uses imaging technology such as ultrasound or CT scans to guide the probe placement and verify that the tip is precisely positioned. Once each cryoprobe is in place, argon gas is circulated inside the probe to create a very cold iceball at the tip. The iceball encompasses the entire tumor plus a safety margin past the tumor edges. When the
correct low temperature is reached, the doctor thaws the iceball and the probes are removed.

How does ice destroy cells and what is left?

Each year 38,000 people are diagnosed with kidney cancer in the United States. Today, kidney tumors are often found early when they are still small. As a result, survival rates are very high. As with all cancer, the sooner it is treated the greater the chances for cure.

Kidney tumors that are discovered early can be successfully treated without surgically removing all or part of the kidney. Advances in medical technology now allow physicians to ablate (destroy) the tumor in the body, thereby reducing both the risks and the long recovery from open surgery.

Renal Tumor Cryotherapy This illustration demonstrates the use of a cryoprobe positioned at the center of the tumor. The freeze encapsulates the entire tumor with lethal ice. In this illustration the ice ball from the cryoprobe is still forming and will eventually reach its maximum size (typically at 10 minutes). Also, and extra safety margin is created by extending the ice beyond the tumor.

What are the advantages of cryotherapyfor kidney cancer?
Freezing is a natural process that is typically well tolerated by the body. Usually there is minimal to no pain and a relatively short recovery. While no cancer treatment comes with a guarantee of a cure, studies show five-year survival rates near 100%.2

Will I still have my kidney and will it work?
Only a small part of the kidney containing the tumor is frozen. Typically, the rest of your kidney will continue to work as usual. Thus, cryo is a “nephron or kidney sparing” treatment.3

Is cryotherapy new?
Freezing is not new. It has a proven track record in other organs. For example, cryo has been an accepted treatment for prostate cancer for more than a decade.

How successful is kidney cryo?
In a recent study of cryoablation for renal cancer (168 cases), at five years there were no deaths as a result of kidney cancer (100% survival), and only three patients needed further treatment within that period.2

How long does the procedure take?
Your physician can best answer that question but a typical Kidney Cryo procedure takes about 1–2 hours.

How long is the recovery period?
While each person is different, most patients recover relatively fast. Typically, patients spend only one night in the hospital or may even go home the same day. Most patients have fully recovered within a week or so. And because this is not major surgery, there is usually little pain during recovery. However, as with any medical procedure there are risks, and you should always closely follow your doctor’s advice.

How will I know that the procedure was a success?
Your physician will be able to gauge success by taking a CT scan shortly after the procedure. Follow-up scans, usually at 6 months and 1 year, will further confirm that the tumor has been successfully destroyed.

1] American Cancer Society, "Cancer Facts and Figures 2006."
2] Hegarty et al. "Renal cryoablation: 5-year outcomes" presented at AUA 2006 May (Atlanta, GA).
3] Hegarty et al. Urology 2006 Jul: 68(1 Suppl).

Prostate Cancer

THERE'S PLENTY OF LIFE LEFT IN YOU. You have cancer. But you also have options. Thanks to advances in ultrasound imaging and cryogenics, men of all ages are now leading active lives soon after prostate cancer treatment. Physically active. Sexually active. Without resorting to radical surgery or radiation. CRYO STOPS CANCER COLD. By delivering tiny ice balls with pinpoint precision, cryotherapy can destroy only the targeted cancer cells in the prostate gland — sparing the nerves and tissue that preserve your potency and continence. It's not just life-saving. It's lifestyle-saving.

Cryotherapy is not major surgery.
In fact, it's a minimally-invasive treatment that can often be performed as a same-day outpatient procedure. With cryotherapy, there is no open surgery and no radiation beams or radioactive seeds. There is little or no pain, side effects are often low, and recovery is typically fast.

Guided By Ultrasound Imaging.
During the procedure, your physician inserts thin probes into the prostate gland. Guided by ultrasound imaging, the tip of the probe is precisely positioned near the cancerous tissue. Argon gas is then circulated inside the probe to generate a teardrop of ice cold enough to freeze all of the cancer cells. If the cancer is limited to a portion of the prostate, your doctor may be able to freeze only the cancerous tissue, while the remaining prostate stays healthy. If cancer is found throughout the gland your doctor may choose to freeze the entire prostate.

Staying Warm Inside.
During the freeze, temperature sensors carefully monitor the body and precisely determine when target temperatures have been reached. A special warming catheter is used to protect the urethra from cold temperatures, helping to maintain urinary function. If the cancer is limited and a partial gland freeze is performed, nearby nerves may be preserved helping to maintain sexual function and speeding your recovery to a normal life.

The right treatment for the right patient.
Cryotherapy is a primary treatment option appropriate for men with low, intermediate or high-risk prostate cancer, so long as the cancer is confined within the prostate gland and has not spread to other organs.

Tailoring The Treatment To Fit The Main.
One advantage of cryotherapy is that the treatment can be tailored to each patient. If the cancer is limited to only a portion of the prostate, your doctor may be able to freeze just the cancerous tissue, thereby sparing the remaining prostate gland and speeding your return to a normal lifestyle. If the cancer is found throughout the gland, your doctor may need to freeze the entire prostate. While the side effects of a total freeze may be higher, the cancer control rate should also be higher. For men with extensive cancer, your doctor might be able to expand the ice into the surrounding tissue, helping to kill any smaller cancers just outside of the prostate gland. Remember, only your doctor can determine what level of cryotherapy treatment is right for you.

Cryotherapy is repeatable.
Most prostate cancer treatments cannot be repeated; however, cryotherapy offers the unique advantage of repeatability if any cancer cells are detected after initial treatment.

Cryotherapy for recurrent prostate cancer.
Cryotherapy may be appropriate for men whose prostate cancer has returned following radiation treatment. Only your doctor will know if you qualify.

Ice is a highly-effective killer of cancer.
For most men, cryotherapy is an effective treatment option. Studies show that up to 89% of cryotherapy patients maintain low PSA levels for five years or more after the treatment. It's important to continue monitoring your prostate health under the guidance of a physician and certain medical conditions may preclude you from cryotherapy treatment. Only your doctor will know if you qualify.

Associated Risks.
As with all prostate cancer treatments side effects may occur. Side effects may include incontinence, rectal injury and impotence. Studies indicate incontinence occurs in less than 5% of patients and rectal injury in less than 0.5% of patients. Rates of impotence depend greatly on how much prostate tissue is destroyed. The more prostate tissue destroyed the higher the chance of erectile problems. If the cancer is limited and a partial freeze is performed, nearby nerves may be preserved, helping to maintain sexual function. Other side effects may include swelling and bruising. Remember, only your doctor can determine what risks and benefits cryotherapy may hold for you.

Recurrent prostate cancer.
It's important to continue monitoring your prostate health under the guidance of a physician. If cancer returns, finding out early is the best way to keep all options available to you. Cryotherapy offers men who have failed radiation therapy a potentially curative treatment for their recurrent prostate cancer.