cryoablation

I am having cryoablation surgery tomorrow. I'm in a clinical trial that includes hormone therapy and Keytruda. Has anyone had cryoablation surgery? If so, what should I expect?

I believe Johns Hopkins is running a trial that couples cryoablation and immunotherapy. Cryoablation, whether whole or focal, apparently enhances the beneficial effects of immunotherapy. I cannot point you to any conclusive study corroborating that, however. But I have read that anecdotal clinical reports and animal experiments have confirmed an induction of systemic antitumor immune response by tumor cryoablation.

I think it's whole gland cryoablation in a man where a few metastases have been detected already. The theory is that it will dump a lot of cancer cell antigens into the serum that T-cells may learn to recognize and search-and-destroy the distant metastases. The Keytruda keeps the immune effect going. I think this is the clinical trial:

Pembrolizumab and Cryosurgery in Treating Patients With Newly Diagnosed, Oligo-metastatic Prostate Cancer

In theory, it should work similar to SBRT combined with immunotherapy, which is what Nomar Lupron had done. There's an ongoing trial at the University of Virginia of that:

The synergy of combining radiation and immunotherapy in the treatment of prostate cancer

mclovin - Best of luck with this therapy. Cryoablation has improved a lot recently. Here is a recent study that talks about the side effects. Almost all men (91%) regained continence within a year, but only 17% remained potent. Very serious side effects were rare: fistulas in 1.3% and urinary retention requiring surgical intervention in 3.3%.

Primary Cryotherapy for High-Grade Clinically Localized Prostate Cancer: Oncologic and Functional Outcomes from the COLD Registry

Please let us know how it turns out.

As a total newbie to this forum, I'm impressed with the responses as they are spot on. In my first post, I didn't have time to describe my cancer. I have stage 4 metastatic prostate cancer with 5 lesions in my bones throughout my upper body. I had two stage 9 Gleason scores from my biopsy. I also found out that I have the BRCA2 gene mutation (that's the mutation that Angelina Jolie was diagnosed with). I am now trying to determine if the mutation is germline (flowing down to my family bloodline) or somatic (unique to me).

After doing my due diligence, I signed up for a clinical trial at Hopkins that include hormone treatments (Firmagon), Keytruda and Cryoablation. If you have had chemotherapy in the past, you would not be eligible. The trial only has 10 individuals and I have tolerated the hormones and Keytruda with minor side effects. Yesterday I had my surgery and all went well. Recovery over the first 24 hours was rougher than the doc described. I was in a lot of pain and nauseous. Now I am feeling much better and the worst of it is lugging around a catheter bag for two weeks. Very doable.

As an aside, I was told that Keytruda works especially well with the BRCA2 mutation. Quite serendipitous! Also in 30-40% of mice treated with Keytruda go into remission. Two out of 10 in the trial are in remission and all of the others but one are doing very well.

So I feel like I have gone from a poor prognosis to one of great hope. Thanks for the well wishes!

Thanks Allen. I have heard that olaparib has been a successful treatment for BRCA2 cancers. I suppose that would be my plan B if this trial does not produce positive results.

Robert, thanks for your reply. I'm hoping I don't have to urinate 2 times per night, but if that is the worst of it, I can deal with that.