What Should Cancer Patients Know About Cryoablation?

Physicians have long recognized the value of cold for reducing inflammation and relieving pain. Over time, they found that it is also an effective way to destroy specific tissues in a targeted way, a process called cryosurgery or cryoablation. Cryosurgery has been used since the 19^th century to treat a variety of conditions, including warts, shingles, boils, and tumors. Today, cryoablation shows growing potential for the successful treatment of a variety of cancers as well as precancerous conditions.

How does cryoablation work?

During cryoablation, the doctor uses an extremely cold substance, such as liquid nitrogen or compressed argon gas, to destroy problem tissues. Examples include atypical moles, precancerous cervical cells, and some types of cancerous tumors. Depending on the tissue to be treated, cryoablation may be done topically or surgically, either percutaneously (through a small hole in the body) or via an open incision.

The doctor uses imaging technology, such as ultrasound, CT, or MRI to locate the problem area. They then apply the freezing substance with a narrow, hollow applicator called a cryoprobe to destroy the tissue. The procedure may take a few minutes to a few hours, depending on the type of cryosurgery performed. Patients undergoing topical cryosurgery can often resume normal activities immediately following the procedure, while those who have cryoablation via an open incision may need to restrict activity for a week or more.

What are the advantages of cryoablation over traditional surgery?

Generally speaking, cryoablation is associated with faster recovery times, less scarring, and fewer complications than open surgery to cut out problematic tissues. It can also be performed at a lower cost to patients and insurers.

Are there risks associated with cryoablation?

Like any medical procedure, cryoablation has risks. Anytime the skin is opened, there is potential for bleeding and/or infection. If anesthesia is needed, you must also account for its inherent risks. Nerve damage can result from freezing, and other damage may occur due to proximity of certain structures to the area being treated (for example, to the lungs, bowel, or bile ducts). If you’re considering cryoablation, make sure to discuss all benefits and risks associated with your specific procedure with your doctor.

For more information on what you can expect during cryoablation treatment, visit our website.

What’s new in cryoablation?

Some of the most exciting research in cryoablation today is taking place in the treatment of breast cancer. In 2014, the ICE3 trial became the first large-scale, multi-center trial to assess cryoablation as a primary treatment for breast cancer. It included 194 women aged 55–94 who had been diagnosed with invasive ductal carcinoma measuring 1.5 centimeters or smaller.

Doctors used an approximately eight-minute freeze-thaw-freeze cycle to create ice balls around the tumors, killing the tissue encased within. Mammography follow-up was performed at six and twelve months, then annually for up to five years after the procedure. Out of the 194 patients treated, 190 showed no recurrence during follow-up. Dr. Kenneth Tomkovich, sharing results of the ICE 3 study, called the 98% success rate “pretty amazing.” He expressed the hope that within three to five years, cryoablation will become a common treatment for breast cancer, providing huge benefits for patients.

Resources

Cooper SM, Dawber RPR. The History of Cryosurgery. J R Soc Med. 2001 Apr; 94(4): 196–201. https://dx.doi.org/10.1177/014107680109400416.

Cryoablation. ClevelandClinic.org. Accessed February 16, 2022. Updated July 29, 2021. https://my.clevelandclinic.org/health/treatments/16903-cryoablation.

Cryotherapy. Radiologyinfo.org. Accessed February 16, 2022. Updated June 15, 2020. https://www.radiologyinfo.org/en/info/cryo - 98907d603ed149c0a9cd9b642da9932d.

Fine RE, Gilmore RC, Dietz JR, et al. Cryoablation Without Excision for Low-Risk Early-Stage Breast Cancer: 3-Year Interim Analysis of Ipsilateral Breast Tumor Recurrence in the ICE3 Trial. Ann Surg Oncol 2021;28, 5525–5534. https://link.springer.com/article/10.1245/s10434-021-10501-4.

Silverberg M. Promising Results Using Cryoablation as a Primary Treatment for Breast Cancer. RSNA.org. Published December 1, 2021. Accessed February 16, 2022. https://dailybulletin.rsna.org/db21/index.cfm?pg=21wed10.