Cryoablation: a new treatment option

Dr Gareth Bydawell explains cryoablation, its indications, patient selection criteria, procedural expectations, and the long-term success rates.

You can listen to this article below, or by using your favourite podcast player at pod.link/oncologybuddies

As an interventional radiologist, I often encounter patients seeking alternate treatment options for cancer, especially when facing surgery or a long course of chemotherapy. 

One such option is cryoablation, a procedure that uses extreme cold to carefully destroy cancer cells. 

What is cryoablation?

Cryoablation involves inserting thin metal probes, under imaging guidance, into the tumour site and circulating extremely cold gas through these probes to freeze and destroy cancer cells. This technique is also known as cryotherapy or cryosurgery. 

The procedure is minimally invasive, often performed under local or general anaesthesia, and typically allows patients to go home the same day. 

Indications for cryoablation

Cryoablation can treat various types of cancer:

• Bone cancer
• Breast cancer
• Kidney cancer
• Liver cancer
• Lung cancer
• Prostate cancer

It’s particularly useful when surgery isn’t an option due to the size or location of the tumour, or when the patient is elderly or has other health conditions that make surgery unsafe.

Patient selection criteria

The best candidates for cryoablation are those with small localised tumours that are less than 4cm in diameter. For breast cancer, ideal candidates have unifocal invasive ductal carcinoma tumours that are low grade, hormone receptor positive, and ≤1.5 cm in size. 

Patients with early-stage non-small cell lung cancer who are poor surgical candidates or those with chest wall involvement are well-suited to this treatment.

What is expected?

Before the procedure, patients will receive instructions on how to prepare, which may include stopping certain medications and arranging for a lift home after the procedure. 

During cryoablation, the healthcare team will position the patient on an examination table and may use imaging equipment, like ultrasound or CT scans, to guide the cryoprobes into the tumour. This can be done under sedation or general anaesthetic. 

The procedure typically involves cycles of freezing and thawing to ensure complete destruction of the tumour, all using precision imaging guidance.

Benefits of cryoablation

One of the significant advantages of cryoablation is that it can be performed as a day procedure. This means patients can return home the same day, which offers several benefits:

• Reduced hospital stay: Minimises the time spent in the hospital, reducing the risk of hospital- acquired infections.
• Faster recovery: Patients can recover in the comfort of their own homes, often leading to quicker overall recovery.
• Lower costs: Shorter hospital stays can reduce medical costs associated with extended inpatient care.

A great treatment option

Cryoablation offers several advantages:

• Minimally invasive: It doesn’t require large surgical incisions, leading to faster recovery and less pain.
• Targeted treatment: It precisely targets cancer cells while sparing healthy tissue.
• Effective for various cancers: It can treat multiple types of cancer, including those that have spread to other organs.

Post-procedure complications

While cryoablation is generally safe, there are potential risks and complications, including:

• Bleeding
• Infection
• Damage to surrounding structures
• Patients may experience pain at the injection site, flu-like symptoms, or, in the case of lung cancer treatment, pneumothorax (collapsed lung). 

These complications can all be managed with appropriate medical care.

Final thought 

Cryoablation is an emerging minimally-invasive treatment option for patients with certain types of cancer. Extreme cold is used to destroy cancerous tissue, and this technique offers a targeted approach that minimises damage to surrounding healthy cells. 

This precision, combined with fewer complications and shorter recovery times, makes cryoablation an attractive alternative to more traditional treatments like surgery, chemotherapy, or radiation. 

Understanding what to expect during the procedure, as well as the potential long-term outcomes, empowers patients to make informed decisions about their cancer care.

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