UCLA researchers have found that hemi-gland cryoablation, or cryotherapy, is an effective, primary treatment for men with clinically-significant, or grade 2, prostate cancer. Cryotherapy is a centuries-old technique that uses extremely cold temperatures to freeze and kill cancer cells.
In a group of 61 patients with intermediate-risk prostate cancer, researchers found 80-percent of patients had no signs of cancer at six months and 18 months after cryotherapy treatment. In 10-percent of cases, there was minor residual cancer and a 10-percent failure rate among those who didn’t respond to treatment.
BACKGROUND
According to the American Cancer Society, prostate cancer is the most common cancer diagnosed in men in the United States. In 2020, an estimated 191,930 new cases of prostate cancer will be reported, with about 33,330 deaths. Common treatments of low or intermediate-risk prostate cancer include radical prostatectomy, radiotherapy or brachytherapy. Each of these treatments come with varying side effects, fueling research efforts to find if cryotherapy could be a better option.
Cryotherapy, which emerged as a treatment option at UCLA in 2008, is used to treat only the cancerous portion of the prostate, eliminating cancerous cells while also minimizing damage to vital areas. Cancers treated with cryoablation are considered to be of intermediate risk, meaning the tumor might be observed for a while, but could progress if not treated. Patients who select cryoablation are opting for preservation of quality of life and are watched and checked for recurrence of cancer.
METHOD
For this research, a team of clinical scientists used MRI-guided biopsy – an accurate method of collecting tissue samples from the prostate gland – uniformly across patients before and after treatment. Partial prostate cryoablation was performed on 61 male patients diagnosed with intermediate-risk prostate cancer. The patients all underwent the MRI-guided biopsy before and after the procedure and had follow-ups for as long as 18-months.
IMPACT
A less invasive option than traditional surgical approaches, prostate cryotherapy offers the patient the potential for cure without common side effects including erectile dysfunction, incontinence, or other problems that are a result of a traditional surgery or radiation therapy. There is also a shorter recovery period, shorter hospital stay, less blood loss and less pain.
While these results are very encouraging, physician-scientists note that research on the use of cryotherapy treatment for prostate cancer is still very preliminary considering the long history of prostate cancer, and more research on its effectiveness must be done.
AUTHORS
Co-first authors are Dr. Ryan Chuang, resident physician at the David Geffen School of Medicine at UCLA and Dr. Adam Kinnaird, a fellow in the urology department at UCLA. The senior author is Dr. Leonard Marks, the Jean B. deKernion Chair in urology, clinical professor and member of the UCLA Jonsson Comprehensive Cancer Center. Other authors are listed in the journal article.
JOURNAL
The research is published in the July issue of Journal of Urology.
FUNDING
Funding came from private philanthropy and a series of grants from the National Cancer Institute.
