First, I'll bet a buck that the "highly-respected physician" (by whom?) is
a urologist. I have reason not to trust a uro in any enterprise involving PCa.

Second, the idea of a partial freeze has been around for a while, but is
not popular so far as I know. Reason: there is simply too great a risk of
leaving untreated PCa behind.

Third, a full freeze inevitably results in the destruction of the erectile
nerves and permanent, profound, impotence.

How do I know? Simply this: as of November 22, it will be two years since I
underwent a "full-freeze" cryosurgery procedure on a low-PSA, Gleason *9*
tumor, performed without any semblance of proper staging tests. Either
cryosurgery is very apt to result in failure in a high-risk case like mine,
or I fell victim to a bumbling fool.

Oh BTW, there was a Gleason 8 tumor that was not discovered in the initial
biopsy; only later after it became obvious even to the uro that his tx had
failed.

Either way, I've had to undergo IMRT + adjuvant ADT which continues to this
day. There is a rather good chance that, whatever I do, this high-risk PCa
will kill me.

If I had it to do over, I would likely elect IMRT + brachytherapy + ADT and
maybe + chemo.

Regards,

Steve J

"Do not go where the path may lead, go instead where there is no path and
leave a trail."
---Ralph Waldo Emerson

Of those on this NG that tried Cryo and who have been here more than a year,
none reported to have gone to undetectable and stayed there.  If you'd like
to consult, their addresses are:

robert01942@hotmail.com Canada Bob
ewnowak@adelphia.net Ed Nowak
vinge3@cox.net Frank
jsshp@earthlink.net Jack in Phoenix
RobertBob@Att.Net Robert Austin
scrapiro@comcast.net scrapiro
mycroftscj@earthlink.net Stephen Jordan
trishpet@peoplepc.com trishpet@peoplepc.com

I had cryotherapy of the entire prostate three weeks ago.  In the hands of a
competent surgeon, I don't think that damage to adjacent tissues is as much
of a problem with today's equipment as it was years ago.  I didn't have the
choice of a partial freezing since my cancer was multifocal (8 out of 12
samples revealing cancer).  Of course, only future PSA tests will reveal how
successful the procedure has been.

Dan

Alex,

On the question of cryosurgery in general. I defer to others who have already
answered.  It sounds risky to me.

Stephen Jordan said a partial freeze carries too much risk of leaving some
cancer behind.  I agree with that and would like to expand the argument a
bit.

Many, many members of this group have had a radical prostatectomy and have
had their prostates examined by a pathologist after removal.  Finding cancer in
places that didn't show up in the biopsy seems to be more the rule than the
exception.  There's just no way that a biopsy with any finite number of needles
is going to check every place in the prostate and, if I understand the technology
correctly (which I may not - I'm not a doctor or scientist) there's no way that an
ultrasound test is going to show up small or low grade areas of cancer.

Any procedures performed on the prostate are likely to have a pretty significant
impact on both the prostate itself and on the surrounding tissue.  Although again
I have to qualify what I say by saying I'm no expert, I suspect that doing a partial
procedure will give you many of the side effects of a full procedure, without the
greater assurance of success that a full procedure provides.

Finally, I'd worry that any procedure, full or partial, will damage surrounding
tissues in a way makes any follow on procedures more risky and more prone
to side effects.  This is why, for example, that most surgeons will refuse to do
a prostatectomy on someone who has already had radiation.  The reason is
that the radiation does so much damage to the prostate and surrounding
tissue that the surgeon cannot excise the prostate without risking major
side effects.  Getting a partial freeze might, similarly, make getting a later
surgery more difficult or impossible.

My personal choice for treatment would be surgery or radiation.  Surgery is
thought by many to have an edge in long term success rate.  Radiation is thought
by many to have an edge in ease of treatment and recovery.  For low grade
Gleason 6 cancers, both have very high success rates.  Get second opinions
before you consider any more experimental treatments.

You didn't mention your age and PSA.  If it's low and if you're already getting
on in years, "watchful waiting" might also be a viable option.  If you choose
that however be sure to emphasize the "watchful" part, not just the "waiting"
part.  I would want to get a PSA every few months and take action quickly
if it looks like the PSA is going up.  Be sure not to have sex or physically
stressfull activities for several days before the test to get an accurate
result.

    Alan