Prostate Cryotherapy in Korea

Prostate cryotherapy, also known as cryoablation, is a minimally invasive treatment that uses extreme cold to destroy cancerous cells within the prostate gland. In Korea, this technique is utilized as an alternative treatment for localized prostate cancer, especially for patients who may not be suitable candidates for surgery or radiation, or for those whose cancer has recurred after initial radiation therapy. It offers a precise way to target and eliminate cancerous tissue while aiming to preserve surrounding healthy structures.

Understanding Prostate Cancer & Indications in Korea

Prostate cancer is a common malignancy in men, involving the abnormal growth of cells in the prostate gland.

• Causes: While the exact causes are not fully understood, risk factors include age, family history, and ethnicity.
• Symptoms: In early stages, prostate cancer often has no symptoms. As it progresses, symptoms can include urinary problems (frequent urination, weak stream), blood in urine or semen, and pain in the lower back or pelvis.
• Indications for Prostate Cryotherapy: Cryotherapy is typically considered for:
• Localized Prostate Cancer: Especially for early-stage, low-risk cancers confined to the prostate, particularly in men who prefer a less invasive option than surgery or radiation, or those for whom surgery/radiation are not ideal.
• Salvage Therapy: When prostate cancer recurs after initial radiation therapy.
• Focal Therapy: In some cases, to treat only the cancerous part of the prostate, aiming to reduce side effects, though this is a more advanced and less commonly applied approach.
• Diagnosis: In Korea, diagnosis involves Prostate-Specific Antigen (PSA) blood tests, digital rectal exams (DRE), transrectal ultrasound (TRUS)-guided prostate biopsy (the definitive diagnostic tool), and imaging such as MRI to stage the cancer.

Common Surgical Procedure in Korea

Prostate cryotherapy involves precisely inserting thin probes into the prostate gland to deliver freezing and thawing cycles.

• Anesthesia: Performed under spinal/epidural anesthesia (numbing the lower body) or general anesthesia.
• Probe Insertion: Using transrectal ultrasound (TRUS) guidance, several thin, hollow needles (cryoprobes) are inserted through the skin between the anus and scrotum (perineum) directly into the prostate gland.
• Freeze-Thaw Cycles: Very cold gases (e.g., argon) are circulated through the needles to create ice balls that encompass and freeze the cancerous prostate tissue. Warmer gases (e.g., helium) are then circulated to thaw the tissue. This freeze-thaw cycle is typically repeated at least once to ensure complete destruction of the cancer cells.
• Temperature Monitoring: To protect nearby structures like the urethra and rectum, tiny temperature probes are placed in and around the prostate. A catheter is also inserted into the urethra, through which warm saline is circulated to prevent it from freezing.
• Duration: The procedure usually lasts one to two hours.

Recovery & Outcomes in Korea

Recovery from prostate cryotherapy is generally less extensive than traditional surgery, but patients should be aware of potential side effects.

• Hospital Stay: Many men can go home the same day or stay overnight for monitoring.
• Post-Op Care: Patients may experience soreness and bruising in the perineal area for several days. A urinary catheter is typically left in place for several weeks to allow the bladder to drain while the treated area recovers.
• Recovery Period: A shorter recovery period compared to radical prostatectomy, with many patients returning to work within one week.
• Oncological Outcomes: Success rates are often measured by PSA stability (no rise over time) and freedom from recurrence. Long-term data for modern cryotherapy techniques are continuously emerging, with reported biochemical disease-free survival rates.
• Side Effects: The most common side effects are erectile dysfunction (which may improve over 12-18 months for some), and urinary incontinence (usually temporary, often less severe than with radical prostatectomy). Other possible side effects include pain/swelling in the scrotum/penis, blood in urine, painful urination, and rare but serious complications like rectourethral fistula (abnormal connection between rectum and urethra) or injury to surrounding tissues.

Korean Guidelines & Practice

Prostate cryotherapy is available in specialized urology and oncology centers in Korea.

• Alternative Treatment: It is considered a viable alternative for selected patients, particularly for those with localized cancer who cannot undergo or choose against radical surgery or radiation, or for salvage therapy after radiation failure.
• Advanced Centers: Major medical centers in Seoul and other cities, such as Samsung Medical Center, Gangnam Severance Hospital, and Asan Medical Center, are equipped to perform cryotherapy.
• Patient Selection: Careful patient selection and thorough counseling regarding benefits, risks, and potential long-term outcomes are crucial.
• National Health Insurance: Coverage for prostate cancer treatments, including cryotherapy, generally falls under Korea's national health insurance for medically indicated conditions, though specific coverage details may vary.

Key Takeaways for Prostate Cryotherapy in Korea

To summarize the essential points about Prostate Cryotherapy in Korea:

• Minimally Invasive: Uses extreme cold (cryoablation) to destroy localized prostate cancer cells.
• Alternative/Salvage Option: Considered for selected patients, especially those unsuitable for surgery/radiation or with recurrent cancer after radiation.
• Targeted Treatment: Performed with precise imaging guidance to protect surrounding tissues.
• Relatively Quick Recovery: Shorter hospital stay and recovery than open surgery, but with potential side effects like erectile dysfunction and temporary incontinence.

We hope this guide clarifies Prostate Cryotherapy in Korea. Always consult a qualified medical professional for personalized advice, diagnosis, and treatment options for prostate cancer.