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Cryosurgery for Prostate Cancer

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Posted 1/23/2017 1:59 AM (GMT 0)
As I wait to see the RO for the first time on Thursday just trying to read as much as possible about many different treatments. Does anybody have any experience with Cryosurgery for Prostate Cancer??

Thanks
Jay
Posted 1/23/2017 2:46 AM (GMT 0)
Jay: If you toss Cryo into the search bar, I am sure some of the folks on this forum will show up. There is one particular gentlemen that has a great success story with Cryo. Sorry, I don't remember his name but hope he will chime in.
Posted 1/23/2017 3:51 AM (GMT 0)
Jay-

You are not a good candidate for focal cryo because you had cancer top and bottom, in the center and at the edge. And your TZ tumor is too close to the urethra - it could cause great damage if ablated. Whole gland cryo has horrible SEs and poor cancer control compared to radiation or surgery.
Posted 1/23/2017 4:12 AM (GMT 0)
Thanks Tall Allen..
Posted 1/23/2017 10:42 AM (GMT 0)
My urologist explained it the same as TA did. He said it would guarantee three things in my case; complete ED, incontinence, and failure to control the cancer. He presented cryo to me as the worst treatment option.

Compared to radiation, surgery, and AS very few are treated with cryo.
Posted 1/23/2017 11:42 AM (GMT 0)
My father-in-law was frightened of surgery and radiation so he got the whole gland frozen many years ago. While it did get rid of the cancer, he has had to go in and get a TURP done and been catheterized due to the buildup of scar tissue.

Personally, I would pass on that mess, thanks! smile
Posted 1/23/2017 1:55 PM (GMT 0)
Jay - what is your reason for deselecting RP or RT? CS (Cryosurgery) has a large percentage of complications in reports! One advantage is that it is cheaper if cost is an issue. In Europe CS is more common as salvage treatment when RT have failed than as primary treatment, I think.
Posted 1/23/2017 3:08 PM (GMT 0)
Hi Jay, you caught me on a day where I saw your question as I was posting an update to my present situation. I will be happy to share some of my thoughts about cryo.

I had cryosurgery in April 2006, which was not curative. With a Gleason 4+3, cryo was somewhat of a risk that I offset partially, knowing that my cancer engulfed only part of the left side of my prostate and I was being treated by one of the top 5 cryosurgeons in the nation (Ralph Miller, Allegheny General Hospital, Pittsburgh).

I had ten good years of absolutely NO problems, except the fact that I knew within a year following surgery that my cancer was likely not contained in the prostate. Micromets resulted in a slowly growing psa from a low of 0.2 in late 2006 to 7.9 by my tenth anniversary. No PCa was ever confirmed in the prostate, as I have had numerous biopsies during this period. Up to my tenth anniversary, the cancer was too small or just still circulating as all of several bone scans and CT scans were clean.

In September of this year, just several months following my tenth anniverasy, my psa suddenly showed a rapid increase to 13.4. Dr miller and I agreed that once it hit 10, I would go on Lupron. Dr Miller also ordered a new bone scan and a CT scan.....the bone scan revealed two small "spots" on my bones...one on a rib and one on a shoulder blade. The CT scan revealed a nodule on my left lung that was noted as 'malignant appearing, could be prostate cancer mets but cannot rule out primary lung cancer. Turns out, after lung surgery that it was lung cancer. I posted an update to this today, which you may read.

**************************

I cannot tell you which procedure you should use. If I had to do it again, I probably would have had the gland surgically removed. With cryo, you will STILL have a prostate gland and even if subsequent biopsies show no cancer, there is still a chance that some prostate tissue may still be alive and producing psa. The failure guideline for cryo is nadir +2. But if no cancer is evidenced in the prostate, no insurance will cover
salvage treatment, in the form of a second cryo or radiation.

I am not sorry I tried cryo. I just think that surgery may be better, particularly because surgery can reveal the need almost immediately, if further salvage treatment may be necessary.

One last thing, I agree with Tall Allen, that if the cancer is near the urethra, my layman instincts say that you may want to avoid cryo. However, I would also have reservations about radiation, too. If you decide that radiation may be the treatment you want, I would grill the RO on this so that you are satisfied that the risk is not significant.


I wish you the best of luck, Jay!!
Posted 1/23/2017 5:47 PM (GMT 0)

JNF said...
My urologist explained it the same as TA did. He said it would guarantee three things in my case; complete ED, incontinence, and failure to control the cancer. He presented cryo to me as the worst treatment option.

Compared to radiation, surgery, and AS very few are treated with cryo.

Sounds as if your urologist was referring to whole gland cryoablation, not focal cryoablation. Tall Allen was careful to make the distinction. And that distinction is important. I have had focal cryo, and I had none of the side effects or consequences that your urologist described.

That said, I do not advocate focal cryoablation -- or any other specific treatment for that matter.

It can take years to know for certain if you made the right choice, as in did the treatment control the cancer. Wrong choices can manifest themselves relatively soon. Right choices do not.
Posted 1/23/2017 9:38 PM (GMT 0)
Boon check my signature. I was loaded and neede whole gland and then some.
Posted 1/23/2017 9:48 PM (GMT 0)

JNF said...
Boon check my signature. I was loaded and neede whole gland and then some.

I did check your signature. I'm sorry if my reply didn't make it clear enough that I was referring solely to what your urologist said about cryo, and not to the specifics of your case.

The comments he made about cryo are long-standing common complaints about whole gland cryo, especially permanent ED and incontinence. They are quite irrespective of your case. Focal cryo avoids those side effects, certainly in my situation, although I did not have focal cryo alone. Best, B

Post Edited (Boon1) : 1/23/2017 2:53:57 PM (GMT-7)

Posted 1/23/2017 9:56 PM (GMT 0)
I had whole gland cryoablation in January 2011.
The first 2-3 months afterward were quite uncomfortable with pain in member and urge to urinate.

At this point I have irritable bladder although I drink 100 ounces of liquid a day due to kidney stone history. Get up to pee twice a night.
No permanent ED. PSA ok so far.
Posted 1/23/2017 10:06 PM (GMT 0)

RobertC said...
I had whole gland cryoablation in January 2011.
The first 2-3 months afterward were quite uncomfortable with pain in member and urge to urinate.

At this point I have irritable bladder although I drink 100 ounces of liquid a day due to kidney stone history. Get up to pee twice a night.
No permanent ED. PSA ok so far.

Robert, I see from your profile that you took Metformin. How long did you take it, and do you think it helped?

I am have just started taking it. Thanks. B
Posted 1/23/2017 11:26 PM (GMT 0)
Boon I think you may be confused about what I reported. In my case I would clearly need the whole gland ablated. My uro said specifically for me that cryo would be the worst treatment option.
Posted 1/24/2017 1:01 AM (GMT 0)

JNF said...
Boon I think you may be confused about what I reported. In my case I would clearly need the whole gland ablated. My uro said specifically for me that cryo would be the worst treatment option.

JNF, I'm afraid we're just talking past each other. I get it that he was talking about cryo in the context of your case, of your treatment options.

But the criticisms he made of cryo are exactly the same criticisms many by many others about cryo in general. And, important: they're talking about whole gland cryo, not focal cryo. A lot of people -- not you -- conflate the two. Anyway, the best of luck to you, and thanks for the exchange. B.
Posted 1/24/2017 1:39 AM (GMT 0)
I don't know if metformin helped with pca.
It supposed to help weight control; might help with longevity.
I don't currently take it.
Posted 1/24/2017 12:54 PM (GMT 0)
I look at cryotherapy, or cryosurgery, as one of those niche treatments that is valid in certain, special cases. When it burst on the scene 25 years ago, it was seen as the next great thing. Yes, it's been around at least that long.

I view it as a cautionary tale, and a very personal one for me. My dad was in one of the early cohorts to have it for PC. Now, I do not know what his gleason score was, or even what his PSA was at the time of discovery. What I do know is that he had cryosurgery around 1992 or 1993 at Cleveland Clinic. It's my recollection that over the next 10 years, he had to have a TURP done, he had a second cryo treatment, HT that ultimately failed, RT that failed, and spinal mets that killed him.

And, yes, I'm talking about whole-gland cryo. Maybe it's better now. What I know for sure is that it's far from the magic wand that we might want it to be.
Posted 1/24/2017 1:01 PM (GMT 0)

halbert said...
I look at cryotherapy, or cryosurgery, as one of those niche treatments that is valid in certain, special cases. When it burst on the scene 25 years ago, it was seen as the next great thing. Yes, it's been around at least that long....And, yes, I'm talking about whole-gland cryo. Maybe it's better now. What I know for sure is that it's far from the magic wand that we might want it to be.

+1
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