Dan Theodorescu MD PhD

University of Virginia

Charlottesville, VA

  

 

 

Last update:

07/15/2001

 

Cryotherapy

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 Cryosurgery is a surgical technique that involves destruction of malignant tissue by freezing of the tumor and a surrounding rim of healthy tissue. The technique can be applied to both Prostate Cancer and Kidney Cancer. In the case of kidney cancer, the ice ball formation is monitored visually and using ultrasound during a laparoscopic procedure.

Cryosurgery for prostate cancer is less well established than standard prostatectomy and long-term outcomes are less well known. Serious toxic effects include bladder outlet injury, urinary incontinence, sexual impotence, and rectal injury with fistula formation. However, recent technical advances have produced instruments which allow a much more refined and conformal freezing process which may impact favorable on both disease control and side effects.

Recently the Health Care Financing Organization (HCFA) has approved the use of prostate cryotherapy for the primary treatment of localized prostate cancer and also for the treatment of prostate cancer which is recurrent after radiation therapy and meeting the following conditions; Stage T2B or below, Gleason score <9, and PSA <8 ng/ml.

Effective July 1, 2001, Medicare will reimburse SeedNet cryosurgical salvage therapy for recurrent prostate cancer following radiation failure. This follows a national coverage decision approving cryosurgical salvage therapy for recurrent prostate cancer issued by CMS (formerly HCFA) on December 5, 2000.

At the University of Virginia we have Galil Medical's SeedNetTM system, a minimally invasive treatment for clinically localized prostate cancer including both organ confined and locally advanced disease. This IceSeedsTM technology combines the curative potential of cryotherapy with the accuracy and simplicity of brachytherapy.

The SeedNetTM system uses an array of ultra-thin 17-gauge needles introduced through a template (as in brachytherapy) for precise insertion. Transrectal ultrasound (TRUS) is used to monitor the accurate sculpting of the frozen zone to the exact size and shape of the target tissue. This procedure assures evenly distributed cancer killing temperatures and provides safe and effective treatment.

 

 

 

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