Cryoablation is a minimally invasive interventional oncology procedure that uses extreme cold to destroy cancer cells. One or more thin needle-like instruments called cryoprobes are placed within the tumour. Pressurised gas passes through the probes, creating an area of frozen tissue known as an ice ball.
The tumour is usually frozen and allowed to thaw in controlled cycles. These freeze–thaw cycles damage the cancer cells and their blood supply, causing the treated tissue to die. The body gradually breaks down and absorbs the destroyed tissue.
Cryoablation is usually performed through the skin under CT, ultrasound or MRI guidance. It is a local treatment used for selected tumours that can be safely reached with a cryoprobe. It may be used alone or combined with surgery, systemic therapy, radiation therapy, embolization or other cancer treatments.
- Selected kidney tumours
- Primary liver cancers in selected patients
- A limited number of liver metastases
- Selected early-stage lung cancers when surgery is not suitable
- A limited number of lung metastases
- Painful bone tumours or bone metastases
- Selected primary bone tumours
- Small soft-tissue tumours in selected locations
- Selected adrenal tumours or metastases
- Selected prostate cancers, including certain localised or recurrent tumours
- Residual or recurrent tumours following surgery or other treatment
- Patients who cannot undergo surgery because of other medical conditions or reduced organ function
- Patients for whom surgery would require removal of a significant amount of healthy tissue
- Selected patients requiring local treatment of a limited number of metastatic tumours
How Cryoablation Is Performed
Before Treatment
The interventional oncologist or interventional radiologist reviews the diagnosis, biopsy findings, imaging, previous treatments and medical history.
CT, MRI, ultrasound, PET-CT or other imaging is used to assess the tumour and plan a safe route for the cryoprobes.
Blood tests are performed to assess blood counts, kidney or liver function and the ability of the blood to clot.
Blood-thinning medicines and certain other medications may need to be temporarily adjusted under medical guidance.
The patient is usually instructed to avoid eating or drinking for a specified period before the procedure.
An anesthesia assessment may be performed when deep sedation or general anesthesia is planned.
Antibiotics may be recommended in selected cases.
The possible need for a biopsy before or during the procedure is discussed.
The treating team determines the number and position of cryoprobes needed to cover the tumour and a planned margin.
Protective techniques may be planned to separate nearby organs or protect the skin, nerves and other sensitive structures.
During Treatment
The patient is positioned according to the tumour’s location.
Local anesthesia, sedation or general anesthesia is administered depending on the treatment area and procedure.
Ultrasound, CT or MRI is used to locate the tumour.
A small skin puncture is made, and one or more cryoprobes are guided into the tumour.
The position of each cryoprobe is confirmed before freezing begins.
Pressurised gas passes through the cryoprobes, producing extreme cold and forming an ice ball around the target.
The tumour is frozen and then allowed to thaw in controlled cycles.
Imaging is used to monitor the size and position of the ice ball and help protect nearby structures.
The cryoprobes may be repositioned, or additional probes may be used, to cover different parts of the tumour.
The patient’s vital signs and response to treatment are monitored throughout the procedure.
The cryoprobes are removed after the planned ablation is complete, and a dressing is placed over the insertion site.
The procedure may take approximately one to three hours or longer, depending on the number, size and location of the tumours.
After Treatment
The patient is monitored in a recovery area while the effects of sedation or anesthesia wear off.
Pain relief and other medicines are provided when needed.
Imaging may be performed immediately or shortly after treatment to assess the ablation area and identify complications.
Some patients can return home on the same day, while others may require an overnight hospital stay.
Mild pain, bruising, tiredness, low-grade fever or flu-like symptoms may occur for a few days.
Temporary numbness or altered sensation may occur when treatment is performed near a nerve.
The dressing and insertion site should be cared for according to the team’s instructions.
Strenuous activity may need to be avoided for a short period.
Follow-up CT, MRI, ultrasound or PET-CT is arranged to assess the treated area.
Additional ablation or another treatment may be recommended if viable tumour remains or the cancer returns.
Potential Benefits of Cryoablation
- Minimally invasive treatment through one or more small skin punctures
- Destruction of a localised tumour without removing the entire organ
- Preservation of surrounding healthy tissue where possible
- An alternative for selected patients who cannot undergo surgery
- Real-time visualisation of the developing ice ball on imaging
- The ability to use multiple cryoprobes to treat selected larger or irregularly shaped tumours
- Potentially less pain during and immediately after treatment than some heat-based ablation procedures
- A shorter recovery period than major surgery in many cases
- A short hospital stay, with same-day discharge possible for some patients
- The possibility of repeating treatment if clinically appropriate
- Treatment of more than one tumour during the same procedure in selected cases
- The ability to be combined with surgery, embolization, systemic therapy or radiation therapy as part of a multidisciplinary treatment plan
- Relief of pain caused by certain bone tumours or metastases
Side Effects of Cryoablation
- Pain, tenderness, bruising or swelling at the insertion site
- Tiredness or weakness
- Low-grade fever, chills or flu-like symptoms after treatment
- Nausea or reduced appetite
- Bleeding or a collection of blood near the treated area
- Infection at the insertion site or within the treated organ
- Cold injury to the skin or nearby tissues
- Temporary or permanent nerve injury, numbness or weakness
- Injury to nearby blood vessels or organs
- Collapse of part of the lung or air around the lung following treatment of a lung tumour
- Bleeding into the chest following lung ablation
- Injury to the bile ducts, gallbladder, bowel or diaphragm following liver ablation
- Urine leakage or injury to nearby structures following kidney ablation
- Weakening or fracture of bone following treatment of certain bone tumours
- Changes in liver, kidney or other organ function
- Rare severe inflammatory reaction following ablation of a large volume of tissue
- Rare blood clots or serious reactions related to anesthesia
