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Salvage cryotherapy for recurrent prostate cancer after radiation failure: current status and future perspectives
Mohamed Ismail, Pandha Hardev and John DaviesIn the last decade, cryotherapy has emerged as a minimally invasive alternative for the treatment of localized or locally advanced prostate cancer. With better understanding of the pathophysiology of cryogenic injury and the introduction of the gas-driven systems, the procedure has been optimized to improve patient survival and reduce complication. The results of salvage cryotherapy are becoming more promising. Modifying standard cryotherapy technique by the use of a urethral warming catheter and thermocouples has resulted in the reduction in serious complications and improved quality of life following the procedure. Focal nerve-sparing cryotherapy represents a novel approach to treat prostate cancer and preserve potency. Cryoimmunotherapy and cryochemotherapy are new concepts in adjuvant therapy. Early in vitro studies revealed the feasibility of such an approach. Further clinical trials are essential before using these models as standard treatment.