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Any Experiences with Focal Cryotherapy

DougS
Posts: 11
Joined: Dec 2011

I began my journey with PC being diagnosed in Feb/2008 with GL (4+5), psa 34, T3a with bulging of the left seminal vesicles observable.  Radiation was completed in Aug/2008 (73.8 gy) and luprone shots completed in April, 2011.  The psa slowly rose from a low of 0.21 with a DT finally reaching 6-7 months.

After CT/MR fear heme imaging, F18 Pet Bone scans, and C-11 acetate Pet Scans it was discovered the PC was still located within the left side of the prostate As well as within the seminal vesicles.  If additional biopsies confirm this, I have the option of salvage focal therapy and ruling out salvage surgery.  The potential benefits of cryotherapy seems to out weigh the potential side effects from surgery.

Good or bad experiences with salvage cryotherapy?  

Drahmed
Posts: 2
Joined: Jan 2013

I have done and continue to do salvage CRYO after radiation therapy but in your case I would not rule out salvage RALP if you are healthy and under 70 yrs of age.  Your disease is high grade and CRYO may not be able to get it all. If you do decide to do CRYO I would recommend you start ADT and stay on it for three years. Good luck!

 

mrspjd
Posts: 693
Joined: Apr 2010
Hi Doug,
 
I wonder if you've looked at high dose rate brachytherapy (HDRB) as another viable salvage tx option to consider. In addition to being an effective primary tx for PCa with excellent long term outcomes, studies have found that HDRB is also an effective salvage modality for recurrent PCa after RT and has relatively few long-term toxicities. HDRB was one of 3 primary txs (combined with ADT3 & IG/IMRT) that my husband chose to aggressively treat his T3 stage, G7, locally advanced, high volume PCa. Almost three years after completing txs PJD is healthy, feels great & continues in remission with no evidence of disease (NED) progression. 
 
Here are links to two studies that you may find interesting. (You can research other similar studies on PubMed.)
 
"Salvage HDR brachytherapy for recurrent prostate cancer after previous definitive radiation therapy: 5-year outcomes."
 
"Feasibility of high-dose-rate brachytherapy salvage for local prostate cancer recurrence after radiotherapy: the University of California-San Francisco experience."
 
As with any primary or salvage PCa tx, it is imperative to select a knowledgeable, experienced & skilled specialist in his/her field of medical expertise, be it cryo, RP, or HDRB. 
 
Doug, no matter which salvage tx you decide is right for you, I wish you all the best for a successful outcome as you go forward. 
 
mrs pjd 
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