is a Safe, Efficacious Treatment for Prostate Cancer
During its 40-year evolution,
cryoablation has overcome many technological hurdles. The physics
were always there, but the technology itself was not adequate. Today,
physicians remain appropriately cautious due to cryosurgery's early
legacy of severe complications. Nonetheless, the technology has
made enormous strides since its latest reemergence in 1992: improved
ultrasound imaging; an FDA-approved urethral warmer; and, argon
gas - a safer, more controllable cryogen - has replaced liquid nitrogen.
The literature demonstrates that cryoablation of the prostate is
as safe and efficacious as brachytherapy in selected patients.
One may or may not recall
that as recently as 1988, many outspoken professionals in the medical
community denied that seed implants would find acceptance. Time
has proven them wrong. In much the same manner, the skeptics are
now voicing their concerns about cryoablation. I predict that in
a short time, these naysayers of cryosurgery will also be convinced
that this novel therapy represents a clear medical and technological
reimbursement for cryosurgery of the prostate is only slightly less
favorable than payments for radical prostatectomy. In the future,
payors may begin to realize that cryosurgery can be a more cost
effective means of treating many prostate cancers and contributes
substantially to the long-term health and satisfaction of patients.
Both brachytherapy and cryoablation provide meaningful alternatives
to radical prostatectomy among older patients. In addition, cryosurgery
is the treatment of choice when radiation treatment fails.
Cryoablation of the prostate
is a targeted, minimally invasive surgical technique - after training,
the urologist can safely perform cryosurgery with morbidity comparable
to brachytherapy. In essence, the "future" for cryoablation
of the prostate is "now." Every urologist should be excited
about cryosurgery and its potential as urocentric technology. Moreover,
all urologists should have access to both brachytherapy and cryoablation;
these two state-of-the-art technologies currently represent the
least invasive treatment options for localized prostate cancer.
Patients who meet the selection criteria deserve these options,
and urologists have a growing obligation to discuss these important
therapies with their patients - many of whom will have already read
about them on the Internet.
Robert B. Barnett,
Executive Chairman & Chief Medical Officer
Dr. Barnett is the founder
of Urology Healthcare Group / UroTech and presides as the Executive
Chairman and Chief Medical Officer. He is a practicing physician
with Urology Associates, a Tennessee professional corporation comprised
of 25 urologists. Dr. Barnett has practiced with Urology Associates
since 1974. He is a 1969 Vanderbilt University Medical School graduate.
Dr. Barnett interned at Vanderbilt University, and he completed
his residency at the University of Michigan. Dr. Barnett is Board
Certified in Urology and is a Fellow of the American College of