Freezing Prostate Cancer Does a Man's Body Good

SAN DIEGO -- The so-called "male lumpectomy" -- a minimally invasive interventional radiology treatment for prostate cancer -- is as effective as surgery in destroying diseased tumors and can be considered a first-line treatment for patients of all risk levels and particularly those who have failed radiation, according to studies released at the Society of Interventional Radiology's 34th Annual Scientific Meeting. Additionally, the use of 3-D transperineal mapping biopsy for determining the extent of prostate cancer -- when compared with the commonly used transrectal ultrasound (TRUS) biopsy -- heavily impacted how patients' disease was managed in 70 percent of the cases.

"Our data show that focal cryoablation is as good for prostate cancer control as any other treatment -- including surgery, radiation and hormone therapy -- but it is less invasive and traumatic for patients, preserves sexual and urinary function and has no major complications. Interventional radiologists tailor treatment to each patient's disease. Instead of removing the entire prostate, or freezing the entire prostate or using radiation on the entire prostate, interventional radiologists can find out where the cancer is and just destroy the cancer," said study author Gary M. Onik, M.D., interventional radiologist and director of the Center for Safer Prostate Cancer Therapy in Orlando, Fla. "We've reached a tipping point: treating only the tumor instead of the whole prostate gland is a major and profound departure from the current thinking about prostate cancer," added Onik. With cryoablation, interventional radiologists insert a probe through the skin, using imaging to guide the needle to the tumor; the probe then circulates extremely cold gas to freeze and destroy the cancerous tissue. This minimally invasive treatment targets only the cancer itself, sparing healthy tissue in and around the prostate gland rather than destroying it, as traditional approaches do, noted the professor at the University of Central Florida. "You cango home on the same day of the procedure, and you can repeat the treatment, if needed, in later years," said Onik. Additionally, Onik presented results of a 3- D biopsy method that provides superior information on the extent and grade of prostate cancer as opposed to the current standard TRUS biopsy.

Calling focal cryoablation a "male lumpectomy" reflects the origins of this approach in the breast-sparing surgery that replaced radical mastectomy as the preferred treatment for breast cancer, said Onik. Unlike breast lumpectomy, a surgical lumpectomy for prostate cancer is not technically feasible; so to treat just a portion of the prostate, minimally invasive cryoablation is needed. Cryoablation (or cryo or cryotherapy) spares as much as possible of the prostate gland and its neurovascular bundles, limiting the side effects of bladder control problems (incontinence) and erectile dysfunction (impotence) that result from more radical prostate cancer treatments. It also represents an advantage over "watchful waiting," because all treatment options are preserved. "Any risks are fewer and lesser in intensity than surgery; so if you have the equivalent chance of cancer being cured with far less chance of having any complications, why wouldn't you choose it?" asked Onik.