How effective is cryotherapy for whole-gland ablation?
Cryotherapy has been used as a primary treatment for prostate cancer since the early 1990s. In the past several years, long-term data have become available that suggest that cryotherapy is effective (Babaian RJ et al. J. Urol. 180:1993-2004 (2008); Jones JS et al. J. Urol. 180:554-558 (2009)). One measure of the effectiveness of any treatment for prostate cancer is the residual PSA that can be detected after treatment. As with radiation therapy, a measurable PSA is often seen after cryotherapy, since there is often a very small amount of PSA-producing prostate tissue refractory to ablation. This small amount of PSA does not necessarily indicate a cancer recurrence. Most cryosurgeons employ the Phoenix ASTRO definition of PSA failure (nadir (lowest) point + 2.0). Recent studies have shown that a PSA of Levy DA et al. J. Urol. 182:931-7 (2009)). If the PSA rises above this level after cryotherapy, a repeat prostate biopsy is necessary to search for residual or recurrent cancer. Unlike af
