Cryoablation is an innovative approach in prostate cancer treatment. Tiny needles are used to target cancerous tissues. These needles cool tumors to –140 °C, destroying them. Thus, this method preserves the prostate while providing an effective solution. Compared to other treatments, it has lower rates of erectile dysfunction, urinary incontinence, and urethral stricture, making it a leading option. Offering a non‑surgical choice, cryoablation stands out for its minimally invasive nature.
Interventional Radiology / Interventional Neuroradiology
Prof. Dr. Özgür KILIÇKESMEZ
What Is Cryoablation?
Cryoablation is a revolutionary method in prostate cancer treatment. This modern medical solution directly intervenes in cancerous tissue. The treatment involves applying extreme cold to the tumor via small needles. As a result, the tumor freezes, shrinks, and eventually disappears. The patient remains comfortable under local anesthesia during the procedure.
With this method:
- The procedure lasts approximately 15 minutes.
- Patients feel no pain.
- Recovery is rapid.
- Same‑day discharge is possible.
How Is Cryoablation Performed?
Cryoablation is a non‑surgical technique used in prostate cancer treatment. The procedure consists of several carefully executed stages. First, bowel preparation is required, including dietary restrictions and laxatives. For patient comfort, general or regional anesthesia is administered. To prevent freezing injury to the urethra, a catheter is placed. Next, under transrectal ultrasound guidance, the surgeon places cryoprobes into the prostate:
- Careful placement of probes.
- Freezing initiated using argon gas.
- Thawing performed using helium gas.
The final stage is monitoring. The interventional radiologist uses ultrasound imaging to confirm probe position and ensure only cancerous tissue is treated.
What Are the Advantages of Cryoablation?
Cryoablation offers a minimally invasive alternative for prostate cancer treatment. Compared to traditional surgery, it requires far fewer incisions, resulting in less postoperative pain and discomfort. With a shorter recovery time, patients return to normal life more quickly. Additionally, this method reduces complication risks and minimizes damage to surrounding healthy tissue.
- Reduced Pain and Discomfort: Minimal postoperative pain and rapid recovery.
- Precision and Efficacy: Targets cancerous tissue without harming adjacent structures.
- Enhanced Immune Response: Release of tumor‑specific antigens stimulates immunity.
- Versatility: Capable of treating various cancer types and other conditions.
- Low Complication Risk: Minimizes infection and blood loss.
These features have made cryoablation an effective solution for various cancers and other serious conditions, accelerating recovery and improving quality of life. Advanced imaging techniques ensure precise targeting of cancerous tissue, making it ideal for patients unsuitable for surgery.
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What Is the Post‑Treatment Process?
The post‑treatment process prioritizes patient comfort and recovery. Most patients are discharged the same day, though deeper interventions may require an overnight stay. Post‑procedure pain is usually mild and managed with simple analgesics; deeper treatments may need more intensive pain control.
Hospital Stay and Recovery:
- Small procedures: immediate discharge.
- Deep tissue treatment: overnight observation.
- Most patients resume normal activities within 1–3 days.
The treatment area is bandaged, and patients are instructed to watch for infection signs. Seek medical help if swelling, redness, or discharge occurs. Heavy lifting is discouraged.
Activity Restrictions:
- No heavy lifting for 72 hours.
- Return to normal activities may take up to 10 days.
Follow‑up appointments assess cryoablation success, often using ultrasound or CT scans.
Follow‑Up Visits:
- Within a few weeks post‑procedure.
- Imaging tests to verify treatment efficacy.
This process ensures rapid and effective management of post‑treatment recovery.
What Is the Success Rate of Cryoablation in Prostate Cancer Treatment?
Success rates vary by risk group. A large study showed high ten‑year survival in low‑risk patients:
- Low‑risk: 80.56 %
- Intermediate‑risk: 74.16 %
- High‑risk: 45.54 %
These rates reflect biochemical recurrence‑free survival. Another seven‑year study reported high disease‑free survival in low and intermediate groups:
- Low‑risk: 87 %
- Intermediate‑risk: 79 %
- High‑risk: 71 %
These findings demonstrate long‑term efficacy in less advanced cases. Common side effects include erectile dysfunction (most frequent), with urinary incontinence being rarer. Side effects include:
- Erectile dysfunction
- Urinary incontinence
- These occur less often than with other methods.
Considering risks and patient challenges, cryoablation offers a less invasive alternative with shorter recovery, ideal for those unsuited to surgery or seeking faster recovery.
What Are the Side Effects and Risks of Cryoablation?
Side effects and risks are key considerations. Mild bleeding at probe entry sites is common, as are pain and swelling. Notable side effects:
- Pain, swelling, or bruising
- Infection risk limited to probe insertion sites
- Nerve damage causing numbness or weakness
Skin and urethral issues may also occur:
- Skin irritation or blisters
- Urinary incontinence, hematuria, dysuria
Who Is Cryoablation Suitable For and Who Is Not?
Cryoablation is suitable for patients with early‑stage cancers, particularly small, well‑defined tumors in organs like the prostate and breast. Tumors must be localized. It also treats tumors difficult to operate on due to location, such as those in the kidney, liver, lung, and bone metastases.
Patients with serious comorbidities, such as severe heart disease or poor general health, may opt for this less invasive method. It can also relieve pain in bone cancer patients.
Not suitable for:
- Advanced or aggressive cancers (e.g., inflammatory breast cancer or extensive lymphovascular invasion)
- Diffuse or multifocal tumors
- Tumors > 1.5 cm with significant intraductal components
- Patients with active infections or conditions impairing healing (e.g., uncontrolled diabetes or certain hematologic disorders)
Prof. Dr. Özgür Kılıçkesmez graduated from Cerrahpaşa Medical Faculty in 1997. He completed his specialization at Istanbul Education and Research Hospital. He received training in interventional radiology and oncology in London. He founded the interventional radiology department at Istanbul Çam and Sakura City Hospital and became a professor in 2020. He holds many international awards and certificates, has over 150 scientific publications, and has been cited more than 1500 times. He is currently working at Medicana Ataköy Hospital.
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