Freezing prostate cancer: Study shows notable outcomes with cryoablation

September 28, 2020

September 28, 2020 -A less-invasive treatment technique called hemi-gland cryoablation (HGCryo) - destroying the areas of the prostate where cancers are located by freezing them - provides a high rate of effective prostate cancer control, according to a new study published in The Journal of Urology®, Official Journal of the American Urological Association (AUA). The journal is published in the Lippincott portfolio by Wolters Kluwer.

"Freedom from cancer, as documented by biopsy, was found in 82 percent of men who underwent HGCryo, at their 18 month follow-up," according to the research by Ryan Chuang, MD, and colleagues at the University of California, Los Angeles. The importance of utilizing modern magnetic resonance imaging (MRI)-guided prostate biopsy in monitoring the effectiveness of HGCryo is also emphasized as part of this study.

'Hemi-Gland Cryoablation' Eliminates Clinically Significant Cancer in Most Patients

In the HGCryo procedure, using an advanced ultrasound/MRI fusion system, needles are precisely placed in and around the area of the prostate where the cancer is located. Argon gas is then injected to create extremely cold temperatures, destroying the cancer and surrounding area.

According to the study, 61 men with clinically significant prostate cancer (grade 2 or higher) involving one side of the prostate gland, underwent HGCryo. Cryotherapy was performed using general anesthesia; patients were discharged on the same day as the procedure. The results were assessed through follow-up imaging procedures and MRI-guided biopsies.

Biopsies were performed at 6 months in all patients; 27 patients underwent an additional biopsy after reaching 18 months' follow-up. At both times, biopsies showed no evidence of clinically significant prostate cancer in 82 percent of patients. In men who had areas of prostate cancer detected at follow-up, repeated HGCryo or other treatments were effective.

The study assessed three different biopsy approaches for monitoring the outcomes of HGCryo therapy: tracking of prior cancer-positive sites, biopsy targeting of MRI-visible lesions, and systematic biopsy of the entire prostate using a template. "While tracking biopsy was the most sensitive, all three methods were required for maximum cancer detection," Dr. Chuang and coauthors write.

HGCryo provided notable cancer control even in six patients with more advanced prostate cancers (grade 3 or 4). None of the patients died from their cancer, and none developed metastatic prostate cancer.

Postoperative complications of HGCryo were "generally mild and short-lived." There were no serious complications, including urinary incontinence - a common complication after prostate cancer surgery. One patient developed erectile dysfunction , which was successfully treated with medication.

Cryotherapy is an FDA-approved treatment for prostate cancer and is increasingly popular as a less-invasive alternative to surgery. However, there has been limited evidence on its long-term effectiveness in controlling prostate cancer. Most studies of prostate cryoablation were performed before the availability of modern multiparametric MRI scanning of the prostate, which can provide "a targeted path to precise biopsy and focal treatment" in most men with prostate cancer.

As with other types of partial gland ablation (PGA) for treatment of prostate cancer, the findings highlight the importance of follow-up biopsy as "the most important criterion for success" in evaluating the results of HGCryo. Dr. Chuang and colleagues conclude, "As utilization of MRI-guided biopsy increases, with resulting improved accuracy of prostate tissue characterization, numbers of candidates for PGA are expected to rise."
-end-
Click here to read "Hemigland Cryoablation of Clinically Significant Prostate Cancer: Intermediate-Term Followup via Magnetic Resonance Imaging Guided Biopsy." DOI: 10.1097/JU.0000000000001133

###


About The Journal of Urology®

The Official Journal of the American Urological Association (AUA), and the most widely read and highly cited journal in the field, The Journal of Urology® brings solid coverage of the clinically relevant content needed to stay at the forefront of the dynamic field of urology. This premier journal presents investigative studies on critical areas of research and practice, survey articles providing brief editorial comments on the best and most important urology literature worldwide and practice-oriented reports on significant clinical observations. The Journal of Urology® covers the wide scope of urology, including pediatric urology, urologic cancers, renal transplantation, male infertility, urinary tract stones, female urology and neurourology.

About the American Urological Association Founded in 1902 and headquartered near Baltimore, Maryland, the American Urological Association is a leading advocate for the specialty of urology, and has more than 23,000 members throughout the world. The AUA is a premier urologic association, providing invaluable support to the urologic community as it pursues its mission of fostering the highest standards of urologic care through education, research and the formulation of health care policy. To learn more about the AUA visit: http://www.auanet.org.

About Wolters Kluwer

Wolters Kluwer (WKL) is a global leader in professional information, software solutions, and services for the clinicians, nurses, accountants, lawyers, and tax, finance, audit, risk, compliance, and regulatory sectors. We help our customers make critical decisions every day by providing expert solutions that combine deep domain knowledge with advanced technology and services.

Wolters Kluwer reported 2019 annual revenues of €4.6 billion. The group serves customers in over 180 countries, maintains operations in over 40 countries, and employs approximately 19,000 people worldwide. The company is headquartered in Alphen aan den Rijn, the Netherlands.

Wolters Kluwer provides trusted clinical technology and evidence-based solutions that engage clinicians, patients, researchers and students with advanced clinical decision support, learning and research and clinical intelligence. For more information about our solutions, visit https://www.wolterskluwer.com/en/health and follow us on LinkedIn and Twitter @WKHealth.

For more information, visit http://www.wolterskluwer.com, follow us on Twitter, Facebook, LinkedIn, and YouTube.

Wolters Kluwer Health

Related Prostate Cancer Articles from Brightsurf:

Low risk of cancer spread on active surveillance for early prostate cancer
Men undergoing active surveillance for prostate cancer have very low rates - one percent or less - of cancer spread (metastases) or death from prostate cancer, according to a recent study published in the Journal of Urology®, an Official Journal of the American Urological Association (AUA).

ESMO 2020: Breast cancer drug set to transform prostate cancer treatment
A drug used to treat breast and ovarian cancer can extend the lives of some men with prostate cancer and should become a new standard treatment for the disease, concludes a major trial which is set to change clinical practice.

Major trial shows breast cancer drug can hit prostate cancer Achilles heel
A drug already licensed for the treatment of breast and ovarian cancers is more effective than targeted hormone therapy at keeping cancer in check in some men with advanced prostate cancer, a major clinical trial reports.

The Lancet: Prostate cancer study finds molecular imaging could transform management of patients with aggressive cancer
Results from a randomised controlled trial involving 300 prostate cancer patients find that a molecular imaging technique is more accurate than conventional medical imaging and recommends the scans be introduced into routine clinical practice.

Common genetic defect in prostate cancer inspires path to new anti-cancer drugs
Researchers found that, in prostate cancer, a mutation leading to the loss of one allele of a tumor suppressor gene known as PPP2R2A is enough to worsen a tumor caused by other mutations.

First prostate cancer therapy to target genes delays cancer progression
For the first time, prostate cancer has been treated based on the genetic makeup of the cancer, resulting in delayed disease progression, delayed time to pain progression, and potentially extending lives in patients with advanced, metastatic prostate cancer, reports a large phase 3 trial.

Men taking medications for enlarged prostate face delays in prostate cancer diagnosis
University of California San Diego School of Medicine researchers report that men treated with medications for benign prostatic hyperplasia (enlarged prostate) experienced a two-year delay in diagnosis of their prostate cancer and were twice as likely to have advanced disease upon diagnosis.

CNIO researchers confirm links between aggressive prostate cancer and hereditary breast cancer
The study has potential implications for families with members suffering from these types of tumours who are at an increased risk of developing cancer.

Distinguishing fatal prostate cancer from 'manageable' cancer now possible
Scientists at the University of York have found a way of distinguishing between fatal prostate cancer and manageable cancer, which could reduce unnecessary surgeries and radiotherapy.

Researchers find prostate cancer drug byproduct can fuel cancer cells
A genetic anomaly in certain men with prostate cancer may impact their response to common drugs used to treat the disease, according to new research at Cleveland Clinic.

Read More: Prostate Cancer News and Prostate Cancer Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.