Treatment of cancer in any part of the body involves either removal of the cancer or the organ containing cancer by surgery or destroying the cancer by radiation or chemotherapy. A newer way of destroying cancer is using cryo (freezing of cancerous tissue). Very fine needles are passed into the cancerous tissue under ultrasound guidance. Argon gas is passed through these needles. This freezes the tissue surrounding the tip of the needle to less than -40 degrees C. This computer controlled freezing is continuously monitored by ultrasound as the frozen tissue can be clearly identified on the scan.

Certain types of cancers of prostate and kidney can be treated by this method. Cancers that have failed to respond to radiotherapy or those that are not suitable for radiotherapy or surgery can be treated by this method. The advantages of this treatment are:

1. It is minimally invasive with minimal post-operative discomfort
2. Very rapid recovery
3. Minimal complication rate
4. Has been shown to be as effective as other modalities
5. Can be repeated if cancer recurs

Treatment of prostate cancer by cryo-therapy

An example of a CRYO MACHINE

The treatment
You will be admitted a day before the procedure to clear the bowels and for starting antibiotics. The procedure can be performed under a spinal or a general anaesthetic. The bladder is inspected with a telescope to make sure that the urinary passage is not too narrow and the bladder lining is healthy. A special catheter is then passed through the water pipe into the bladder. Through this, warm water is circulated during the treatment. The purpose of this is to keep the water pipe from being affected by the freezing process. Up to 16 fine needles are passed into the prostate through the skin under the scrotum under ultrasound control. The entire prostate is frozen for up to 20 minutes. The tissue is then warmed to the body temperature and frozen again for a few minutes. The prostate is continuously monitored by ultra sound during the treatment. The whole treatment takes about two hours. In the end a urinary catheter is left in.

After the treatment
You will stay over-night in the hospital. You may experience slight discomfort in the area below the scrotum. This usually responds to simple painkillers. You will be discharged home with the urinary, which will be removed as an outpatient two weeks later.

Your blood PSA level will be measured 3 months after the treatment to assess the response to treatment. Usually you will not require a further biopsy as the response is monitored by PSA test.

TREATMENT OF KIDNEY CANCER BY CRYO-THERAPY

Kidney cancer is not uncommon. The standard treatment for this is removal of the kidney (by conventional or by Laparoscopic method). However, in the past ten years these cancers are being detected incidentally when a scan of the abdomen is performed for other reasons. Therefore, we are detecting them very early when they are small.

If the cancerous tumour is small (less than 4 cm in size) or if the opposite kidney is not functioning very well for any reason, instead of removing the kidney, the current recommendation is to remove just the tumour surgically or "freeze" the tumour by cryo-therapy.

The Treatment
The cryo needles are passed into the tumour either through a small incision in the loin or using a telescopes and instruments passed into the abdomen by means of a laparoscopic technique. The procedure is performed under a general anaesthetic.Up to 10 fine needles are passed into the tumour which is frozen for up to 20 minutes. The tissue is then warmed and frozen again for a few minutes. The freezing process can be monitored using an ultrasound scan. The whole treatment takes about two hours. In the end a small tube (drain) is left in.

After Treatment
You may have some discomfort from the wound. But this controlled well with painkillers taken by mouth or given by an injection. The drainage tube will be removed 24 to 48 hours after the operation in the ward. Recovery is quick and you will be able to go home after 24 to 48 hours.

You should be able to return to full physical activity with in 2 weeks. The response to treatment will be assessed by a CT scan of the kidney between 3 to 6 months after the opeation.