Cryotherapy for Mesothelioma
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Cryotherapy for mesothelioma can be used either as an alternative or adjuvant to the three main treatments of chemotherapy, surgery, and radiation therapy. Cryotherapy freezes and destroys cancer cells using liquid nitrogen or a substance of similar temperature at the tumor site.[1] Research into the effectiveness of treating mesothelioma with cryotherapy is ongoing but promising.
What Is Cryotherapy?
Cryotherapy, also known as cryosurgery, is a treatment that uses extremely cold substances to damage and destroy abnormal cells and tissue. Liquid nitrogen is typically used. This substance reaches temperatures as low as negative 300 degrees Fahrenheit. Liquid nitrogen (or argon gas) is also used in cryotherapy.[1]
Cryotherapy can be used to freeze and kill abnormal skin growths, including skin cancer, by applying liquid nitrogen with a swab; however, most cancers have tumors inside the body, making it difficult to use this therapy successfully.
Cryotherapy Use in Mesothelioma
Cryotherapy can treat several types of cancer, including skin, eye, kidney, prostate, liver, and lung cancer. Some patients with mesothelioma have been treated with cryotherapy. This is relatively uncommon, however. Research continues on cryotherapy treatments for mesothelioma patients in clinical trials.[2]
One important way cryotherapy may help mesothelioma patients is by providing a less invasive treatment after major surgery. Tumor removal surgery in the chest cavity, including radical surgeries like extrapleural pneumonectomy, is often effective; however, in many cases, the tumors return. Repeating these invasive surgeries is impractical; therefore, minor surgery with cryotherapy may be a viable option.
Cryotherapy may also be useful for mesothelioma patients who could benefit from palliative treatment. If surgery is too risky, less invasive cryotherapy can reduce tumor masses and relieve cancer symptoms.[3][4]
This procedure may not be performed widely at all hospitals or medical centers; however, it can generally be found where medical providers treat cancer and most certainly in centers that specialize in mesothelioma. It may be possible to request the treatment since many radiology departments have the equipment to perform cryotherapy.
The Procedure
Cryotherapy procedures differ depending on the patient and tumor location. In most cases, it follows these steps:[1]
- The medical team uses an MRI or ultrasound image of the tumor to guide the procedure.
- An instrument called a cryoprobe, a thin, hollow tube, is inserted through a small incision.
- With the help of the images, the cryoprobe is guided to the tumor and then delivers liquid nitrogen directly to the tumor.
Images guiding the probe help target the tumor but also help limit damage to nearby tissue. The procedure is minimally invasive, requiring only a small incision, although multiple probes may be used during the treatment. The frozen tumor is not removed; instead, the body reabsorbs destroyed cells.[1]
Benefits of Cryotherapy
Many patients may benefit from cryotherapy; although, it may not be the right choice for everyone. Compared to traditional surgery, cryotherapy is less invasive. This means it may be a great option for patients who are not good candidates for traditional surgery due to health concerns.
Because the incision is so small, cryotherapy may not even require general anesthesia. Recovery time is short, and there are fewer complications and side effects.[1]
Cryotherapy may also be preferred over chemotherapy and radiation because it targets the tumor precisely. Doctors can apply liquid nitrogen directly to the tumor, avoiding the healthy tissue that surrounds it. With chemotherapy and radiation, healthy tissue is destroyed along with the cancerous tumor.[1]
In one study, twenty-four patients underwent surgery for mesothelioma, followed by a cryoablation procedure. It was well tolerated and led to a median survival time of 11.4 months.
There is also some evidence that cryotherapy could enhance the immune system in mesothelioma patients, helping it attack cancer cells.[5]
Risks and Complications
Cryotherapy is relatively safe; however, there are limitations and possible side effects. If the liquid nitrogen is not correctly guided, it can damage healthy tissue. Treatment will damage healthy cells as well as cancer cells, so cryotherapy must be directed with precision.
Other potential side effects are minor, including bleeding or infection at the incision site. The patient may also experience post-procedure pain, although it is usually temporary and controllable with painkillers.
Cryotherapy has been used to treat lung cancers successfully; however, there is a high risk of complications. In one study, 12% of patients experienced a collapsed lung.
Some patients experienced respiratory distress, respiratory failure, atrial fibrillation, and a cough with blood; however, most patients did not have serious side effects and experienced complications that resolved soon after the procedure.[3]
Cryotherapy is an exciting new treatment that may become more standard in treating mesothelioma. It is minimally invasive, with few side effects. This strategy may become more important as research continues the effectiveness of cryotherapy.
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Anne Courtney has a Doctor of Nursing Practice degree and is an Advanced Oncology Certified Nurse Practitioner. She has years of oncology experience working with patients with malignant mesothelioma, as well as other types of cancer. Dr. Courtney currently works at University of Texas LIVESTRONG Cancer Institutes.