At the gynecologist, cryosurgery is most commonly used to treat precancerous abnormal cells in the cervix, also called neoplasia. Surgeons are also using the technique internally, inserting a cryoprobe to freeze early stage cancerous tumors in the liver, prostate, the retina of the eye and bones. The probe is placed directly in contact with the internal tumor, guided by ultrasound or MRI to minimize any damage to surrounding healthy tissue.
Dr. Janice Werbinski, staff physician at Borgess Women's Health in Kalamazoo, currently utilizes cryosurgery in her office. “My standard for years for treating early cervical lesions is cryocautery, but it is not appropriate for cancers that have invaded into the deeper tissues, or far up the cervical canal,” she notes. “If there is a slight precancerous change, the hope is that cryocautery will destroy any abnormal cells growing on the cervix. It's done on an outpatient basis in the office and you do not usually need an anesthetic. That makes it a convenient, low cost way to treat abnormal pap smears. After healing for three months, a repeat pap smear usually comes back normal.” Dr. Werbinski adds that she also applies the freezing technique to condyloma, or genital warts.
In the arena of women's health concerns, Dr. Werbinski notes that cryoablation is now under consideration for treating abnormal bleeding or heavy menstrual periods. Cryoablation freezes out the endometrium lining of the uterus, which is also often done using heat (bipolar cautery) to reduce the internal layer. Over the past 25 years of her practice, Dr. Werbinski has seen cryosurgical applications expand. “There is research being done on its effectiveness on breast cancer, but the jury is still out,” she says. ““It's an old tool for which they're finding new uses. My field is changing so rapidly that we seem to have a new modality for treatment of uterine fibroids and heavy menstrual bleeding twice a year,” Dr. Werbinski states. “Each has its own advantages and some need a form of sedation before the procedure. Cost may end up being the determining factor for many patients, as long as the effectiveness and safety is there.”
As with any surgery, the deep freeze method can have side effects, although it's acknowledged that in patients with cancer, the complications may be less severe than those from conventional surgery or radiation therapy. Freezing might miss some microscopic cancer cells, allowing another tumor to form. When used on the skin, it can cause some scarring, hair loss or discoloration where the wart or lesion has been removed.
In the near future, cryosurgery may also be an effective tool for the treatment of other cancers, including breast, colon and kidney cancer. Those uses are currently undergoing the extensive research evaluations necessary for approval. The benefits of using cryosurgery for cancer treatment? It's less invasive, can often be done on an outpatient basis, with faster recovery times. In the war on cancer, cryosurgery may end up being another weapon in the medical community's growing arsenal of hormone therapy, traditional surgery, chemotherapy and radiation.
Talk to your doctor about cryosurgery or contact the Breast and Cervical Cancer Control Program, part of Kalamazoo County's Human Services department. For more information. Call 269-373-5383.
