Cryosurgery, also called cryotherapy or cryoablation, is the process of using extremely cold temperatures to kill abnormal tissue, most commonly benign and malignant skin conditions such as warts, moles, and certain skin cancers. Cryosurgery freezes tissue at the cellular level, forming ice crystals from within the cells, which destroy them. Other treatment of conditions for which cryosurgery is sometimes used include:
Hemorrhoids
Cataracts
Solar Keratoses
Fibroma
Cervical Dysplasia
Oral, bone, liver, and prostate cancers
Cryosurgery is frequently used to treat certain conditions because it is considered safe, effective, and it produces minimal side effects. Liquid nitrogen or argon gas is applied through a cryoprobe or cryoneedles, or sometimes dabbed on with a cotton swab. If you have ever had a wart or mole frozen off, you have experienced cryosurgery.
Cryosurgery and the treatment of prostate cancer: Cryosurgery has been used for the treatment of prostate cancer for more than 40 years, most commonly in men who have had cancer cells return after radiation treatments, or for whom radiation treatment was unsuccessful. However, cryosurgery is now being used more often as a first option or as an alternative to radiation therapy.
Prostate cryosurgery is performed by putting a catheter full of a warm saline solution inside the urethra, in order to protect it from the freezing temperatures. An ultrasound probe is placed inside the anus so that that the surgeon can use the cryoprobe to perform the surgery. Finally, a cryoneedle is inserted into the prostate and the freezing gas is applied to the entire prostate until it is frozen. The prostate is allowed to thaw and then the procedure is repeated to ensure that all cancerous cells have been frozen and killed.
Men who have a very large prostate are not good candidates for prostate cryosurgery because it becomes difficult to freeze the entire prostate. However, some doctors are first using hormone therapy to shrink the prostate, and if successful, cryosurgery may be used as a first treatment option for prostate cancer patients.
Cryosurgery and the treatment of cervical dysplasia: Cryosurgery is performed on women who have had a pap smear showing cervical dysplasia (precancerous cells). The presence of precancerous cervical cells is reconfirmed by a colposcopy before the cryosurgery is performed.
During the cervical cryosurgery procedure, a speculum is used to hold the vaginal canal open so the cervix can be seen. The cryoprobe is inserted through the vagina and the freezing gas is applied to the area of the cervix where the abnormal tissue it located. As with the prostate procedure, this area is frozen, allowed to thaw, and then the procedure is immediately repeated.
The procedure is effective in the majority of cases, but it is not as successful for cases in which the abnormal cells are located in the upper portion of the cervix. For two to four weeks after the cervical cryosurgery is performed, the patient may have a watery discharge caused by the dead cells shedding off the cervix. In addition, the patient may experience vaginal bleeding and pelvic cramps. Tampons should not be used, and sexual intercourse should be avoided during the month following the procedure.
Cryosurgery and the treatment of other cancers: Cryosurgery has been used for the treatment of both benign and malignant bone tumors. It is also an alternative to more invasive surgeries for liver cancer that has not spread to other parts of the body, or for liver cancer that has spread from another part of the body (liver metastases). Cryosurgery is also very effective for precancerous skin conditions such as solar keratoses (also called actinic keratosis) and for skin cancers in the early stages of progression. Cryosurgery is currently being studied as an alternative to traditional surgery and chemotherapy for breast cancer, colon cancer, and kidney cancer, so cryosurgery procedures are not yet being offered to most patients with these types of cancer.
The advantages of cryosurgery: Cryosurgery is considered less invasive than many other alternative treatments of the above conditions because it can be limited to a very small area, preventing the healthy tissue in and around that area from being destroyed as well. In many cases, patients may be able to stay awake during the procedure, only a local anesthetic is necessary, patients may be able to go home the same day as the surgery, and recovery time is much shorter. Although there are some side effects of cryosurgery, different for each type depending on the condition, the side effects are usually minimal or at least fewer and less severe than the side effects resulting from alternative treatments and procedures.
