Cryosurgery For Prostate Cancer

WHAT YOU SHOULD KNOW:

Cryosurgery, also called cryotherapy or cryoablation, is surgery to treat prostate cancer by freezing the prostate cancer cells. The prostate is a male sex gland that helps make semen.


CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

  • Problems may happen during your cryosurgery that may lead to an open prostate surgery. The cold temperature may cause irritation or damage in and around the prostate. Your prostate or other parts of the urinary tract may get injured during surgery. There is also a danger that a blood or nerve supply may be affected. This may cause you to have more problems urinating or having an erection. You may also have swelling, pelvic pain, or a numb feeling down to your legs. Even after cryosurgery, there is a chance that all of the cancers cells may not be killed or that the tumor may come back. You may need to have more cryosurgeries or other procedures.

  • You may get a blood clot in your leg or arm. The clot may travel to your heart or brain and cause life-threatening problems, such as a heart attack or stroke.

  • Without treatment, your prostate cancer may continue to grow and push on other structures near it. You may develop more bowel, sex, or urinary problems. Your cancer may also spread to other parts of your body. Once cancer spreads, it becomes more difficult to treat, and other serious problems may develop. This may lead to more serious and often life-threatening problems, such as heart, liver, or brain damage.

WHILE YOU ARE HERE:

Before your surgery:

  • Informed consent is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

  • An IV is a small tube placed in your vein that is used to give you medicine or liquids.

  • Pre-op care: You may be given medicine right before your procedure or surgery. This medicine may make you feel relaxed and sleepy. You are taken on a stretcher to the room where your procedure or surgery will be done, and then you are moved to a table or bed.

  • Monitoring:

    • Heart monitor: This is also called an ECG or EKG. Sticky pads placed on your skin record your heart's electrical activity.

    • Vital signs: Caregivers will check your blood pressure, heart rate, breathing rate, and temperature. They will also ask about your pain. These vital signs give caregivers information about your current health.

  • Anesthesia:

    • General anesthesia will keep you asleep and free from pain during surgery. Anesthesia may be given through your IV. You may instead breathe it in through a mask or a tube placed down your throat. The tube may cause you to have a sore throat when you wake up.

    • Regional anesthesia: Medicine is injected to numb the body area where the surgery or procedure will be done. You will remain awake during the surgery or procedure.

During your surgery:

  • A warming catheter (tube) is placed in your urethra. This helps protect the urethra and rectum from getting frozen by the cold temperature. Caregivers put an ultrasound probe into your rectum to guide the insertion of the cryoprobes (probes or needles). Small incisions may be made in your perineum if large cryoprobes are used. The perineum is the area between your penis and rectum. Six to 30 cryoprobes will be placed into the prostate through your perineum. These cryoprobes are connected to a machine and computer that allows your caregiver to control the temperature. Sensors are also placed to monitor the temperature of the prostate and the structures around it. A cryogen (freezing liquid chemical) is then passed into the cryoprobes until it fills the prostate.

  • Once the cryogen is inside the prostate, your caregiver may set the temperature to the freezing point or lower. This forms small ice balls that freeze the cancer cells. Your caregiver may then allow the ice to thaw by replacing the liquid with another chemical called helium. This whole process damages and kills the prostate cancer cells. He may repeat the freezing and thawing process to make sure all the cancer cells are killed. When the last thawing is complete, a catheter is inserted into your bladder to help drain your urine. The cryoprobes will be removed and any incisions that were made will be closed and covered with bandages.

After your surgery:

You will be taken to a recovery room until you are fully awake. Caregivers will monitor you closely for any problems. Do not get out of bed until your caregiver says it is okay. When caregivers see that you are okay, you may be taken back to your hospital room. The bandages used to cover your stitches keep the area clean and dry to prevent infection. A caregiver may remove the bandages soon after your surgery to check your perineum. The catheter inserted into your bladder may be left there for 1 to 3 weeks to drain your urine. Ask your caregiver for information on how to take care of your catheter.

  • Activity: You may need to walk around the same day of surgery, or the day after. Movement will help prevent blood clots. You may also be given exercises to do in bed. Do not get out of bed on your own until your caregiver says you can. Talk to caregivers before you get up the first time. They may need to help you stand up safely. When you are able to get up on your own, sit or lie down right away if you feel weak or dizzy. Then press the call light button to let caregivers know you need help.

  • Deep breathing and coughing: This will help decrease your risk for a lung infection after surgery.

    • Hold a pillow tightly against your incision when you cough to help decrease pain. Take a deep breath and hold it for as long as you can. Deep breaths help open your airways. Let the air out and follow with a strong cough. Spit out any mucus you cough up. Repeat the steps 10 times every hour.

    • You may be given an incentive spirometer to help you take deep breaths. Put the plastic piece into your mouth and take a slow, deep breath. Let out your breath and cough. Repeat the steps 10 times every hour.

  • You will be able to drink liquids and eat certain foods once your stomach function returns after surgery. You may be given ice chips at first. Then you will get liquids such as water, broth, juice, and clear soft drinks. If your stomach does not become upset, you may then be given soft foods, such as ice cream and applesauce. Once you can eat soft foods easily, you may slowly begin to eat solid foods.

  • A Foley catheter is a tube put into your bladder to drain urine into a bag. Keep the bag below your waist. This will prevent urine from flowing back into your bladder and causing an infection or other problems. Also, keep the tube free of kinks so the urine will drain properly. Do not pull on the catheter. This can cause pain and bleeding, and may cause the catheter to come out. Caregivers will remove the catheter as soon as possible to help prevent infection.

  • Intake and output: Caregivers will keep track of the amount of liquid you are getting. They also may need to know how much you are urinating. Ask how much liquid you should drink each day. Ask caregivers if they need to measure or collect your urine.

  • Medicines:

    • Antibiotics: This medicine is given to help treat or prevent an infection caused by bacteria.

    • Antinausea medicine: This medicine may be given to calm your stomach and to help prevent vomiting.

    • Hormone medicines: These medicines are needed to block male hormones, such as testosterone, that make the tumor bigger. Hormone medicines help shrink the tumor and prevent further problems. Ask your caregiver for more information about these medicines.

    • Pain medicine: Caregivers may give you medicine to take away or decrease your pain.

      • Do not wait until the pain is severe to ask for your medicine. Tell caregivers if your pain does not decrease. The medicine may not work as well at controlling your pain if you wait too long to take it.

      • Pain medicine can make you dizzy or sleepy. Prevent falls by calling a caregiver when you want to get out of bed or if you need help.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Cryosurgery For Prostate Cancer (Inpatient Care)

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