Find out how you have cryotherapy and how you’ll feel after treatment.
What it is
Cryotherapy uses extreme cold to destroy cancer cells. It is also called cryosurgery or cryoablation.
Cryotherapy is a local treatment. It only treats the prostate and not other areas in the body.
Who has cryotherapy
The National Institute for Health and Care Excellence (NICE) guidelines recommend using cryotherapy for prostate cancer only as part of clinical trials. Specialist centres doing their own research can also use it.
Your doctor might recommend cryotherapy if:
- your cancer is contained inside your prostate (localised prostate cancer)
- your cancer is just breaking through the covering of the prostate (locally advanced prostate cancer)
- your cancer has come back after treatment with radiotherapy or brachytherapy
Before your treatment
Check your appointment letter for any specific ways to prepare for your cryotherapy.
You have this treatment under local anaesthetic or general anaesthetic. If you have a local anaesthetic you usually have some sedative medicine to help you feel relaxed and sleepy.
You usually need to stop eating for 6 hours before the procedure but can still drink fluids. You stop drinking 4 hours beforehand.
Your doctor will ask you to sign a consent form to say that you agree to have the treatment. This is a good time to make sure you ask all the questions that you have.
You need to make sure your bowel is empty before your cryotherapy. You might have an enema to do this. Your doctor or nurse will gently put some fluid into your back passage to empty your bowels. Or you drink a laxative drink.
You change into a hospital gown before the procedure.
During the cryotherapy
You have cryotherapy in the hospital. You have it in the operating theatre if you have it under general anaesthetic. You have it in a procedure room if you have it under local anaesthetic.
A surgeon puts a tube called a warming catheter into the urethra. The urethra is the tube that takes urine from the bladder to the tip of the penis. The warming tube protects the urethra from damage.
The surgeon then puts between 12 and 15 special cryotherapy needles through the skin of the perineum (the area of skin behind the testicles). They usually use a trans rectal ultrasound scan to make sure the needles are in the right place. This gives a clear image of the prostate on a screen.
A machine then sends gas through the needles to freeze the prostate area.
The surgeon uses temperature needles to monitor the temperature of other structures in the area such as the back passage (rectum). This makes sure these areas don’t get too cold.
The procedure usually takes between 1 and 2 hours.
The surgeon removes all the needles and any temperature probes once it is finished.
When you are fully awake you go back to your ward or department to rest. The nurses check on you to make sure your pain is well controlled. They also check the amount of bleeding.
After cryotherapy treatment
You have a tube (catheter) to drain urine from your bladder. You might have this for a couple of days or it might be for 1 to 2 weeks.
Your surgeon tells you before your treatment how long you will need the catheter for.
You can usually get up and about a few hours after the procedure. But avoid doing anything strenuous while the catheter is still in.
You can eat and drink when you are ready.
You will have a dressing on the perineum area to keep it clean and dry.
You can take painkillers as you need them. You will have a course of antibiotic tablets to help prevent any infection.
You won’t be able to drive home after a general anaesthetic, as it takes some time to wear off.
You might be able to go home that day or you might need an overnight stay. Your doctor will let you know what to expect.
After the treatment, the body’s immune system clears away the damaged prostate tissue over a few weeks.
Your doctor explains all the potential side effects to you before you sign the consent form.
All treatment has risks and benefits and it’s important you have all the facts before your cryotherapy treatment. You might have some of these side effects:
- blood in the urine
- bleeding from the cryotherapy area
Let your doctor or nurse know if you have any side effects from your cryotherapy. There is a lot they can do to help.
Long term side effects
Possible long term side effects include
- erection problems
- loss of control of urine (urinary incontinence)
- problems passing urine due to blockage of the urethra (the tube from the bladder to the tip of the penis)
- a hole between the bladder and the back passage – this is rare
You have regular check ups after your cryotherapy. Let your doctor know about any side effects that you have.
The FORECAST trial is one study looking at scans and treatment for men with prostate cancer. Part of this includes seeing if they can safely treat just the area of cancer with cryotherapy, rather than the whole prostate gland.
Men can enter this trial if their prostate cancer has come back after some types of treatment, or if they have advanced cancer.