Prostate Cancer (cont.)

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What is cryotherapy for prostate cancer?

Cryotherapy is another treatment being evaluated for use in the early stage of prostate cancer. This treatment kills the cancer cells by freezing them. The freezing is accomplished by inserting a freezing liquid (for example, liquid nitrogen or argon) through needles directly into the prostate gland. The procedure is accomplished under the guidance of ultrasound images. Cryotherapy is not a new technique. Rather, it is a modification of a procedure that was tried previously but had an unacceptably high rate of complications. Thus, cryotherapy was used in the 1960s to freeze the lining of the stomach to treat ulcers but was discontinued because it also severely damaged the lining of the stomach.

At present, cryotherapy is recommended for patients with locally advanced prostate cancer who, for whatever reason, are not candidates for the more established treatments. Cryotherapy is further being studied to determine which other patients might benefit from this treatment. For example, studies are under way to establish whether cryotherapy is beneficial as an initial treatment for organ-confined (localized) prostate cancer. The effectiveness of cryotherapy in eliminating prostate cancer, however, has not yet been proven. We do know that sometimes the freezing liquid fails to kill all of the cancer cells. Moreover, the potential side effects of this treatment include damage to the urethra and bladder. This damage can cause obstruction (blockage) of the urethra, fistulas (abnormal tunnels) that leak urine, or serious infections.

What is HIFU for prostate cancer?

HIFU, which stands for high intensity focused ultrasound, was first developed as a treatment of benign prostatic hyperplasia (BPH) and now is also being used as a procedure for the killing of prostate cancer cells. This procedure utilizes transrectal (across the rectum) ultrasound that is highly focused into a small area, creating intense heat of 80-100 C, which is lethal to prostate cancer tissue. However, the published clinical experience with HIFU for this application is limited and the procedure is not yet approved by the FDA for use in the United States.

Medically Reviewed by a Doctor on 12/9/2013

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