What is cryotherapy?

Cryotherapy is a treatment for early prostate cancer or prostate cancer that has come back after radiotherapy. It is suitable for very small prostate cancers that are contained in the prostate. It cannot be used for cancers near the outer edge of the prostate.

Cryotherapy is not widely available. It is given as part of a clinical trial, so it is only available in some hospitals in the UK.

Having cryotherapy for prostate cancer

Cryotherapy is usually given under a general anaesthetic. This means you will be asleep during the treatment. If you cannot have a general anaesthetic, you will have spinal anaesthetic. This will numb the lower half of your body, so you will not be able to feel anything. You may also be given a sedative to make you feel relaxed and sleepy.

Cryotherapy destroys cancer cells by freezing them with a special gas. A doctor gently passes thin needles through the skin behind the scrotum (perineum). The doctor also uses an ultrasound probe through the back passage (rectum). This helps them get a good view of the prostate and make sure the needles are going into the right place. The gas is then passed through the needles into the area of the prostate where the cancer is.

Cryotherapy can be used to treat the whole prostate when there might be cancer in more than one area, so that all areas of cancer are treated.

But it may also be used for men who only need treatment to one small area of cancer in the prostate. Doctors call this focal therapy. It takes less time than whole-prostate treatment. It may also cause fewer side effects, because less of the healthy tissue is damaged.

Men who have had this treatment for early prostate cancer can have radiotherapy or surgery if the cancer comes back.

Side effects of cryotherapy for prostate cancer

Problems peeing (passing urine)

After cryotherapy, some men may have problems peeing. To prevent this, a tube (catheter) is put into the bladder through the skin in the tummy (abdomen) to drain urine. This is left in for 1 to 2 weeks. Then you have it removed as an outpatient.

Pain

You may have some pain in your lower tummy or back passage (rectum). You will be given painkillers for this.

Swelling and numbness

You may have some swelling, numbness or tingling around the penis and scrotum. This happens 1 to 2 weeks after the cryotherapy. It will slowly improve over a few months.

Possible late effects of cryotherapy for prostate cancer

Erection problems

Cryotherapy for prostate cancer can cause problems getting an erection (called erectile dysfunction or ED). Your age and taking hormonal therapy can also affect this.

ED problems may not happen straight after treatment. They can develop slowly after treatment, over 2 to 5 years. Talk to your cancer doctor about your risk of ED. There are different treatments that can help if you have ED.

Urinary incontinence

This is when urine leaks from the bladder. Most men have some incontinence when their catheter is first removed. This usually improves over a few months after finishing treatment. You will be encouraged to do exercises to strengthen the pelvic floor muscles. You can do these at home. The Bladder and Bowel Community can give you more information on how to do these exercises.

Because cryotherapy is still quite a new treatment, we do not know if there are any other long-term side effects yet.

About our information

  • References

    Below is a sample of the sources used in our prostate cancer information. If you would like more information about the sources we use, please contact us at cancerinformationteam@macmillan.org.uk

    European Association of Urologists. Guidelines on Prostate Cancer. 2016.

    European Society for Medical Oncology. Cancer of the prostate: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. 2015.

    National Institute for Health and Care Excellence (NICE). Prostate cancer overview. Available from: pathways.nice.org.uk/pathways/prostate-cancer (accessed from March 2017 to November 2017).

    National Institute for Health and Care Excellence (NICE). Surveillance report 2016. Prostate cancer: diagnosis and management (2014). NICE guideline CG175. 2016.



  • Reviewers

    This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Senior Medical Editors, Dr Jim Barber, Consultant Clinical Oncologist and Dr Lisa Pickering, Consultant Medical Oncologist.

    Our cancer information has been awarded the PIF TICK. Created by the Patient Information Forum, this quality mark shows we meet PIF’s 10 criteria for trustworthy health information.


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