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NONSURGICAL TREATMENTS FOR PROSTATE CANCER: CRYOSURGERY

In cryosurgery, a metal probe is placed directly into the tumor tissue, and the tumor is destroyed by freezing. This is accomplished by liquid oxygen that is circulated through the probes, freezing the tissue of the prostate. The process is monitored by ultrasound. This procedure takes just two or three hours under spinal or general anesthesia; patients report little pain and are able to resume normal activities within a week. The process works best when the prostate gland weighs 40 grams or less and has never been operated on. A 1993 Cancer Communication Newsletter favorably compared cryosurgery to radical prostatectomy. The article listed the advantages of cryosurgery as follows:

No surgical incision is required. Usually an overnight hospital stay is not necessary, and in some cases it can be performed on an outpatient basis.

No blood needs to be taken for autologous transfusion (using the patient's blood for transfusion during surgery).

Usually only one day of recovery is needed before resuming normal activity.

Incontinence and impotence occur much less frequently than with a radical prostatectomy.

It is considerably less expensive than a radical prostatectomy.

If necessary, it can be repeated if residual cancerous tissue is found.

However, proof of the procedure's efficacy is lacking. Only about 115 men have undergone cryosurgery over the last fifteen months at the only hospitals to use the procedure so far, Allegheny General Hospital in Pittsburgh and M. D. Anderson Cancer Center in Houston. There have been no published follow-up studies, and such short-term results wouldn't mean much even if they did exist—if the cancer isn't completely eliminated, it can reappear in ten or fifteen years.

There are concerns that some of the malignant cells may not be frozen and that cells outside the process will escape being treated. Other disadvantages are that it can be very irritating to the bladder and urethra. Although only temporary, about 50 percent of the patients complain of some degree of swelling in the penile and scrotal area. Others complain of frequent urination without any warning, blood in their urine, a burning pain when urinating, impotence, and discomfort in the rectal wall.

At this point, medical opinions of cryosurgery vary widely, and further research will be needed in order to determine its long-term value.

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Men's Health Erectile Dysfunction