Does Cryotherapy for Prostate Cancer Cause Infertility?

Cryotherapy is one of alternative treatments for prostate cancer. Though it is not the main treatment (surgery, radiotherapy, and hormone therapy are commonly the main options of treatment for cancer of prostate), but sometime doctors may need to use it. There are some potential side effects, but does it cause male infertility, too?

What actually is cryotherapy?

It is often called as local freezing treatment, cryoablation, or cryosurgery. Yap, it uses extremely cold substances to freeze and kill the cancerous cells.

Typically, it is used to freeze only area where the treatment is directed. In other words, it works locally and doesn’t affect other cancerous cells in another part of the body. And within a few weeks after the treatment, the immune system of the body will naturally remove the dead tissues.

Currently, again it is not the main treatment for prostate cancer. Although it can help treat early stage of the disease (when the cancer has not spread yet beyond the gland of the prostate), it should be only used as a part of trials (clinical trials to compare its effectiveness to other standard treatments for prostate cancer)!

See also the drawbacks & benefits between surgery and radiation treatment for prostate cancer in this section!

How to do it?

You need to take it in the hospital, typically in the specialist hospitals since not all hospitals have it. You and your specialist will discuss about the advantages and possible risks before you take it.

You can have it under local or general anesthetic. And you may also need to take an enema, a procedure to clear out your bowel (especially your lower bowel) before the treatment.

The specialist will put a special device called warming catheter, a kind of tube, into your urethra (your natural tube that carry urine from the bladder to your male genital organ). The use of this option is purposed to protect your urethra from damage during freezing process.

warming_catheter_in_cryotherapy_for_prostate_cancer

*Image credit to Cancer Research UK

Then special needles inserted through the skin between the anus and scrotum, this area is also called as the skin of perineum. Imaging guidance with X-rays or ultrasound scan is usually used to help ensure that the needles are not in the wrong place. And then the machine release cold argon gas through these needles to freeze the target.

The temperature needles are also used. They can help observe and monitor the temperature of other parts (particularly such as rectum and bowel muscles). This is required to ensure that there is no damage by the cold to these areas.

Cryotherapy for Prostate Cancer and Infertility

In general, there may be no specific explanation that cryotherapy has a direct contribution to cause infertility, but the treatment can pose the risk of some problems that can affect the way of how you make a pregnancy with your partner.

For instance, it poses the risk of ED (erectile dysfunction) in long term. It may not directly affect your fertility, but it can be a problem if you are still trying to have a baby with your partner.

Problems of erection affect almost half of men who took cryotherapy. The nerves that control male erection lie behind the prostate, and there is a chance that they can be affected in the freezing process.

image_illustration274Other long-term side effects from this freezing treatment may include:

  1. In very rare case, it could cause damage to the back passage (rectum).
  2. The small risk of bacterial infection.
  3. Urinary incontinence, a condition associated with loss of bladder control. It occurs after the treatment in about 18 % of men with cryotherapy.
  4. Urethra blockage, causing difficulty passing urine. In long term, the treatment may affect the urethra (the tube that carries urine from the bladder), too. If you cannot pass urine at all, an operation called TURP (transurethral resection of the prostate) can be suggested.

Furthermore, the prostate itself is so crucial in the male reproductive system. With seminal vesicles, it has function to secret fluid (semen) to help nourish and protect sperm.

Without this fluid, it can be difficult for sperm to go down through the urethra (in the end of intercourse) and reach the egg for fertilization. And depending on the stage of the cancer, having prostate cancer itself can affect the normal function of the prostate.

Overall, it can be difficult for men with prostate cancer to have a baby with their partner after taking the initial treatment. Fortunately, this cancer is relatively more common in elderly men, the age of when the male fertility is not a big issue. However in a few cases, cancer of prostate can affect younger men, too.

You might also like to see facts of fertility in men over 30 in here!

Each case is unique and should be evaluated in case-by-case basis. There are several options if you do concern about your fertility, talk with your doctor for a complete guidance!

For instance, if your doctor thinks that you can safely delay taking the treatment, you can be suggested to take an active monitoring. In this option, you don’t need to take the treatment immediately but the progression of cancerous cells in the prostate is continuously monitoring, allowing you with your partner to have a better chance to make a pregnancy.

Another option may be with a procedure called ‘sperm banking’. In this method, the harvested microscopic sperm is injected into the egg. Once the embryo forms, it then will be implanted in the wall of uterine of your partner, allowing it to grow for pregnancy.

References:

  1. http://www.cancerresearchuk.org/about-cancer/type/prostate-cancer/treatment/cryotherapy-prostate-cancer
  2. http://www.pcf.org/site/c.leJRIROrEpH/b.5837043/k.B194/Loss_of_Fertility.htm