Cryotherapy

Cryotherapy uses extreme cold to destroy cancer cells. It is also called cryosurgery or cryoablation. During cryotherapy treatment the doctor freezes the cancer cells to kill them. Cryotherapy is called a local treatment, which means that it only treats the area where you have treatment. It doesn’t treat any cancer cells in other parts of the body. After the treatment the body’s immune system gets rid of the dead tissue over a few weeks.

Doctors use cryotherapy to treat a number of different types of cancer and precancerous conditions. Cryotherapy has been a treatment for abnormal cells on the cervix and for basal cell skin cancer for some time. It works well for these conditions.

Research has shown that cryotherapy is safe to use for some other types of cancer and kills the cancer cells in the treatment area. But we need more information about the long term outlook to find out if it is as good as other treatments at stopping the cancer coming back.

Even if cryotherapy isn’t a standard treatment for your type of cancer you may have it as part of a clinical trial.

You have cryotherapy in hospital. For skin cancer or cervical changes you usually have the cryotherapy in the outpatient department. For internal cancers you may have treatment as an outpatient or in the operating theatre.

For skin cancer, a doctor sprays liquid nitrogen on to the area of cancer. Or they put it directly on to the area with a cotton swab. The liquid freezes the area. After treatment the liquid nitrogen dissolves and the area thaws. A scab forms in the area. Over the next month or so the scab falls off along with any dead cancer cells.

To treat precancerous changes on the cervix the doctor or nurse specialist puts a speculum into the vagina so they can see the cervix. They then put special instruments called cryo probes into the vagina so that they firmly cover the abnormal areas of cervical tissue. The liquid nitrogen in the cryoprobes then freezes the cells. The doctor or nurse may repeat this a couple of times. This treatment usually takes less than half an hour. You can find information about cryotherapy for cervical cancer and the possible side effects in the cervical changes section of CancerHelp UK.

For cancers inside the body the doctor puts a small probe next to or inside the tumour. This probe is called a cryoprobe. The cryoprobe is attached to a supply of liquid nitrogen controlled by the doctor. Your doctor or specialist nurse will talk to you beforehand about how you will have treatment and exactly what it involves for you.

Some cancers need to be frozen and thawed a number of times. Depending on the treatment area, it can take from a few minutes to a couple of hours.

To help the doctor position the cryoprobe you may have either an ultrasound scan or CT scan.

The position of the cancer in the body affects how the doctor puts the cryoprobe into the area. This may be

• Through the skin (percutaneously)
• Through a scope

Cryotherapy through the skin (percutaneously)

If you are having the cryoprobe put in through your skin you may have a general or a local anaesthetic. For example, men having cryotherapy for prostate cancer have the probes put into the skin of the perineum (the area of skin between your back passage and your testicles). For cryotherapy to the liver the doctor puts the probe in through the skin of the abdomen.

And for kidney cancer the doctor uses a thin, flexible tube called a laparoscope to help them position the cryoprobe. The laparoscope has a light and a tiny camera at the tip. The doctor makes a small cut in the skin on the side of the abdomen to put the laparoscope through. They can then position the cryoprobe.

Cryotherapy through a scope

The other way doctors can reach tumours inside the body is by using a scope without going through the skin. For example for lung cancer the doctor may use a bronchoscopy to position the probe. Or for cancers in the food pipe you may have an endoscopy.

Before you agree to treatment your doctor will talk to you about the possible risks. The risks and possible side effects depend on the type of cancer you have and its position in the body. An advantage of cryotherapy is that it is not as invasive as having an operation. People usually recover within a few days after the treatment with very few side effects.

The side effects it can cause include the following.

• Pain and discomfort in the treatment area – your doctor will prescribe painkillers to help to control this and it should settle within a few days
• Bleeding from the treatment area – your nurse will check your blood pressure, pulse and wound on your skin (if you have one) regularly  
• Damage by freezing normal tissue close to the treatment  area – your doctor will try to avoid this as much as they can

People having cryotherapy for a lung tumour may have a build up of fluid around the lung and damage to the lung tissue.

Men having cryotherapy for prostate cancer have a small risk of nerve damage, which can cause difficulty getting an erection (impotence).

The following cancers may be treated with cryotherapy. You can find more information by using the links below

• Pre cancerous changes on the cervix
• Skin cancer (basal cell)
• Kidney cancer
• Liver cancer
• Lung cancer – to treat a blocked airway 
• Penile cancer
• Prostate cancer
• Retinoblastoma – a type of eye cancer
• Secondary liver cancer – research is looking into cryotherapy for a number of different cancers that spread to the liver including bowel and breast cancer 
• Barrett’s oesophagus