Technological aspects of delivering cryotherapy for prostate cancer

Abstract

Since the era of prostate specific antigen (PSA) testing, there has been a stage and grade migration seen with prostate cancer along with a reduction in mortality. Subsequently, concerns have been raised about the over treatment of patients following the diagnosis of localized prostate cancers. Cryotherapy, in which extremely low temperatures induce cell death via multiple mechanisms, has seen a drastic improvement in its technology since the 1800s. Such advances have improved oncological outcomes while reducing complication rates. Furthermore, technological advances have allowed the development of focal cryotherapy which aims to reduce morbidity associated with more radical whole-gland therapies. There is growing evidence that focal cryotherapy provides good oncological and morbidity rates when compared with traditional radical/whole-gland therapies.

Keywords:

• cryoablation
• cryobiology
• cryoimmunology
• cryotherapy
• history
• prostate cancer
• technology

Financial & competing interests disclosure

HU Ahmed receives Trial funding from Sonacare Inc, AMD SAS, Angiodynamics Inc., Sophiris Inc and Trod Medical. He receives funding for lectures/attendance at conferences from Sonacare Inc., Astra Zeneca and Sanofi as well as proctoring fees from Sonacare Inc and Nuada Medical Ltd. The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.

Key issues

• Cryotherapy is a minimally invasive procedure used in the treatment of prostate cancer.

• The physiology by which cell death achieved is multifactorial involving both direct and indirect immune mechanisms.

• Improvements in technology have decreased complication rates and improved outcomes.

• Focal cryotherapy is an increasingly popular alternative to the more radical whole gland treatments for primary localized prostate cancer and radio-recurrent prostate cancer.

Notes