Cryotherapy may be used in patients with low-risk tumor factors, such as an original prostate specific antigen (PSA) level less than 10 ng/mL, Gleason score lower than 6, and less advanced clinical stage (for example, T1c or T2a, and some say, even up to T3a). A Gleason score is a way of grading prostate cancer cells on a scale of 2 to 10. The higher the number, the faster the cancer will likely grow and the more chance it will to spread beyond the prostate. Men who aren't as concerned about their erectile function after surgery may consider cryosurgery as an option, as the risk for temporary or permanent impotence after the procedure is high.
When the intent isn't to cure, cryosurgery may be useful for patients who have disease that has spread beyond the prostate gland and need treatment for symptoms. Sometimes cryoablation may be used as an alternative for patients who have had unsuccessful results with radiation therapy. Some experts believe cryotherapy can be helpful when the prostate cancer cells aren't as sensitive to radiation. Cryotherapy may not be recommended for men who have a very large prostate gland.
Cryosurgery is also used because it's less invasive than radical prostatectomy, and subsequently, there's generally less blood loss, a shorter hospital stay (or even no hospital stay), shorter period of recovery, and less pain.
Cryosurgery has only been used since the late 1990s. Because there are no long-term studies of cryosurgery available, it may not be among the first options presented to many prostate cancer patients. However, initial studies indicate that cryotherapy is a safe and effective treatment. There may be other reasons for your physician to recommend cryotherapy.