Cryosurgical Ablation of Prostate

Abstract

Since the development of the prostate-specific antigen (PSA) assay and transrectal ultrasonography (TRUS) the incidence of prostate cancer has progressively increased especially during the 1990s. In 1995 it was estimated that 244,000 men in the United States would have been diagnosed with prostate cancer, among whom 40,400 would succumb.¹ The main treatment options, radical prostatectomy and radiation therapy, have also shown dramatically increased rates. Although prostatectomy rates increased sixfold between 1984 and 1990 in the United States, it is still controversial as to whether radical prostatectomy improves survival at any stage of prostate cancer.^2,3 There is also a significant increase in the use of radiation therapy for men over 70 years of age.⁴ Patients treated with radiation therapy for clinically localized prostate cancer show significant rates of biochemical and clinical progression.^5,6 Because of the limitations of current therapies for prostate cancer, other treatment options are currently being scrutinized and investigated, including watchful waiting, androgen ablation therapy, and cryosurgical ablation. Cryosurgical ablation has potential for treatment of non-organ-contained disease that is not metastatic to nodes or distant sites because the freezing process is not limited by the gland capsule.⁷ The goal of cryosurgical ablation is local control of the prostate cancer.