Partial Gland Cryoablation: Long-Term Prostate Cancer Success
- Five-year study demonstrates long-term success in treating intermediate-risk prostate cancer while preserving quality of life.
- A recent five-year study offers compelling evidence for the effectiveness of partial gland cryoablation (PPGCA) in treating prostate cancer.
- PPGCA involves precisely targeting and destroying only the cancerous portion of the prostate gland using extreme cold, a process known as cryotherapy.
Partial Gland Cryoablation: A Promising Treatment for Prostate Cancer
Table of Contents
- Partial Gland Cryoablation: A Promising Treatment for Prostate Cancer
- Partial Gland Cryoablation (PPGCA): Your Questions Answered About This Promising Prostate Cancer Treatment
- What is partial Gland Cryoablation (PPGCA)?
- What are the Benefits of Partial Gland Ablation Compared to Traditional Prostate Cancer Treatments?
- How Effective is PPGCA? What Does the Research Show?
- What Does “Freedom-From-Failure” (FFF) Mean in the Context of PPGCA?
- Who is a Good Candidate for Partial Gland Cryoablation?
- Why is the Focus on Intermediate-Risk Prostate Cancer Significant?
- How Vital is Monitoring after PPGCA?
- What is the recovery time for partial gland cryoablation?
- Study Details
- key elements of PPGCA and traditional options
Five-year study demonstrates long-term success in treating intermediate-risk prostate cancer while preserving quality of life.
organ-Sparing Treatment offers Hope
A recent five-year study offers compelling evidence for the effectiveness of partial gland cryoablation (PPGCA) in treating prostate cancer. The study, conducted at NYU Grossman School of Medicine, focused on men with localized, intermediate-risk prostate cancer. The results indicate that this targeted approach can successfully manage the disease while minimizing the side effects often associated with traditional treatments.
PPGCA involves precisely targeting and destroying only the cancerous portion of the prostate gland using extreme cold, a process known as cryotherapy. This focal therapy is gaining traction as an alternative to more invasive procedures like surgical removal or full-gland irradiation.
The Benefits of Partial Gland Ablation
Traditional methods of prostate cancer treatment, such as removing the entire prostate gland, can lead to significant side effects. These include urinary incontinence and sexual dysfunction, such as erectile dysfunction and the absence of semen. The NYU Grossman School of Medicine researchers had previously shown that PPGCA reduces the risk of incontinence and minimizes sexual dysfunction.
This latest study goes further by tracking the long-term effectiveness of PPGCA,combined with rigorous follow-up to detect and address any recurrence promptly. The findings, published in the journal *Urology*, are encouraging.
Key Findings: Freedom From Failure
The study revealed that 81 out of 91 participants (89 percent) achieved “freedom-from-failure” (FFF) over the five-year study period. FFF is defined as the absence of prostate cancer-related death, metastasis (cancer spread outside the prostate), or the need for whole-gland therapy following PPGCA.
While 15 of the 91 patients required a second round of focal therapy for cancer recurrence after the initial FFF period, 15 others (16.5 percent) ultimately needed whole-gland treatment.
It’s worth considering that the need to take out the whole gland was judged to be treatment failure in our study, even tho nearly all of these men, before the advent of partial gland removal, would have had the whole-gland procedure. We found that PPGCA can avert the profound consequences that can come with gland removal while still showing excellent results in preventing recurrence.
Herbert Lepor, MD, senior study author, the Martin Spatz chair of the Department of Urology at NYU Langone Health
the Importance of Careful Tracking
The success of PPGCA relies heavily on accurate diagnosis and careful monitoring. Advances in magnetic resonance imaging (MRI) have enabled doctors to pinpoint the location and aggressiveness of cancerous cells, allowing them to select the best candidates for focal therapy.
Between May 2017 and March 2024, researchers identified 313 men with MRI-determined, intermediate-risk prostate cancer who met the study criteria. Of these, 91 were eligible for the five-year freedom-from-failure evaluation.
The focus on intermediate-risk patients is significant, as this level of disease aggressiveness typically necessitates immediate whole-gland treatment.
According to Dr. Lepor, the study results, combined with his extensive experience performing over 5,000 radical prostatectomies, suggest that approximately 80 percent of men with intermediate-risk prostate cancer would opt for focal cryotherapy over prostatectomy if given the choice.
Intense Surveillance is Key
The study’s design incorporated particularly intense surveillance of patients following PPGCA. This ongoing monitoring is considered as crucial as the initial ablation procedure itself. Patients underwent prostatic-specific antigen (PSA) tests every six months and received an MRI or biopsy at 6 to 12,24,42,and 60 months.
This rigorous follow-up may explain the low dropout rate of just 3.3 percent over the five-year study period. A dedicated team ensures that patients return for regular PSA tests and MRI scans.
This study represents the largest comprehensive, prospective study of men with intermediate-risk prostate cancer treated with partial gland cryoablation.
According to study author james S. Wysock, MD, assistant professor in the Department of Urology, the team “ensured rigorous follow-up over five years, with high patient compliance for PSA testing, MRI, and follow-up biopsies, to thoroughly understand outcomes. As our cohort matures, we’ll expand our evaluations to include a broader spectrum of patients—particularly those with lower-risk cancer that’s not appropriate for active surveillance, but may not require whole-gland treatment.”
Study Details
The study was a collaborative effort involving Eli Rapoport, Majlinda Tafa, and Rozalba Gogaj from the Department of Urology at NYU Langone. Funding was provided by private donors, many of whom had undergone the PPGCA procedure.
Partial Gland Cryoablation (PPGCA): Your Questions Answered About This Promising Prostate Cancer Treatment
Learn about partial gland cryoablation, a targeted treatment for prostate cancer that preserves quality of life.This Q&A covers benefits, effectiveness, and more.
What is partial Gland Cryoablation (PPGCA)?
Partial Gland Cryoablation (PPGCA) is a focal therapy used to treat prostate cancer. It involves precisely targeting and destroying only the cancerous portion of the prostate gland using extreme cold (cryotherapy). This approach aims to manage the disease effectively while minimizing side effects associated wiht conventional, more invasive treatments.
What are the Benefits of Partial Gland Ablation Compared to Traditional Prostate Cancer Treatments?
Traditional methods, like removing the entire prostate gland, can lead to meaningful side effects such as urinary incontinence and sexual dysfunction (erectile dysfunction and absence of semen). PPGCA offers the potential to reduce these risks by targeting only the cancerous tissue, preserving more of the healthy prostate gland.
How Effective is PPGCA? What Does the Research Show?
A five-year study conducted at NYU Grossman School of Medicine provides compelling evidence for the effectiveness of PPGCA. Key findings include:
- Freedom-from-Failure (FFF): 89% (81 out of 91 participants) achieved FFF over the five-year study period. FFF was defined as the absence of prostate cancer-related death, metastasis, or the need for whole-gland therapy following PPGCA.
- Need for Additional focal Therapy: 15 of the 91 patients required a second round of focal therapy for cancer recurrence after the initial FFF period.
- Need for Whole-Gland Treatment: 16.5% (15 patients) ultimately required whole-gland treatment.
What Does “Freedom-From-Failure” (FFF) Mean in the Context of PPGCA?
In the NYU Grossman School of Medicine study, “freedom-from-failure” (FFF) is defined as the absence of the following conditions over the five-year study period:
- Prostate cancer-related death
- Metastasis (cancer spread outside the prostate)
- The need for whole-gland therapy following PPGCA
Who is a Good Candidate for Partial Gland Cryoablation?
The study at NYU Grossman School of Medicine focused on men with localized, intermediate-risk prostate cancer. Advances in magnetic resonance imaging (MRI) help doctors pinpoint the location and aggressiveness of cancerous cells, allowing them to select the best candidates for this focal therapy.
Why is the Focus on Intermediate-Risk Prostate Cancer Significant?
The focus on intermediate-risk patients is significant as this level of disease aggressiveness typically necessitates immediate whole-gland treatment.PPGCA offers a potential option that minimizes side effects while still effectively managing the cancer.
How Vital is Monitoring after PPGCA?
Intense surveillance following PPGCA is considered as crucial as the initial ablation procedure itself. Patients underwent rigorous monitoring, including:
- Prostatic-specific antigen (PSA) tests every six months
- MRI or biopsy at 6 to 12, 24, 42, and 60 months
This rigorous follow-up may explain the low dropout rate of just 3.3% over the five-year study period. A dedicated team ensures that patients return for regular PSA tests and MRI scans.
What is the recovery time for partial gland cryoablation?
The recovery time is specific to each individual, but as PPGCA is minimally invasive, most men can get back to their normal life within a relatively short period. This procedure allows faster recovery as an inevitable result of this minimally invasive intervention.
Study Details
The study was a collaborative effort involving Eli Rapoport, Majlinda Tafa, and Rozalba Gogaj from the Department of Urology at NYU langone. Funding was provided by private donors, manny of whom had undergone the PPGCA procedure.
key elements of PPGCA and traditional options
| Aspect | Partial Gland Cryoablation (PPGCA) | Traditional Prostate Cancer treatments (e.g.,radical prostatectomy) |
|---|---|---|
| Treatment area | Targets only cancerous portion of the prostate | Removes or irradiates the entire prostate gland |
| Risk of Side Effects | Lower risk of urinary incontinence and sexual dysfunction | Higher risk of urinary incontinence and sexual dysfunction |
| Suitability | Best for localized,intermediate-risk prostate cancer | Might potentially be used for various stages and risk levels of prostate cancer |
| Monitoring Required | Intense surveillance with regular PSA tests and MRI scans | Follow-up care and monitoring are essential |
| “Freedom From Failure” Rate in the NYU Study | 89% over 5 years | Varies depending on the stage and aggressiveness of cancer |