cryosurgery (cryoablation)

Introduction

A technique for freezing & killing abnormal cells. Also see cryotherapy.

Indications

• liver cancer or metastases to the liver
  • colorectal carcinoma
• prostate cancer confined to the prostate gland
• cervical intraepithelial neoplasia
• tumors of the bone (malignant & benign)
• skin cancer (see cryotherapy)
  • actinic keratosis
  • basal cell
  • squamous cell carcinomas
  • Kaposi's sarcoma
• retinoblastoma
• incidental renal neoplasm
  • patients who are not good surgical candidates
• fibroadenomas of the breast
• small, low-risk, early-stage breast cancers in older patients

Advantages

• less invasive than surgery
• sometimes cryosurgery can be done using only local anesthesia
• may have fewer side effects
  • pain, bleeding, & other complications of surgery are minimized
  • bone cancer: may reduce the risk of joint damage & reduce need for amputation
  • prostate cncer may reduce incidence of impotence
• less expensive
• requires shorter recovery times
• procedure can be repeated
• may be used along with standard treatments such as surgery, chemotherapy, hormone therapy, & radiation
• can be in patients who cannot have surgery or radiation therapy because of their age or other medical problems
• may offer an option for treating cancers that are considered inoperable or that do not respond to standard treatments

Disadvantages

• long-term effectiveness is not known
• insurance coverage issues may arise
• does NOT treat metastases

Adverse effects

• prostate cancer (treatment of)
  • adverse effects may occur more often in men who have had radiation to the prostate
  • obstructive uropathy
  • urinary incontinence
  • impotence
  • injury to the rectum.
• liver cancer (treatment of)
  • injury to the bile ducts &/or major blood vessels, which can lead to hemorrhage or infection
• cervical intraepithelial neoplasia (treatment of)
  • has not been shown to affect a woman's fertility
  • cramping, pain, or bleeding
• skin cancer (treatment of)
  • scarring
  • edema
  • if nerves are damaged, loss of sensation may occur
  • loss of pigmentation
  • loss of hair in the treated area
• tumors of the bone (treatment of)
  • destruction of nearby bone tissue
  • fractures
  • interaction with certain types of chemotherapy
• renal cancer (treatment of)
  • urosepsis
  • pulmonary embolism
  • hematoma

Procedure

• use of extreme cold produced by liquid nitrogen (or argon gas) to destroy abnormal tissue
• for external tumors, liquid nitrogen is applied directly to the cancer cells with a cotton swab or spraying device
• for internal tumors, liquid nitrogen or argon gas is circulated through a hollow instrument called a cryoprobe, which is placed in contact with the tumor
• cryoprobe may be used during surgical or laparoscopic procedure percutaneous procedure used for incidental renal neoplasms
• ultrasound or MRI to guide the cryoprobe & monitor the freezing of the cells, thus limiting damage to nearby healthy tissue.
• a ball of ice crystals forms around the probe, freezing nearby cells
• after cryosurgery, the frozen tissue thaws & is either absorbed by the body (internal tumors), or it dissolves & forms a scab (external tumors)

Notes

Availability:

• widely available in gynecologists' offices
• a limited number of hospitals & cancer centers

More general terms

• surgery

More specific terms

• cryoablation for pulmonary tumor
• cryosurgery, anus
• cryosurgery, benign rectal neoplasm
• cryosurgery, endometrium
• cryosurgery, fibroadenoma
• cryosurgery, kidney
• cryosurgery, liver
• cryosurgery, penis
• cryosurgery, prostate
• cryosurgery, rectal cancer
• ocular cryosurgery,

Additional terms

• cryotherapy; cutaneous cryotherapy