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Of those who did not have previous prostate surgery, all remained continent. He reported that 85 percent of the men retained sexual function. "There were no local recurrences in the areas we treated, and with the ability to re-treat the 7 percent of patients who developed a focus of cancer at a different site in the gland cryoablation was 100 percent effective in local control of the patient's disease," said Onik. Of those patients, 112 (93 percent) had no evidence of cancer-in spite of 72 being labeled medium to high risk for cancer recurrence. He studied 120 men who had focal cryoablation over the past 12 years, including testing the levels of prostate-specific antigen (PSA) in the blood. "There is no question that we can eradicate prostate cancer (when that cancer has not spread to other parts of the body) by freezing it and that there is a better way to 'map' the disease," said Onik. "Any risks are fewer and lesser in intensity than surgery so if you have the equivalent chance of cancer being cured with far less chance of having any complications, why wouldn't you choose it?" asked Onik. It also represents an advantage over "watchful waiting," because all treatment options are preserved. Cryoablation (or cryo or cryotherapy) spares as much as possible of the prostate gland and its neurovascular bundles, limiting the side effects of bladder control problems (incontinence) and erectile dysfunction (impotence) that result from more radical prostate cancer treatments. Unlike breast lumpectomy, a surgical lumpectomy for prostate cancer is not technically feasible so to treat just a portion of the prostate, minimally invasive cryoablation is needed. Additionally, Onik presented results of a 3-D biopsy method that provides superior information on the extent and grade of prostate cancer as opposed to the current standard TRUS biopsy.Ĭalling focal cryoablation a "male lumpectomy" reflects the origins of this approach in the breast-sparing surgery that replaced radical mastectomy as the preferred treatment for breast cancer, said Onik. "You can go home on the same day of the procedure, and you can repeat the treatment, if needed, in later years," said Onik. This minimally invasive treatment targets only the cancer itself, sparing healthy tissue in and around the prostate gland rather than destroying it, as traditional approaches do, noted the professor at the University of Central Florida. With cryoablation, interventional radiologists insert a probe through the skin, using imaging to guide the needle to the tumor the probe then circulates extremely cold gas to freeze and destroy the cancerous tissue.
"We've reached a tipping point: treating only the tumor instead of the whole prostate gland is a major and profound departure from the current thinking about prostate cancer," added Onik. Onik, M.D., interventional radiologist and director of the Center for Safer Prostate Cancer Therapy in Orlando, Fla. Instead of removing the entire prostate, or freezing the entire prostate or using radiation on the entire prostate, interventional radiologists can find out where the cancer is and just destroy the cancer," said study author Gary M. Interventional radiologists tailor treatment to each patient's disease. "Our data show that focal cryoablation is as good for prostate cancer control as any other treatment-including surgery, radiation and hormone therapy-but it is less invasive and traumatic for patients, preserves sexual and urinary function and has no major complications. Additionally, the use of 3-D transperineal mapping biopsy for determining the extent of prostate cancer-when compared with the commonly used transrectal ultrasound (TRUS) biopsy-heavily impacted how patients' disease was managed in 70 percent of the cases.