Cryotherapy and cryoablation as an alternative to conventional cancer treatments
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Cryoablation (cryotherapy) is a method of ultra-fast freezing of tissue in order to destroy it. The technique is used in oncology, most commonly for kidney cancer, prostate cancer, and metastatic liver cancer. It can also be used for other types of cancer as a palliative procedure that partially destroys the tumor and relieves symptoms. To this end, cryoablation is used for the treatment of pancreatic cancer, lung cancer, and soft tissue and bone malignant tumors.
Content
- How is cryoablation performed?
- Cryoablation for prostate cancer
- Ablation for kidney cancer
- Treatment of colorectal cancer metastases in the liver
- Percutaneous bone cryoablation
- Innovations in cryotherapy
- Where can I undergo cryoablation and find out the cost of treatment?
How is cryoablation performed?
During the procedure, critically low temperatures are applied to the tissue to be destroyed. The cryoablation procedure is minimally invasive and is performed under general anesthesia. The doctor inserts a probe (a needle) into the tissue. Necrosis forms around this area due to freezing, disruption of blood supply, and cell death. Temperatures of minus 190 to minus 195 degrees are used for cryoablation. Freezing is done with argon and thawing is done with helium. Doctors can perform two cycles of freezing and thawing during a single procedure.
The benefits of this method are as follows:
- Cryoablation can destroy a tumor of any size because several probes can be inserted into it if necessary.
- An important benefit of cryoablation compared to other methods is the incomplete destruction of cells. After their death, their fragments enter the bloodstream. Antigens (tumor proteins) stimulate the immune system, enhancing the anti-tumor immune response.
- The cryoablation technique is also characterized by high health safety. It can be used close to important anatomical structures.
- Cryotherapy is used in patients from a high surgical risk group (when poor health is a contraindication to surgery).
Radiation diagnostic methods are used to control cryoablation. CT scans are mainly used, ultrasound scans less often, and in the long term it is possible to evaluate the effectiveness of the medical procedure using MRI.
Cryoablation for prostate cancer
For patients with early-stage prostate cancer, one of the radical treatment options is cryoablation. This method is preferred when there are contraindications to a surgical intervention. It is characterized by higher safety, especially when using more modern devices. The best hospitals in Germany use state-of-the-art equipment that allows forming a zone of necrosis quite precisely at low temperatures. As a result, the risk of postoperative erectile dysfunction in patients can be reduced to 50% and the risk of urinary incontinence to 1.6%. After the creation of new devices, many complications that used to occur have become a thing of the past, such as urethral strictures, cold injuries of the rectum are no longer encountered, and the risk of fistula formation does not exceed 0.2%.
The method of focal cryoablation, in which only the focus of the tumor is destroyed rather than the entire prostate, is currently being studied. It provides preservation of erection with a probability of 100%. Hemiablation, the destruction of only half of the prostate gland where the tumor is located, is also possible as a sparing version of the medical procedure for prostate cancer treatment. So far, these approaches are not standard, although studies have shown that the frequency of cancer recurrence over 10 years is only 5%.
When prostate cancer recurs after the procedure of radiation therapy, salvage cryoablation may be performed instead of conventional surgery. It provides a five-year survival rate of 60%, although the recurrence rate remains high due to the spread of cancer cells to the lymph nodes (micrometastasis) at the time of cryoablation.
Ablation for kidney cancer
Kidney cancer is the second most common indication for cryoablation after prostate cancer. The medical procedure is an alternative to partial kidney removal to treat early-stage cancer. Cryodestruction is performed for patients with poor health who are contraindicated for surgery. It can also be performed in healthy patients who refuse surgery.
People with poor health are a significant category of kidney cancer patients. The average age of diagnosis is 65 years. Half of the people have concomitant chronic pathology, which can be a limitation for surgery.
For localized kidney cancer, a safer medical procedure called cryoablation may be an alternative for these patients. It has a 4.5% risk of complications compared to 20% for partial kidney removal. Kidney function is preserved, and the hospitalization and rehabilitation time are shortened. Local control of kidney cancer is achieved in 90.6% of cases.
Kidney ablation requires surgery, although it is more sparing than conventional operation. Cryodestruction is usually performed through a laparoscopic or retroperitoneoscopic (retroperitoneal) approach. There is much less mobilization of the kidney, and ischemia (blockage of the blood supply) is not required.
In some cases, the tumor can be destroyed percutaneously without surgery. Probes are inserted through the skin. This treatment option is the most sparing because it is an outpatient procedure, but it can only be used if the tumor is located on the back surface of the kidney.
Treatment of colorectal cancer metastases in the liver
In 2016, ESMO (European Society for Medical Oncology) approved cryoablation as one of the possible methods to destroy colorectal cancer metastases in the liver. Since then, the procedure has been widely used in Europe.
Cryoablation can create significant zones of necrosis in the liver, up to 10 cm or more, allowing destruction of even large metastatic foci. At the same time, cryodestruction can lead to bleeding, so this method is usually used for the treatment of metastases no larger than 4-6 cm. To make the procedure safer for health, angiographic guidance may be used for the imaging of large blood vessels.
Several probes are used for cryodestruction. Their number roughly corresponds to the diameter of the tumor in centimeters. During the cryoablation procedure, an ice ball is formed at the site of the metastasis. This process takes 1-2 minutes. To ensure reliable destruction of the tumor and minimize the risk of recurrence, the doctor also destroys a small amount of surrounding tissue, leaving a reserve of 3 to 15 mm, depending on the diameter of the tumor.
Percutaneous bone cryoablation
Many types of cancer metastasize to bone: prostate cancer in 70% of cases, lung, kidney and thyroid cancer in about 40% of cases. This cohort of patients experiences a sharp decline in quality of life due to bone fractures, pain, and compression of the spinal cord and nerves.
The standard method of suppressing bone metastases is radiation therapy. It is ineffective in about 25% of cases. In these situations, cryoablation can be used. The main goal of this procedure is pain relief.
Innovations in cryotherapy
The cryotherapy method is developing. Innovations in equipment and ablation methods are being developed in countries with advanced medicine. Below is more about the innovations and improvements in medicine that have occurred in recent years:
- New gases that allow for much faster cooling and destruction of tissue
- The use of cryosensitizers: drugs that increase the susceptibility of a tumor to cryotherapy
- Combination of cryoablation with other cancer therapy options: cryochemotherapy or cryoimmunotherapy
- Combination with radiation therapy
- Cryoablation with a device with a robot-assisted console
- Targeted or pinpoint ablation for more precise destruction of tumors with complex structures
You can take advantage of innovations and modern types of cryoablation and receive the highest level of medical services abroad.
Where can I undergo cryoablation and find out the cost of treatment?
You can have your treatment in one of the countries with developed medicine, such as Germany. You can choose a hospital, a therapy program, and find out the cost of treatment on Booking Health. The website presents the programs of leading German hospitals and programs of hospitals in other countries with a high level of services in the field of medicine.
On the Booking Health website, you can choose a suitable German hospital, see the program, and compare prices for doctors' services. Once you have chosen a hospital and a program, you can make an appointment for your treatment through the Booking Health website. In this case, the cost of treatment for you will be lower as there are no additional fees for foreign patients. Our company's specialists will make an appointment at the hospital for your preferred dates and provide travel arrangement services.
Choose treatment abroad and you will for sure get the best results!
Authors:
The article was edited by medical experts, board certified doctors Dr. Nadezhda Ivanisova and Dr. Vadim Zhiliuk. For the treatment of the conditions referred to in the article, you must consult a doctor; the information in the article is not intended for self-medication!
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