Andrew Price, MD, is an interventional radiologist at Banner MD Anderson Cancer Center.
Question: What is cryoablation and how is it used to treat cancer?
Answer: Cryoablation refers to procedures that use extremely cold temperature to destroy tissue. It reflects a modern advancement of an old technology, as cold has been used to destroy tumor cells for more than 100 years.
Initially used to ablate skin lesions, the applications of cryoablation later expanded to treatment for kidney and prostate cancer. It can now be used to destroy tumors throughout the body, including the liver and lungs, while also being used in palliative care for painful bone metastases.
Cryoablation was originally possible only through open or laparoscopic surgery; however, advances in technology now enable it to be done percutaneously (without incisions) using image guidance. Through ultrasound, CT, or MRI guidance, cryo needles are precisely placed within a tumor. Pressurized Argon gas is then passed through these hollow-tipped needles. Extreme cold is produced as the gas expands in the needle tip, leading to the formation of an expanding ice ball around the tip of the needle. The ice ball reaches a temperature well below minus 40 degrees Celsius, which is lethal to cells. Imaging of the expanding ice ball during the procedure enables physicians to ensure a tumor is fully engulfed by ice while sparing as much normal, healthy tissue as possible. After thawing, the destroyed tumor tissue is slowly absorbed by the body over time.
Percutaneous cryoablation is minimally invasive and associated with lower rates of complication. As ice is a natural anesthetic, it is less painful than other treatment options and can be performed on an outpatient basis using only intravenous sedation.
With impressive intermediate-term outcomes, cryoablation is gaining increasing acceptance as an effective alternative to traditional surgery and a viable treatment option for those who are poor surgical candidates. However, not all patients are candidates for cryoablation. Discuss with your physician whether cryoablation may be an option for you.