Table of Contents

Chapter 5: "Secondary" Local Treatment

e. Cryotherapy Following Radiation Therapy

As we noted in Chapter 2, cryotherapy is an option worth exploring, particularly for men who have other health problems that might impair their recovery from a surgical procedure. In the same vein, cryotherapy has been used as a secondary local therapy in men who underwent radiation therapy, and has shown five-year disease-free rates around 40%. However, because the procedure does not completely destroy all remaining prostate cells, the PSA generally does not drop to 0, so it is often difficult to determine complete success. Men with lower pre-cryotherapy PSA levels and lower Gleason scores tend to fare better, while those who received hormone therapy in addition to radiation therapy tend to fare worse.

Side effects of cryotherapy tend to be milder compared with standard prostatectomy, and the same holds true when used after radiation therapy. Nevertheless, rates for erectile dysfunction following this procedure remain high, as do rates for pelvic or rectal pain. Because the severity of side effects tends to correlate with the amount of tissue that is frozen during therapy, better techniques that are currently being studied might improve outcomes over time.