Dr. Gonzalo Sanz Interview

The new generation of cryosurgery in the treatment of prostate cancer

Dr. Gonzalo Sanz welcomes us into his consulting clinic to explain to us the atributes of this type of surgery, which has served to improve in a spectacular way many patients who have placed their trust in this brilliant development of modern medicine, with spectacular advantages.

Dr. Sanz, How could we define cryosurgery regarding prostate cancer?.

Prostate cryosurgery is the cellular process that involves controlled freezing of the prostate gland to destroy cancer cells. The damage caused by freezing occurs at several levels: molecular, cellular, and the entire structure of the tissue.

And how is this surgical procedure performed?

Cryosurgery is a surgical procedure that is performed in the operating room with the patient anesthetized, the technique consists of inserting an ultrasound probe through the rectum to obtain an accurate picture of the prostate. Under continuous monitoring by ultrasound images, cryo ablation probes are placed in whose purpose is to freeze the prostate and destroy all tumour cells due to the extreme cold obtained, this sequence allows continuous monitoring and placed with thermocouples or sensors located in the most sensitive areas (rectum, bladder, urethra), we obtain an important information on the temperature of these areas, the purpose of this complex process is to maintain full control of the treatment area without affecting the important organs adjacent to the prostate, the most significant advantage of this new technique compared with the earlier used in the 90s, is the use of argon gas for freezing and helium gas for rapid heating (the temperature of the probe can go from -186 º C to 40 ° C in 30 seconds.) During cryosurgery is applied, normally, two freezing cycles.

What are the advantages of this surgical technique over the others?

Usually a minimum hospital stay between 12 and 24 hours without need for blood transfusions, rapid recovery of normal activity without entry into the ICU, lower morbidity, with incidence of urinary incontinence less than 1%, high quality of life index without the undesirable radiation effects in the short and long term of radiotherapy and brachytherapy and the possibility of repeating surgery if some cancer cells were to persist without additional risk to the patient nor complicated surgeries. What is also very important, it can be used as a salvage therapy for other technique failures such as radiotherapy-brachytherapy.

Which patients can access this type of surgery?

Patients with high and medium risk of periprostatic infiltration with 2 or 3 of the following factors (any age and general condition) with PSA greater than or equal to 10, Gleason greater or = 7, Stage T2b-T3a, patients with cancer confined to the gland with low risk of extracapsular extension with stage T1b-T2a, PSA

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