Cryotherapy
Cryotherapy is a cancer treatment that kills cells by exposing them to extreme cold. Because living tissues cannot survive in drastically cold conditions, radiologists can use this therapy to induce hypothermia and kill solid tumors such as mesothelioma. This treatment, also known as cryoablation, is often used along with other types of treatment to eliminate all of the cancer cells in a patient’s body.
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Cryotherapy is widely used to treat a number of cancers, but its efficiency with mesothelioma is still being tested. Mesothelioma patients can most easily access the treatment through clinical trials, but they may also receive it under a doctor’s discretion at facilities that offer it. Some hospitals may offer this therapy to mesothelioma patients before or after surgery, on a palliative or curative basis. Cryotherapy is effective in relieving the pain associated with mesothelioma because it can shrink tumors that press against the lungs and other organs, and it may also offer long-term management for local recurrences of the cancer.
Unlike other aggressive mesothelioma treatments, this therapy causes very few side effects. Most patients can leave the hospital a day after it is performed. Healthy tissue may eventually regenerate in the treated area.
What is it?
During this therapy, probes are inserted into solid tumors and a cryotherapeutic agent such as liquid nitrogen is injected into the tissue. This process traumatizes the tissue and interrupts blood flow to the area, killing the cancerous cells. Cryotherapy allows the radiologist to selectively destroy the cancerous tissue while leaving most healthy tissues undamaged.
It is performed in a radiology room rather than an operating room and takes approximately 30 minutes. The procedure is administered by a radiologist using a long, thin wand called a cryoprobe. Using video imaging, the radiologist will insert the cryoprobe through a small incision and position it on the tumor. Once the cryoprobe is in place, the tumor is injected with nitrogen or argon. If necessary, the radiologist will thaw and re-freeze the tumor several times during one appointment. The cancerous cells that die are naturally expelled from the body.
Uses with Mesothelioma
Cryotherapy is typically used in mesothelioma patients who have developed new tumors after undergoing surgery for the disease. Even though mesothelioma surgeons strive to remove the entire visible tumor, microscopic cancerous cells can be left behind and tumors may grow back months or years after an operation. Because most mesothelioma surgeries are usually not performed twice (harsh effects on the body make two surgeries disadvantageous), some patients undergo cryotherapy to remove these recurrent nodules.
The treatment [cryotherapy] has made day-to-day life easier…I've got something else I can do to keep me alive now.
-Jan Egerton
Cryotherapy Patient at UCLA
Curative cryotherapy is often reserved for mesothelioma patients who only have one or two new visible tumors. Some oncologists believe that when mesothelioma has spread to more than two locations, it is highly likely that the patient has many other microscopic metastases that would prevent this therapy from effectively curing the cancer. However, palliative cryotherapy may be administered to patients with excessively large tumors that are causing pain or pressure on the patient's organs. A 2005 study presented at the Interventional Oncology Symposium found that 17 of 19 cancer patients — including three who had been diagnosed with mesothelioma — reported pain relief benefits from the procedure.
Many hospitals do not yet offer this treatment specifically for mesothelioma, but some facilities do provide it to mesothelioma patients upon the radiologists' approval. The University of California Los Angeles is one such facility that has treated mesothelioma patients with cryotherapy. Renowned mesothelioma oncologist Dr. Robert Cameron, M.D. is investigating the procedure for mesothelioma and promotes cryotherapy research at the Pacific Mesothelioma Center.
Benefits and Complications
Cryotherapy is a safe form of mesothelioma treatment. It is less invasive than open surgery and requires a much shorter recovery time. Most patients are able to resume their normal schedules as soon as 24 hours after the procedure is completed. It can be performed under anesthesia to reduce the pain experienced during the treatment.
Because treatment is delivered directly to the tumors, there is little risk that the healthy surrounding tissues will be damaged. One study found that 81 percent of patients with diseases such as lung cancer, mesothelioma and colorectal cancer were treated without any damage to adjacent tissues or organs. Only two patients experienced numbness in their lower extremities for one week after the procedure. In very rare cases, patients may experience lower extremity paresthesia, a tingling sensation commonly referred to as "pins and needles."
Cryotherapy performed on a pleural mesothelioma patient may pose the risk of a collapsed lung or a fluid effusion near the lung, but these complications are rare. For many patients, the benefits exceed the low risks associated with the procedure.
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