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Cryotherapy is a treatment that may be used for mesothelioma, either as an alternative or an adjuvant to the three main treatments of chemotherapy, surgery, and radiation therapy. The treatment freezes cancer cells to death. Like most living cells, cancer cells cannot survive temperatures that are too cold, so by directing liquid nitrogen or something similarly cold at the tumor, it can be frozen and destroyed.

There are many types of cancer that have been targeted in studies and in practice with cryotherapy. Research into its effectiveness in treating mesothelioma is still ongoing, but some patients have already benefitted from it. Cryotherapy has also been shown to be useful in treating lung cancer in certain patients, including those with cancer caused by asbestos exposure.

What is Cryotherapy?

Cryotherapy, also known as cryosurgery, is a treatment that involves the use of something very cold to damage and destroy abnormal cells and tissue, like cancer cells and tumors. The cold substance is typically liquid nitrogen, which reaches temperatures as low as negative 300 degrees Fahrenheit and even colder. Argon gas may also be used in the procedure in place of liquid nitrogen.

Cryotherapy can be used to freeze and kill abnormal growths on the skin, like skin cancers, simply by applying liquid nitrogen to the tissue with a swab. However, for most cancers the tumors are inside the body, so surgery must be used to reach the tumor and to apply liquid nitrogen or argon gas to it.

Cryotherapy Use in Mesothelioma

Cryotherapy is already used in the treatment of several types of cancers, including skin, kidney, prostate, liver, and lung cancer, as well as some types of eye cancers. Some patients with mesothelioma have been treated with cryotherapy, but this is not yet common. Research continues into how cryotherapy can be used fight mesothelioma and how effective it may be.

One important way in which cryotherapy may be able to help patients with mesothelioma is by providing a less invasive type of treatment after major surgery. Surgery to remove tumors in the chest cavity, including such radical surgeries as extrapleural pneumonectomy, are often effective, but in many cases the tumors eventually return. It is not feasible to do surgery again, because this surgery is so invasive and risky, so minor surgery with cryotherapy to destroy tumors that regrow may be an option.

Cryotherapy may also be useful for mesothelioma patients who have little hope that any treatment will be curative, but who could benefit from palliative treatment. If surgery is too risky, cryotherapy, which involves less invasive surgery, can help reduce tumor masses and provide a patient with relief from symptoms and a better quality of life as a result.

Not many hospitals or medical centers currently offer cryotherapy for mesothelioma patients, but it may be possible to have the treatment on request. Many radiology departments are equipped to perform cryotherapy; it simply is not yet part of standard mesothelioma treatment. Some specialty centers treating mesothelioma may provide the service for patients.

The Procedure

For cryotherapy the procedure is a little bit different depending on the patient and the location of the tumor. In most cases the medical team will use an MRI or ultrasound image of the patient’s tumor to guide the procedure. An instrument called a cryoprobe, a thin, hollow tube, is inserted through an incision in the patient’s skin. With the help of the images, it is guided to the tumor and then liquid nitrogen can be delivered to the tumor.

The images guiding the probe not only help to target the tumor but also help limit damage to nearby, healthy tissue. The procedure can be done in a minimally invasive way, with only a small incision, or it can be done while the patient is undergoing surgery. Multiple probes may be used during the treatment. The frozen tumor is not removed, but the cells die and are reabsorbed by the body. Cryotherapy is typically performed in the radiology department rather than in a surgical environment.

Benefits of Cryotherapy

There are some benefits of cryotherapy that make it a useful treatment for some patients, although it may not be the right choice for everyone. As compared to surgery it is less invasive. For a patient that is not a good candidate for surgery because of health reasons, cryotherapy may be a valid alternative. It may not even require general anesthesia, the incision is small, recovery time is short, and there are fewer risks of complications or side effects than with surgical removal of tumors.

Another advantage of cryotherapy over other types of treatment, such as chemotherapy and radiation therapy is that it targets the tumor precisely. The doctor performing the procedure is able to direct the liquid nitrogen to the tumor and avoid healthy tissue surrounding it. In many ways cryotherapy is safer than chemotherapy, radiation, and surgery, but it may be limited in how it treats the cancer when used alone.

Risks and Complications

Cryotherapy is relatively safe, but there are some limitations and possibilities of side effects. If the liquid nitrogen is not guided correctly to the tumor it can damage healthy tissue inside the body. The treatment will freeze and damage healthy cells as much as cancer cells, so it needs to be directed with precision to avoid this. Other potential side effects are relatively minor and bleeding or infection at the incision site or pain, which is temporary and can be controlled with painkillers.

Cryotherapy has been used successfully to treat lung cancers, but this has higher risks of complications. In one study, for instance, 12 percent of the patients experienced a collapsed lung. Some patients experienced respiratory distress, with a few dying from respiratory failure, atrial fibrillation, and a cough with blood.  Most patients did not have serious side effects or experienced complications that resolved soon after the procedure.

Cryotherapy is an exciting new and emerging treatment that may become more standard in treating patients with mesothelioma. With few side effects, lower risks of complications, and as it is minimally invasive, this strategy may become more important as research continues to find out if it is as effective, or more effective, than other treatments.

Page edited by Dave Foster

Dave has been a mesothelioma Patient Advocate for over 10 years. He consistently attends all major national and international mesothelioma meetings. In doing so, he is able to stay on top of the latest treatments, clinical trials, and research results. He also personally meets with mesothelioma patients and their families and connects them with the best medical specialists and legal representatives available.

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