Putting the Freeze on Cancer With Cryotherapy
During the summer of 2022 I learned my friend Les had been diagnosed with prostate cancer. Eagle-eyed readers of this website may remember I wrote an article titled "A Friend Phones With Bad News" where we left Les considering either brachytherapy or cryotherapy to treat his condition.
To refresh your memory, his prostate cancer was discovered relatively early. He had been on active surveillance, so when the bad news came, the cancer had not spread outside the prostate. His PSA stood at 5, and his combined Gleason was 7.
To cut to the chase, Les decided to go with focal cryotherapy, so a brief look at this not-so-well-known treatment seems in order.
What is cryotherapy?
There are two types of cryotherapy: whole prostate and focal. As the names suggest, the former targets the whole prostate and the latter just the cancerous area. Both take place under general anesthesia. Cryotherapy is generally offered if the cancer has not spread outside the prostate. This treatment tends to be less invasive than others, such as surgery.1
Cryotherapy involves thin needles being put through the perineum, the area between the anus and scrotum. Freezing gases can then be passed through to freeze and kill the cancer cells. A warming catheter is also used to protect the urethra (the tube that carries urine out of the body) from the cold temperatures, which can drop to nearly -40°C.1
Les had two cryotherapy treatments, one immediately following the first.
What others shared about the procedure
A few days before his treatment began, Les sent me a note asking for a little help. He wanted to know if any of the people who read my articles had undergone focal cryotherapy and what their experience had been a few days after the procedure.
I posted his question on various forums. Typically, when you ask about prostate cancer online you get a deluge of responses. Not this time, but fortunately I got a couple useful replies. They mentioned mild soreness or some fatigue after the procedure, but also good results with their followup PSA levels (they had dropped).
So relatively comforting thoughts from those who had frontline experience of the treatment.
My friend's experience
On the day of his procedure, Les was admitted for surgery at 10:30 a.m., had the 90-minute operation, and was released from the hospital later that afternoon. He had a catheter inserted that allowed him to pee into a bag.
If the bladder is not working correctly, bacteria can find its way back into the kidneys and cause an infection.2 Les knew he was going to be told to drink a great deal of water and took incontinence pads to the hospital, which he continued to use for several days after the event.
The catheter was removed eight days later, but not before he had to endure a great deal of pain.
Pain after the procedure
Initially, everything was fine. He had the op on a Wednesday, but by Friday he was suffering cripplingly painful bladder spasms. I asked whether this was mentioned as a possibility before he was sent home.
He replied: The Consultant may have mentioned it after the op - I was still a bit spaced out due to the anaesthetic - but the discharge team didn’t mention it.
Unfortunately, he was unable to get any meds until the Monday afternoon, leaving him in severe discomfort over the weekend. Once taking a drug (Mirabegron or Betmiga) to relax his bladder muscles, he felt better within a few hours.
Latterly his consultant told him the bladder spasms were caused by the catheter and are not a common side effect.
Still happy with his decision
Looking back, and despite the pain he had to endure, Les is happy with the treatment he chose but suggests having the bladder-relaxing pills on hand should the spasms start.
He has had a post-op MRI scan, and his consultant says his prognosis is good. He will now have six monthly tests and check-ups.
Given there is not a ton of long-term data on cryotherapy, I’d like to hear from others. For those lucky enough to catch prostate cancer early, it may be a treatment whose time has come.
Have you had cryotherapy? If so, how did it go, and what side effects did you experience? Let us know in the comments below.
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