What is prostate cancer?
Prostate cancer is a condition in which malignant cells form in the
prostate, one of the male sex glands. These cells form a lump or
mass called a tumor that can grow directly through the prostate
gland and spread cancer cells to surrounding tissue, including
the rectum and bladder. In the UK, nearly 20,000 men are expected
to be diagnosed with prostate cancer and 12,000 men are expected to
die of this disease this year.
How is prostate cancer treated? Several options are available to treat prostate cancer. Because some men have aggressive forms of prostate cancer, while others have slow-growing cancer, patients consult their doctor to determine which treatment is most effective for their particular disease. Ideally, the treatment for prostate cancer should cure the disease, be easily tolerated and cause minimal problems for the patient for the remainder of his life.
Current treatment options include targeted cryosurgery of the
prostate,
radical prostatectomy, external beam radiation and internal radiation
seed implants (brachytherapy). While radical prostatectomy, or
removal of the prostate gland, is the gold standard for treatment of
prostate cancer, many men are considering less-invasive treatment
options that involve faster recovery, less sever side effects and
fewer
complications.
How does targeted cryosurgery treat prostate cancer?
During targeted cryosurgery, a patient is first treated given general
or epidural
anesthesia. A thin catheter that circulates warm fluid is placed in
the urethra to protect it from cold temperatures. Next, six to eight
slender cryoprobes are inserted through a small incision into the
prostate gland. Liquid argon is circulated at the tips of the
cryoprobes,
freezing the entire prostate gland. This begins the cooling process,
during which the cryoprobes freeze tissue symmetrically around the
probe
tip. Tissue that reaches -40C is destroyed. After approximately
10 minutes, the surgeon completes the first freeze cycle and then
administers another treatment to help ensure that all cancer cells
are
killed. The entire procedure lasts about one to two hours.
What does the patient experience during targeted cryosurgery?
During the targeted cryosurgery procedure, the patient may receive
epidural
anaesthesia so he is awake and can talk to the physician, but feels
no pain, otherwise he can opt for general anaesthesia
How does the surgeon monitor the freezing process?
What happens following the targeted cryosurgery procedure? Following the targeted cryosurgery procedure, the patient waits in the recovery room until the anesthesia wears off and then, depending on how he feels, can return home immediately or spend the night at the hospital. The patient goes home with a catheter in place to help with urination the week following treatment. In general, patients can resume a normal lifestyle immediately after the procedure, but strenuous activity should be avoided for a few weeks. Some patients may experience mild soreness for two to three days following TCAP, however, this side effect is common among all surgical prostate cancer treatments. To relieve any soreness or swelling, patients can be managed with ice packs. Long-term side effects of targeted cryosurgery are similar to other therapies and may include impotence, bladder outlet obstruction, pelvic pain, chronic urgency, rectal injury and incontinence. However, targeted cryosurgery incontinence rates are lower than other therapies. Patients should be aware that impotency occurs in 80%-90% of patients who undergo targeted cryosurgery. This is due to the intentional freezing of tissue outside the prostate gland to kill cancer cells that may have already spread beyond the prostate capsule.
Freezing tissue beyond the prostate capsule is an important decision
that helps in curing the cancer and not leaving viable prostate
tissue
that could become malignant. Although this process may damage the
nerves
that allow a man to get an erection, most uroligists advise treating
such tissue because, if not, cancer cells may still remain.
What factors are used to assess the success of a prostate cancer treatment?
After treatment for prostate cancer,the urologist will monitor the
disease
carefully, checking to see if the cancer recurs or spreads further. A
physician uses both a prostate-specific antigen test (PSA) and
prostate
biopsies following treatment to keep the cancer in check. The PSA
test
can detect elevated levels of the PSA protein while a biopsy shows if
cancer
is present in the prostate tissue.
How effective is targeted cryosurgery in the treatmenty of prostate cancer?
In the July issue of the peer-reviewed journal Urology, a comparative
study
of 163 cancer prostate patients treated with two methods of
cryosurgery
reports that 97% of patients treated with targeted cryosurgey were
cancer-free
after six months. In another study presented at the 1998 World
Endurology
Conference, 97% of patients treated with targeted cryosurgery showed
no signs
of cancer at one year. Five-year combined data for traditional
cryosurgery
showed that 82% of patients had negative biopsies.
Who is a candidate for targeted cryosurgery?
The best candidates for cryosurgery are men with Stage T1-T3 disease
and
high Gleason scores and PSA levels. In these patient populations,
cryosurgery
has been found to be safe and effective. Some patients
choose the treatment because targeted cryosurgery can be repeated if
the cancer
recurs. Others turn to targeted cryosurgery for treatment if
radiation therapy
has failed.
How many prostate cancer patients have been treated with cryosurgery? Several thousand men have received cryosurgery to treat prostate
cancer. This
therapy, first introduced in the 1960s, has seen dramatic
improvements during
the past five years with the use of temperature monitoring,
argon-based
cryogen and ultrasound guidance techniques. Temperature monitoring
and ultrasound
visualization allow the surgeon to precisely freeze the prostate
gland
while sparing other critical areas of surrounding tissue. The use of
argon-based
cryogen provides surgeons with better control and accuracy, ensuring
that a freezing level of -40C is achieved and confined to a specific
area.
How can patients learn of physicians performing targeted cryosurgery? Simply click here for the contact information that you need.
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Targeted cryosurgery, with equipment manufactured by Endocare, Inc.,
is the use of extreme cold to destroy tissue in combination with
ultrasound and temperature monitoring to accurately and precisely
destroy cancer
cells in and around the prostate gland. When extreme cold is
introduced
into the prostate gland, all of the prostate tissue is destroyed,
including cancerous cells. Physicians have found that targeted
cryosurgery
is most effective for patients with Stage T1 through T3 prostate
cancer.
Unlike other surgical procedures, targeted cryosurgery can be
repeated
if prostate cancer recurs.
The CRYOcare targeted cryosurgery control unit continuously monitors
the cryoprobe temperature and surrounding tissue temperatures, and
surgeons use
ultrasound imaging throughout the procedure, enabling clear
visualization
of the freezing process. Visualization allows the surgeon to be
confident that the entire prostate is destroyed for a successful
outcome,
while ensuring that surrounding tissues are unaffected. Additionally,
the
use of argon-based cryogen during the targeted cryosurgery procedure
enables the physician to begin or stop freezing instantaneously and
to
achieve faster and colder freezing.
