When it comes to battling cancer, innovation and evolution in medical technology play a vital role in improving treatment outcomes and patients' quality of life. One such innovation that has been making strides in recent years is cryotherapy for kidney cancer. Cryotherapy, also known as freezing therapy, cryosurgery, or cryoablation, is a cutting-edge procedure that harnesses the power of extreme cold to combat cancer cells effectively. This revolutionary technique is particularly promising for treating small, early-stage kidney cancers.

How Does Cryotherapy Work?

Cryotherapy is a minimally invasive procedure that involves the precise application of extreme cold to cancerous tissue. Here's how it works: small needles are inserted into the cancerous area within the kidney. Through these needles, a cold gas is administered, effectively freezing and destroying the cancer cells. The extreme cold temperatures essentially act as a lethal weapon against the cancer, causing the cells to die off.

This procedure can be conducted through the skin into the kidney, a method known as percutaneous cryotherapy, or as laparoscopic surgery, often referred to as laparoscopic cryotherapy.

Indications for Cryotherapy

Cryotherapy is typically reserved for patients with small, early-stage kidney cancers, specifically those tumors that are less than 4 centimeters in size. The primary goal of cryotherapy in these cases is to eradicate the cancer without the need to surgically remove part or all of the kidney, preserving the patient's kidney function and overall quality of life.

In certain situations, cryotherapy may also be an option for recurrent kidney cancer or when the initial treatment fails to eliminate all cancer cells. The decision to proceed with cryotherapy is typically made by a specialized urological cancer multidisciplinary team and is most readily available in specialized hospitals. Your healthcare provider will provide you with a comprehensive explanation of the potential benefits and risks associated with this treatment.

Preparing for Cryotherapy

Before undergoing cryotherapy, patients will receive thorough guidance and preparation from their healthcare providers. This includes detailed explanations of the procedure and an opportunity to address any questions or concerns. Additionally, patients may need to discontinue certain medications, especially blood-thinning agents, in preparation for the treatment. There will also be specific instructions regarding fasting before the procedure.

The Cryotherapy Procedure

The actual cryotherapy procedure can take two forms: percutaneous cryotherapy and laparoscopic cryotherapy. In percutaneous cryotherapy, the patient may receive general anesthesia, ensuring they remain deeply asleep and do not experience any discomfort. Alternatively, a local anesthetic may be applied to numb the treatment area. Patients under local anesthesia may also receive sedation to help them relax during the procedure. A small tube (cannula) may be inserted into a vein for these cases. To guide the cryotherapy, the doctor employs imaging techniques such as CT or ultrasound scans, enhancing precision and accuracy. After the procedure, a simple dressing is applied over the incisions, typically eliminating the need for stitches.

Laparoscopic cryotherapy, performed under general anesthesia, involves creating small incisions in the patient's abdomen. A laparoscope equipped with a camera is introduced through one of these incisions to visualize the kidney and guide the placement of cryotherapy needles. Depending on the situation, stitches may be needed to close the incisions, and your healthcare provider will provide post-operative care instructions.

Recovery and Potential Side Effects

Following cryotherapy, patients are monitored closely to ensure their recovery progresses smoothly. Most patients can expect to stay in bed for approximately four hours after the procedure. After an initial recovery period, patients are typically allowed to eat and drink. Pain relief medication may be prescribed to manage any discomfort, and in some cases, blood-thinning medication may be administered by injection. The good news is that most patients can return home on the same day or the following day after the procedure, making cryotherapy a minimally disruptive treatment option.

Potential Side Effects and Complications

While cryotherapy is generally well-tolerated, like any medical procedure, it carries some potential side effects and complications. Common side effects may include localized pain after the anesthesia wears off, which can be managed with painkillers at home. Some patients might experience a temporary burning or prickling sensation in the treated area, or even a temporary weakness or loss of sensation in the flank region due to minor nerve damage.

It's worth noting that major complications are rare in individuals undergoing cryotherapy for kidney cancer. These infrequent complications could include injury to nearby organs, bleeding requiring a blood transfusion, or a minor urine leak around the kidney. Nonetheless, healthcare teams closely monitor patients during and after treatment, providing clear guidance on post-procedure care and whom to contact in the event of any concerns.

In the ever-evolving landscape of cancer treatment, cryotherapy for kidney cancer shines as an innovative and effective option, particularly for patients with small, early-stage tumors. Its minimally invasive nature, rapid recovery times, and the potential to preserve kidney function make it a promising addition to the arsenal of treatments available to those facing this challenging diagnosis. As medical science continues to advance, cryotherapy stands as a beacon of hope for kidney cancer patients, offering the possibility of a brighter and cancer-free future.

References

(1)    European Association of Urology (EAU). (2023). EAU guidelines on renal cell carcinoma.

(2)    National Institute for Health and Care Excellence (NICE). (2011, July). Percutaneous cryotherapy for renal cancer.

(3)    National Institute for Health and Care Excellence (NICE). (2011). Laparoscopic cryotherapy for renal cancer.

(4)    Seager, M., et al. (2021). Renal cryoablation – a practical guide for interventional radiologists. The British Journal of Radiology, 94(1118).

(5)    Zargar, H., et al. (2016). Cryoablation for Small Renal Masses: Selection Criteria, Complications, and Functional and Oncologic Results. European Urology, 69(1), 116-128.

 Image: One of the probes used for cryosurgery. Credit: Cryosurgery.uk

Source: Cancer Research UK is a registered charity in England and Wales (1089464), Scotland (SC041666), the Isle of Man (1103) and Jersey (247).