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Cryotherapy

Cryotherapy is a freezing procedure that destroys abnormal cells by the extreme cold produced by liquid nitrogen (or argon gas). In about six or eight weeks, healthy cells will replace those that were frozen and destroyed. The procedure should be scheduled in the first two weeks after your period starts. Cervical cryosurgery or cryotherapy is a gynecological treatment that freezes a section of the cervix. Cryosurgery of the cervix is most often done to destroy abnormal cervical cells that show changes that may lead to cancer. These changes are called precancerous cells (cervical dysplasia). Cryosurgery is done only after a colposcopy confirms the presence of abnormal cervical cells. Cyrotherapy is also used for the treatment of cervicitis or inflammation of the cervix. Cryosurgery is not a treatment for cervical cancer.

Cryosurgery is widely available in gynecologists' offices for the treatment of cervical neoplasias. A limited number of hospitals and cancer centers throughout the country currently have skilled doctors and the necessary technology to perform cryosurgery for other noncancerous, precancerous, and cancerous conditions.

Conditions:

  • Cryosurgery may be used to treat primary liver cancer. It is mainly used if surgery is impossible due to other medical conditions. In some cases, chemotherapy and/or radiation therapy may be given before or after cryosurgery. Cryosurgery in the liver may cause damage to the bile ducts and/or major blood vessels, which can lead to hemorrhage or infection.
  • Cryosurgery can be used to treat men at early-stage prostate cancer. It is less well established than standard prostatectomy and various types of radiation therapy. Long-term outcomes are not known. Cryosurgery is not used to treat prostate cancer that has spread outside the gland, or to distant parts of the body.
  • Cryosurgery is also used to treat some types of low-grade cancerous and noncancerous tumors of the bone. It may reduce the risk of joint damage when compared with more extensive surgery, and help lessen the need for amputation. The treatment is also used to treat AIDS-related Kaposi sarcoma when the skin lesions are small and localized.
  • Cryosurgery can be an effective treatment for Retinoblastoma, a childhood cancer that affects the retina of the eye. It is most effective when the tumor is small and localized to certain parts of the retina.
  • Early-stage skin cancers (both basal cell and squamous cell carcinomas) and precancerous skin growths known as actinic keratosis.
  • Precancerous conditions of the cervix known as cervical intraepithelial neoplasia. These abnormal cell changes in the cervix can develop into cervical cancer. Cryosurgery is an adequate treatment for most cases of cervical dysplasia destroying all of the abnormal cervical tissue. But when the cervical changes are located in the upper section of the cervix a cone biopsy, instead of cryotherapy, is prescribed.
  • Cryosurgery is also used to treat tumors in the bone.

Procedure:

A hollow instrument uses special instruments called cryo probes, are inserted into your vagina until they firmly cover the abnormal areas of cervical tissue and then liquid nitrogen or argon gas is circulated through them at a temperature of approximately -50 degrees Celsius. This causes the metal cryo probes to freeze and destroy superficial abnormal cervical tissue. Ultrasound or MRI guides the cryoprobe and monitor the freezing of the cells, to limit the damage to nearby healthy tissue. A ball of ice crystals forms around the probe, freezing nearby cells. Sometimes more than one probe is used to deliver the liquid nitrogen to various parts of the tumor. The probes may be put into the tumor during surgery on other parts of the body or through the skin (percutaneously). After cryosurgery, the frozen tissue thaws and is either naturally absorbed by the body in the case of internal tumors, or it dissolves and forms a scab in the case of external tumors. For external tumors, liquid nitrogen is applied directly to the cancer cells with a cotton swab or spraying device. The most effective treatment result is obtained by freezing for three minutes, letting the cervix thaw, and repeating the treatment for three more minutes.

Post surgery care:

The individual can go back to most normal activities the day after cryosurgery; however, there are a few precautions to be taken for the first two to three weeks following treatment: It is normal to experience a watery discharge for the first few weeks which is caused by the sloughing of dead cervical tissue. Do not insert anything into the vagina for at least two to three weeks. This means no tampons, no douches, and no sexual intercourse.

Complications: Cryosurgery is relatively risk-free, producing fewer complications than any other gynecological procedure. After cryosurgery Pap tests will be advised every three to six months for a period of time. Although the side effects may be less severe than those associated with surgery or radiation therapy, cryosurgery do possess side effects. These effects depend on the location of the tumor. Cryosurgery for cervical intraepithelial neoplasia can cause cramping, pain, or bleeding but may not affect a woman's fertility. When there is high fever, vaginal bleeding, foul discharge or severe pain you can consult the doctor. Foul discharge may possibly an outcome of an infection.

Cryosurgery for skin cancer may cause scarring and swelling; if nerves are damaged, loss of sensation may occur, and, rarely, it may cause a loss of pigmentation and loss of hair in the treated area.

Cryosurgery for the prostate gland can cause side effects. These side effects may occur more often in men who have had radiation to the prostate. Cryosurgery may obstruct urine flow or cause incontinence. Mostly these side effects are temporary. Many men become impotent or it can cause injury to the rectum.

Advantages of cryosurgery: Cryosurgery offers advantages over other methods of cancer treatment. It is less invasive than surgery, involving only a small incision or insertion of the cryoprobe through the skin. Pain, bleeding, and other complications due to surgery are minimized. Cryosurgery is less expensive and requires shorter recovery time and a shorter hospital stay. Cryosurgery may even do under local anesthesia. Since cryosurgical treatment focuses on a specific area, the destruction of nearby healthy tissue is minimal. The treatment can be safely repeated and may be used along with surgery, chemotherapy, hormone therapy, and radiation. Cryosurgery can be used for patients who are not good candidates for conventional surgery due to age or other medical conditions or can be used in cancers that do not respond to standard treatments.

Disadvantages of cryosurgery: Uncertainty regarding the long-term effectiveness is the major disadvantage of cryosurgery. Cryosurgery may be effective in treating tumors which are seen with imaging tests, but it can miss microscopic cancer spread. Furthermore, insurance coverage issues may arise because the effectiveness of the technique is under investigation.

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