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cryosurgery (cryoablation)
A technique for freezing & killing abnormal cells. Also see cryotherapy.
Indications:
1) liver cancer or metastases to the liver
- colorectal carcinoma
2) prostate cancer confined to the prostate gland
3) cervical intraepithelial neoplasia
4) tumors of the bone (malignant & benign)
5) skin cancer (see cryotherapy)
a) actinic keratosis
b) basal cell
c) squamous cell carcinomas
d) Kaposi's sarcoma
6) retinoblastoma
7) incidental renal neoplasm
- patients who are not good surgical candidates
8) fibroadenomas of the breast
9) small, low-risk, early-stage breast cancers in older patients [2]
Advantages:
1) less invasive than surgery
2) sometimes cryosurgery can be done using only local anesthesia
3) may have fewer side effects
a) pain, bleeding, & other complications of surgery are minimized
b) bone cancer: may reduce the risk of joint damage & reduce need for amputation
c) prostate cncer may reduce incidence of impotence
4) less expensive
5) requires shorter recovery times
6) procedure can be repeated
7) may be used along with standard treatments such as surgery, chemotherapy, hormone therapy, & radiation
8) can be in patients who cannot have surgery or radiation therapy because of their age or other medical problems
9) may offer an option for treating cancers that are considered inoperable or that do not respond to standard treatments
Disadvantages:
1) long-term effectiveness is not known
2) insurance coverage issues may arise
3) does NOT treat metastases
Procedure:
1) use of extreme cold produced by liquid nitrogen (or argon gas) to destroy abnormal tissue
2) for external tumors, liquid nitrogen is applied directly to the cancer cells with a cotton swab or spraying device
3) for internal tumors, liquid nitrogen or argon gas is circulated through a hollow instrument called a cryoprobe, which is placed in contact with the tumor
4) cryoprobe may be used during surgical or laparoscopic procedure percutaneous procedure used for incidental renal neoplasms
5) ultrasound or MRI to guide the cryoprobe & monitor the freezing of the cells, thus limiting damage to nearby healthy tissue.
6) a ball of ice crystals forms around the probe, freezing nearby cells
7) after cryosurgery, the frozen tissue thaws & is either absorbed by the body (internal tumors), or it dissolves & forms a scab (external tumors)
Adverse effects:
1) prostate cancer (treatment of)
a) adverse effects may occur more often in men who have had radiation to the prostate
b) obstructive uropathy
c) urinary incontinence
d) impotence
e) injury to the rectum.
2) liver cancer (treatment of)
-> injury to the bile ducts &/or major blood vessels, which can lead to hemorrhage or infection
3) cervical intraepithelial neoplasia (treatment of)
a) has not been shown to affect a woman's fertility
b) cramping, pain, or bleeding
4) skin cancer (treatment of)
a) scarring
b) edema
c) if nerves are damaged, loss of sensation may occur
d) loss of pigmentation
e) loss of hair in the treated area
5) tumors of the bone (treatment of)
a) destruction of nearby bone tissue
b) fractures
c) interaction with certain types of chemotherapy
6) renal cancer (treatment of) [1]
a) urosepsis
b) pulmonary embolism
c) hematoma
Notes:
Availability:
1) widely available in gynecologists' offices
2) a limited number of hospitals & cancer centers
Related
cryotherapy; cutaneous cryotherapy
Specific
cryoablation for pulmonary tumor
cryosurgery, anus
cryosurgery, benign rectal neoplasm
cryosurgery, endometrium
cryosurgery, fibroadenoma
cryosurgery, kidney
cryosurgery, liver
cryosurgery, penis
cryosurgery, prostate
cryosurgery, rectal cancer
ocular cryosurgery,
General
surgery
References
- Atwell TD et al,
Percutaneous renal cryoablation: Experience treating 115
tumors.
J Urol 2008, 179:2136
PMID: 18423719
- Mulcahy N
Freezing Breast Cancer to Death Avoids Surgery.
Medscape - May 10, 2021.
https://www.medscape.com/viewarticle/950821
- Cryosurgery in Cancer Treatment: Questions and Answers
http://cis.nci.nih.gov/fact/7_34.htm