Staff | Cancer Consultants

Researchers from Duke University have reported that early results of third generation cryosurgery suggest that this is a feasible and effective treatment of localized prostate cancer. The details of this study were published in the July, 2007 issue of Urology.

Cryosurgery was first used to treat prostate cancer in the early 1970s, but it was not until 1993, when the results from percutaneous ultrasound-guided cryosurgery were published, that the potential advantages of this treatment became apparent. Changes in equipment and techniques have improved the results of cryosurgery in both tumor control and lower morbidity. Ultrasound-guided percutaneous transperineal placement of the cryoprobes allows monitoring of freezing in real time. Monitoring temperature at critical locations, separating the rectum and prostate by saline injection, and using argon gas rather than liquid nitrogen-based equipment have improved results and lowered complication rates. This technique is reported to produce outcomes similar to those obtained with brachytherapy and three-dimensional conformal radiation. Advantages of cryosurgery include the ability to re-treat patients without added morbidity and to treat salvage post-radiation patients with acceptable results and morbidity. There is also the possibility that "nerve-sparing" cryosurgery is possible. Researchers from Calgary have reported that outcomes of treating stage 1-3 prostate cancer with cryosurgery were equivalent to outcomes following radiation therapy (See first item of related news). This is the only study that has ever been performed comparing two different initial treatments for localized prostate cancer.

In the current study, 50 men underwent primary cryosurgery for localized prostate cancer. The median age was 68 years with the oldest patient being 83 years old. Of these patients, 72% had low-risk disease, 18% had intermediate-risk and 10% had high-risk disease. The median follow-up was 18 months. These authors reported that two patients had persistent prostate cancer documented by biopsy and received salvage radiotherapy or cryosurgery. Three additional patients had elevated PSAs post treatment and two ultimately normalized while one had a persistent PSA up to 1.2 ng/ml. Overall survival was 100%.