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It uses frigid temperatures to freeze and destroy abnormal tissues.
This procedure is used to treat precancerous tumors and to control bleeding.
It is often used to remove abnormal tissue from the cervix, the lower part of the uterus that opens into the vagina (birth canal).
How do you do it?
The cold is introduced through a probe, liquid nitrogen circulating through it. The tissue is cooled to less than -20 degrees Celsius to destroy diseased tissue.
Other procedures that control pain or bleeding are cooled to a lesser degree to prevent tissue damage.
What happens during cryosurgery?
Cryosurgery is an outpatient procedure performed while the patient is awake. During the process, the vaginal canal is held open with a speculum so that the cervix can be seen.
The cryogenic probe is inserted into the vagina and placed firmly on the surface of the cervix, covering the abnormal tissue.
Compressed nitrogen gas (temperature approximately -50 degrees Celsius) flows through the instrument, causing the metal to cool enough to freeze and destroy tissue.
Although some mild cramps can occur, cryosurgery is relatively painless and produces minimal scarring.
What happens after cryosurgery?
Repeat the Pap test or do a biopsy to make sure the procedure successfully removed abnormal tissue.
Almost all normal activities can be resumed immediately after surgery. Avoiding sexual intercourse, as well as douching, may be recommended for several weeks.
Sometimes a woman will feel dizzy immediately after the procedure and may pass out. If this happens, lying face down on the exam table will prevent fainting, and this feeling will go away in a few minutes.
Cryosurgery is also used to treat tumors within the body (internal tumors and tumors in the bone). For internal tumors, liquid nitrogen or argon gas is circulated through a hollow instrument called a cryoprobe, placed in contact with cancer.
The doctor uses ultrasound or MRI to guide the cryoprobe and monitor cell freezing, limiting damage to nearby healthy tissue.
Sometimes more than one tube is used to deliver liquid nitrogen to various tumor parts. The probes can be placed into the tumor during surgery or through the skin (percutaneously).
After cryosurgery, frozen tissue thaws and is naturally absorbed by the body (for internal tumors) or dissolves and forms a scab (for external tumors).
What types of cancer can be treated with cryosurgery?
Cryosurgery is used to treat various types of cancer and some precancerous or non-cancerous conditions. In addition to prostate and liver tumors, cryosurgery can be an effective treatment for the following:
- Retinoblastoma (a childhood cancer that affects the retina of the eye). Doctors found that cryosurgery is most effective when the tumor is small and only in certain parts of the retina.
- Early-stage skin cancers (basal cell and squamous cell carcinomas).
- Precancerous skin growths are known as actinic keratosis.
- Precancerous conditions of the cervix are known as cervical intraepithelial neoplasia (abnormal cell changes in the cervix that can develop into cervical cancer).
Cryosurgery is also used to treat some types of low-grade cancerous and non-cancerous tumors of the bone. It can reduce the risk of joint damage compared to more extensive surgery and help decrease the need for amputation.
The treatment is also used to treat AIDS-related Kaposi sarcoma when the skin lesions are small and localized.
Researchers evaluate cryosurgery as a treatment for several cancers, including breast, colon, and kidney. They are also exploring cryotherapy with other cancer treatments, such as hormone therapy, chemotherapy, radiation therapy, or surgery.
In what situations can cryosurgery be used to treat prostate cancer? What are the side effects?
Cryosurgery can be used to treat men who have early-stage prostate cancer that is confined to the prostate gland.
It is less established than standard prostatectomy and various types of radiation therapy. Long-term results are unknown. Because it is effective only in small areas, cryosurgery is not used to treat prostate cancer that has spread outside the gland or to distant body parts.
Some of the advantages of cryosurgery are that the procedure can be repeated and used to treat men who cannot have surgery or radiation therapy due to their age or other medical problems.
Cryosurgery for the prostate gland can cause side effects. These side effects can occur more often in men who have had radiation to the prostate.
Some side effects of this procedure include:
- Obstruction of the flow of urine or causing incontinence (lack of control over the flow of urine); these side effects are often temporary.
- Many men become impotent (loss of sexual function).
- In some cases, surgery has caused injury to the rectum.
In what situations can cryosurgery be used to treat primary liver cancer or liver metastases?
Cryosurgery can be used to treat primary liver cancer that has not spread. It is mainly used if surgery is not possible due to other medical conditions.
The treatment can also be used for cancer that has spread to the liver from another site (such as the colon or rectum). In some cases, chemotherapy and radiation therapy may be given before or after cryosurgery.
Cryosurgery in the liver can cause damage to the bile ducts and major blood vessels, which can lead to hemorrhage (heavy bleeding) or infection.
Does cryosurgery have any complications or side effects?
Cryosurgery has side effects, although they can be less severe than those associated with surgery or radiation therapy.
Cryosurgery for cervical intraepithelial neoplasia has not affected a woman’s fertility, but it can cause cramping, pain, or bleeding.
When used to treat skin cancer (including Kaposi’s sarcoma), cryosurgery can cause scarring and swelling; If the nerves are damaged, it can cause loss of sensation, and, in rare cases, it can cause a loss of pigmentation and hair loss in the treated area.
When used to treat bone tumors, cryosurgery can destroy nearby bone tissue and cause fractures, but these effects may not be seen after initial treatment. They can often be delayed with other therapies.
In rare cases, cryosurgery can interact poorly with certain types of chemotherapy. Although the side effects of cryosurgery may be less serious than those associated with conventional surgery or radiation, more studies are needed to determine the long-term impact.
What are the advantages of cryosurgery?
Cryosurgery offers advantages over other cancer treatment methods. It is less invasive than surgery, involving only a small incision or insertion of the cryoprobe through the skin. Consequently, pain, bleeding, and other complications from surgery are minimized.
Cryosurgery is less expensive than other treatments and requires a shorter recovery time and a shorter hospital stay or no hospitalization. Sometimes cryosurgery can be done using local anesthesia only.
Because doctors can focus cryosurgical treatment in a limited area, they can avoid the destruction of nearby healthy tissue. Treatment can be safely repeated and used with standard therapies such as surgery, chemotherapy, hormone therapy, and radiation.
Cryosurgery may offer an option to treat cancers that are considered inoperable or that do not respond to standard treatments. In addition, it can be used for patients who are not good candidates for conventional surgery due to their age or other medical conditions.
What are the disadvantages of cryosurgery?
The main disadvantage of cryosurgery is the uncertainty surrounding its long-term efficacy.
While cryosurgery can effectively treat tumors that the doctor can see using imaging tests (tests that produce images of areas inside the body), it can miss the microscopic spread of cancer.
Also, because the technique’s effectiveness is still being evaluated, insurance coverage issues can arise.
What does the future hold for cryosurgery?
Additional studies are needed to determine the effectiveness of cryosurgery in controlling cancer and improving survival.
The data from these studies will allow doctors to compare cryosurgery with standard treatment options, such as surgery, chemotherapy, and radiation.
In addition, doctors continue to examine the possibility of using cryosurgery with other treatments.
Where is cryosurgery currently available?
Cryosurgery is widely available in gynecologist offices for the treatment of cervical neoplasms.
Many hospitals and cancer centers nationwide currently have qualified physicians and the technology necessary to perform cryosurgery for other non-cancerous, precancerous, and cancerous conditions.
