Prostate Patient Resources

PROSTATE PATIENT FAQs

a. Primary Prostate Cryoablation

  • What is primary prostate cryoablation?

    Cryotherapy, also known as Cryosurgery, Cryo, and Cryoablation, is a minimally invasive treatment (no incisions) that uses extremely cold temperatures to kill cancer tumors. Cryotherapy is widely used around the world and has over fifteen years’ clinical experience to support its safety and effectiveness. It is also recognized by both the American Urological Association (AUA) and the European Association of Urology (EAU) as a treatment for prostate cancer.

    Primary prostate cryoablation is a treatment option to men who have clinically organ-confined disease of any grade with a negative metastatic evaluation and have not had any other type of prostate cancer treatment.

    To treat a patient with cryoablation, doctors create iceballs using compressed gas and specially designed thin hollow needles which create ice in the targeted areas. These iceballs are very precisely shaped and positioned to freeze the prostate and destroy all of the cancerous tissue. The process is carefully controlled by your doctor who uses ultrasound imaging and temperature monitors to help ensure that the healthy tissue surrounding the prostate is not affected by the cold temperatures or ice.

  • Will primary prostate cryoablation cure my cancer?

    If your doctor considers you to be suitable for prostate cryoablation, it is very likely that the procedure will cure your prostate cancer. The effectiveness of cancer therapies is measured in terms of the number of years patients enjoy being disease-free after treatment. The graph shows the percentage of patients who are cancer free a number of years after treatment. It demonstrates that cryoablation is at least as effective as any other therapy – including surgery – at giving patients a life free from cancer.

    Since prostate cancer treatments have similar survival rates, side effects and quality of life are important considerations when choosing your treatment.

  • What are the benefits of primary prostate cryoablation?
    • Primary prostate cryoablation offers many advantages over other treatment options, including:
    • A minimally invasive (no incisions), curative treatment.
    • 10-year clinical data supports safety and effectiveness in treating prostate cancer.
    • Single treatment, performed on outpatient basis or requiring just one overnight stay.
    • Short hospital stay reduces risk of hospital-acquired infection.
    • Short recovery time permits rapid return to everyday life.
    • Lower risk of incontinence (leaking urine) than with any other therapy.
    • May improve urinary function in patients experiencing problems prior to cryoablation.
    • Minimal or no pain.
    • No need for radiation or radioactive substances and risk of associated side effects (eg secondary cancer).
    • Low risk of rectal damage or irritation.
    • Can be used when other treatments, such as intensity modulated radiation therapy (IMRT), external beam radiotherapy (EBRT) and brachytherapy have failed to cure prostate cancer.
  • What are the risks and side effects of primary prostate cryoablation?

    Your doctor will advise you that any medical procedure has risks associated with it. However, cryoablation avoids many of the risks and complications of other therapies. The potential side effects of curative prostate cancer treatments include incontinence (although the risk of this is very low with cryotherapy) and erectile problems.

    Risk of Impotence (%) after Treatment for Primary Prostate Cancer.
    A low risk means less likelihood of impotence.

     
  • How long will I need to be in hospital?

    Prostate cryoablation can be performed on an outpatient basis. This means that you do not need to stay in hospital for more than a few hours after your treatment, and no overnight stay is required. Sometimes one overnight stay is preferred, but this is dependent on local arrangements or the individual case.

Would you recommend primary prostate cryotherapy to other patients?

  • How will I feel after a primary prostate procedure?

    You may feel some slight discomfort immediately after the procedure, but you will be given pain medication for this and it will improve very quickly. You will have a drainage catheter left in place for a few days until you are able to urinate. You will be shown how to manage the catheter before you return home.

    Most patients feel a great sense of relief that their cancer has been treated and some feel quite emotional as a result of this.

  • How long before I can return to work?

    Your doctor will advise you on the time you should plan to take off. Because cryoablation does not involve open surgery, most patients are able to return to work and an active lifestyle once they no longer need their catheter – typically a week or less.

  • Will primary prostate cryoablation impact my sex life?

    Your doctor may have explained to you that all curative treatments for prostate cancer can affect a man’s ability to obtain and maintain an erection. This risk can seem daunting, but it is important to remember that there have been significant advances in medication and other aids to help men whose natural ability to obtain an erection is lost or reduced. This condition – called impotence or erectile dysfunction (ED) – is very common among middle-aged men (including those who have not had prostate cancer) and today there is lots of help available to ensure they are still able to lead a fulfilling sex life.

b. Salvage Prostate Cryoablation

Are you pleased with your decision to have salvage cryotherapy?

  • What are the criteria for salvage cryoablation treatment?
    • PSA <10 ng/mL
    • Gleason score of ≤ 8
    • Clinical stage of tumor T1 or T2 (before salvage therapy)
    • Pathologic evidence of locally recurrent disease without clinical evidence of metastatic disease
    • No evidence of seminal vesicle (SV) invasion
    • A life expectancy >10 years
    • A long PSA doubling time
  • What are the advantages of salvage prostate cryoablation?
    • Curative therapy
    • Single-treatment session
    • Compared to surgery and radiation, low rates of incontinence1 (leaking urine)
    • Minimally invasive (no incisions)
    • No radiation or hormones
    • None of the side effects associated with hormones
    • Short hospital stay and quick recovery
    • Can be repeated, if necessary

How has salvage cryotherapy changed your life?

  • What are the disadvantages of hormone therapy?
    • Delays the progression of the cancer but does not cure it
    • Potential health risks include:
      • Bone fracture due to reduction in bone density
      • Reduced cardiovascular function (heart disease)
      • Reduced cognitive function (mental agility)
      • Poor insulin/glucose regulation (diabetes)
      • Unpleasant side effects include:
        • Hot flashes/flushe
        • Reduced sex drive
        • Breast enlargement

Prostate Patient Education Guides

Prostate Definitions

Ablation: The destruction of tissue by the application of extreme cold, heat or light (laser).

Anaesthesia: The loss of sensation and usually of consciousness artificially produced by the administration of one or more agents that block the passage of pain impulses along nerve pathways to the brain.

Benign Prostatic Hyperplasia/Hypertrophy (BPH):  A non-cancerous condition that can affect PSA levels and cause enlargement of the prostate. This growth of the prostate can press on the urethra and cause urination and bladder problems (urinary symptoms).

Biopsy: The removal and examination of a sample of tissue for diagnostic purposes.

Brachytherapy: A procedure in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into or near a tumor.

Cancer: A malignant and invasive growth or tumor.

Catheter: A tube inserted into the bladder to temporarily drain urine into a plastic bag. Depending upon your doctor’s recommendation, a catheter is normally kept in place 1-2 weeks after prostate cryoablation.

Cryotherapy or Cryoablation or Cryosurgery: The destruction of tissue by the application of extremely cold temperatures.

Erectile Dysfunction (ED): The loss of the ability to produce and/or sustain an erection. Often referred to as “impotence”. In many cases, an erection can be achieved with assistance.

External Beam Radiation Therapy (EBRT): See Radiation therapy.

Fistula: An abnormal passage from a hollow organ to the body surface or from one organ to another.

Gleason Score: A system of grading prostate cancer cells based on how they look under a microscope. Gleason scores range from 2 to 10 and indicate how likely it is that a tumor will spread.

Impotence: See erectile dysfunction.

Incontinence: See Urinary incontinence.

Intensity-Modulated Radiation Therapy (IMRT): See Radiation therapy.

Perineum: The area of skin between the scrotum and the anus through which the doctor inserts the ultra-thin cryoablation probes. After the procedure, a dressing is applied and the tiny holes heal rapidly.

Prostate: A gland in the male reproductive system just below the bladder. The prostate surrounds part of the urethra, the canal that empties the bladder, and produces a fluid that forms part of semen.

Prostate Cancer Staging:

Stage I: The cells closely resemble normal cells and the gland feels normal to the examining finger.

Stage II: More of the prostate is involved and a lump can be felt within the gland.

Stage III: The tumor has spread through the prostate wall and the lump can be felt on the surface of the gland.

Stage IV: The tumor has invaded nearby tissue.

Prostatectomy: Surgical removal of the prostate.

PSA: Prostate specific antigen, a protein produced by the prostate.

PSA Test: The PSA test measures levels in the blood and is used to help detect prostate cancer as well as to monitor the results of treatment.Elevated PSA may be an indicator of prostate cancer.

Radiation Therapy (Radiotherapy): Uses high-energy radiation to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external beam or intensity modulated radiation therapy) or from materials placed inside the body (internal radiation therapy, implant radiation, or brachytherapy).

Radical Prostatectomy: The surgical removal of the entire prostate gland, the seminal vesicles and nearby tissue.

Rectum: The short tube located at the end of the large intestine, which connects the intestine to the anus.

Robotic Radical Prostatectomy: Instead of directly moving the instruments, the surgeon uses a computer console to manipulate the instruments attached to multiple robot arms. The computer translates the surgeon’s movements, which are then carried out on the patient by the robot.

Stage: The extent of a cancer. See also Prostate Cancer Staging.

Transrectal Ultrasound (TRUS):  The use of sound waves to create a picture of the prostate on a screen to help examine the condition of the prostate and guide insertion of the cryoablation probes.

Urethra: The tube that carries urine from the bladder to the outside of the body.

Urinary Incontinence: Involuntary loss of urine associated with a sudden strong urge to urinate.

Urinary Symptoms: Problems associated with obstruction to flow of urine, usually caused by BPH.