The recent contradictory results of two large scale studies that investigated the risks and benefits of prostate cancer screening brought about the question of overdiagnosis and overtreatment. It also highlighted the need for less radical and minimally invasive treatment.
Men diagnosed with prostate cancer are usually recommended to undergo prostatectomy, which is the surgical removal of the prostate gland. No one can deny that this treatment is radical and highly invasive, and sadly, sometimes unnecessary. This is because it is extremely difficult to determine whether a prostate tumor is malignant or benign, slow-growing or aggressive and the only way to be sure is looking at the tumor in the lab, long after the organ ahs been removed.
Researchers presented a study at the Society of Interventional Radiology’s 34th Annual Scientific Meeting that may just have the answer. Instead of bombarding tumors with radiation or chemotherapeutic agents, this new technique uses freezing technology. In the treatment of prostate cancer, this method is called “male lumpectomy” or “focal cryoablation.” Instead of surgically removing the entire prostate gland or subject the whole gland to radiation, interventional radiologists can localize the tumor and destroy it by freezing.
With cryoablation, interventional radiologists insert a probe through the skin, using imaging to guide the needle to the tumor; the probe then circulates extremely cold gas to freeze and destroy the cancerous tissue. This minimally invasive treatment targets only the cancer itself, sparing healthy tissue in and around the prostate gland rather than destroying it, as traditional approaches do.
This treatment method has the following advantages over traditional treatments:
- Minimally invasive
- Less traumatic
- More likely to preserve sexual function
- Less likely to interfere with urinary function
- No major complications
- Fewer side effects
The technique has long been used in breast cancer treatment where instead of radical mastectomy, surgical breast lumpectomy is now the preferred method. Unlike breast tumors, however, surgical lumpectomy of prostate tumors is technically not feasible. But the use of cryoablation technique seems to solve this problem. “Cryoablation spares as much as possible of the prostate gland and its neurovascular bundles, limiting the side effects of bladder control problems (incontinence) and erectile dysfunction (impotence) that result from more radical prostate cancer treatments.”
Many health experts advocate the “watchful waiting” strategy over traditional but radical prostatectomy. Advocates of focal cryoablation claim it, too, presents an advantage over the “watchful waiting” approach because all other treatment options are preserved.
The researchers further recommend that focal ablation should be complemented by the 3-D transperineal biopsy. Using 3-D mapping technique, this biopsy can detect very small tumors that can then easily be destroyed by cryoablation.
Indeed, this new development gives hope to men. Current guidelines recommend that men should get screened for prostate cancer at age 50 and above.
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