The Cryosurgery Prostate Cancer Treatment Option

According to a Binghamton University study appearing in a recent Journal of Urology,

cryosurgery is emerging as a primary treatment option for prostate cancer. However, while
cryosurgery offers rapid recovery and low instances of incontinence, there is a higher rate of
erectile dysfunction. In fact, erectile dysfunction is more common after cryosurgery than after
radical prostatectomy.

Cryosurgery, also known as cryotherapy, is touted as a quick, virtually pain-free and bloodless
procedure. It is a relatively inexpensive, outpatient treatment that involves the use of a urethral
catheter for one week. Incontinence rates are roughly less than two percent, with four percent the
highest rate reported in the literature. The best candidates for cryosurgery include obese patients
that cannot withstand a radical prostatectomy (removal of the prostate gland) or external beam
radiation therapy. It should be noted that cryosurgery works best on prostates 40 grams or less in
size and must be used in conjunction with hormone therapy to block production of the hormones
that cause prostate cancer to grow. A smaller prostate allows for uniformly cold temperature to be
maintained throughout the gland.

However, in a recent study that appeared in the Journal of the American Medical Association,
hormone therapy used alone has been linked to a slightly heightened risk of death in older men.
The higher risk of death was found to be more prevalent in older men with serious heart problems
or a history of heart failure. Though more investigation into hormone therapy will be needed,
there had long been a suspected link between cardiac problems and long-term use of hormones.
Hormones increase insulin resistance, raise cholesterol and augments fat, all of which increase the
risk factor for men with pre-existing heart disease.

Risk of impotence is elevated with cryosurgery because very cold gases are passed through the
needles to create ice spheres that destroy the cancer cells in the prostate gland. These spheres
must extend beyond the borders of the prostate, which can then destroy the delicate neurovascular
bundles responsible for erection. It causes impotence in up to 80% of cryosurgery patients.
Immediate post-surgical impotence rates are 100 percent. Restoration can be achieved with
intensive rehabilitation in about 40 percent of patients within one year and in 50 percent within 4
years.

Cryotherapy is used mostly for radiation failure. Long-term data on the use of cryotherapy as a
primary treatment is still unknown. If the prostate remains intact, the PSA levels can fluctuate and
can be difficult to manage. Additionally, if the cancer recurs after cryotherapy, it is very difficult
to perform salvage prostatectomy. However, unlike cryotherapy, where the prostate remains
intact, robotic prostatectomy removes the prostate. Doctors can ascertain the volume and staging
of cancer. The follow-up is much easier to manage as compared to cryotherapy. The post-surgery
PSA level should be undetectable. This lets patients know that they are cancer-free, giving them
freedom from anxiety and stress.

For these reasons, robotic surgery is the best and most thorough way to treat prostate cancer.
Robotic prostatectomy is the safest and best nerve-sparing treatment option that preserves
continence, sexual function and guarantees a higher cure rate.

With the technological advances and surgical knowledge that has been perfected in recent years, a
robotic prostatectomy that is done by an experienced surgeon will know how to work around the
critical nerves. With better odds in less time and with less rehabilitation, why not opt for a
treatment that increases cure rate success, lessens side effects and decreases the risk of morbidity?