Prostate news article, March 2005
| SALVAGE CRYOSURGERY
FOR LOCALLY RECURRENT PROSTATE CANCER FOLLOWING RADIOTHERAPY
S. Ahmed et al. Article in Prostate cancer and prostatic diseases. 2005; 8: 31-35 Reviewed by: Mr. J Bhardwa MBChB MRCS (Eng) |
In this article the authors compare the outcome of cryosurgery and radical prostatectomy in patients who had recurrence of prostate cancer following radiotherapy for localised prostate cancer. When used to treat recurrences the procedures are referred to as "salvage"
Cryosurgery is a technique in which the prostate is frozen to temperatures below -40C killing the cancerous cells in the process. There have been a number of refinements in the process recently mainly in the ability to control precisely the temperature and the area where the freezing occurs which has led to its increasing use in the initial (curative) treatment of prostate cancer. Here the authors compare the use of salvage cryosurgery with salvage radical prostatectomy in patients who initially had radiotherapy intending to cure their prostate cancer, but later had a recurrence of their prostate cancer locally (i.e. it had not spread to the bones) with radical prostatectomy.
Avoiding a major operation is an obvious advantage with cryosurgery but also other complications such as urinary incontinence are lower with cryosurgery at 8% as compared to around 40% with radical prostatectomy. Around 4% of patients in both groups had a fistula (an abnormal connection between the rectum and bladder) and impotency rates were pretty much 100% with both techniques. The number of deaths were same in both the groups (4 in each) suggesting that in the immediate/short term there are no survival benefits in either operation but fewer complications make salvage cryosurgery an attractive option.
However, in the long term the survival rate of salvage cryosurgery has yet to be measured.
Therefore it may be a procedure which is used more commonly in the future in managing patients who have a recurrence of prostate cancer after radiotherapy.