When I performed Cryotherapy for the full prostatic gland or only one lobe, I froze the gland to
-20 to -40 Centigrade, and according the size of the prostate, it took 8-10 minutes to complete. Then, I prefer to keep frozen for one additional minute before defrosting ( thawing ) the gland, which it takes
Approximately the same time as freezing. Then I did a second cycle of freezing-thawing similar to the first one.
My results of the biopsies at 6 months post-Cryo, showed in the 10-12 needle biopsies no more evidence of cancer cells, just Fibrosis, with 97 % of patients free of localized cancer. The other 3 % showed still cancer, of lower Gleason’ score, in few of the post Cryo biopsies and the majority of these were early in my curve of learning how properly to freeze the prostatic gland.
In all my patients with high Gleason scores of 8-10, with visible or not ( microscopic ) distant metastasis, I placed them after Cryo, for one year of hormonal deprivation of Testosterone. This regimen resulted in good survival at 4-to more of 5 years post Cryo, with PSA of less 0.5 ng/ml in patients with Gleson’s score of 8 and 9, and just close to one year in a patient with Gleason’s score of 10.
I have been retired for the past 3 years ( 2017 ) and for more of a year become in aware of the Immunologic reaction that Cryo was producing in the days/weeks following the freezing of the prostate and these Immune reaction were the main reason for my good results, specially in my patients with metastasis.
Today, thanks to the excellent work of several Investigators : By alphabet order
A- Dr. B.M. Aarts & co-workers, from Maastricht University Medical Center, Netherlands
B- Dr. J. Baust & co-workers, from the State University of New York, Binghamton, NY.
C- Dr. C. Yakkala & co-workers, from the University of Lausanne, Switzerland
We now know that freezing the tumor and allowing it to remain in situ ( not removing the prostate ) it “ Unleashes an array of tumor Antigens to be exposed to the Immune System “
The changes that occur in our Immune System, “ Is stimulated by these degrading cancer proteins and numerous cell components with Antigen potential that are able to released Chemokines and Cytokines, DNA, RNA’s and proteins “. Many of these components are pro-inflammatory, attracting various types of white cells : Macrophages, Dendritic cells, T-cells and others and this may result in an Innate Immune Response “
Cryotherapy, to the difference of the heat Ablation, like RFA, Microwave or High Intensity Focus Ultrasound, has demonstrated the highest potential to elicit post-ablative immunological response.
Cryotherapy is a “process that affect the cancer cells independent of the Stage or Degree of cellular Stemness “. Since Cryo is not a repetitive process, “ This treatment does not support Adaptative Mutagenesis “ as do repetitive therapies like to give 30 Radiotherapy sessions to treat cancer of prostate divided in 6 weeks.
It is interesting, but it appears we are born with the capability to develop our personal Pharmacy ,( our own Immune System ) and it depends on us to preserve it’s health, to stimulate properly, so it will become active and provide the specific defensive cells to treat our own cancer and other types of infections. Today for example, one of the best treatments for Covid-19, is the transfusion of Convalescent Plasma of a donor, plasma rich on those specific AB to overcome the Virus, with almost 50 % of effectiveness.
Many publications today show favorable effects for Cryotherapy when is combined with other therapies like : “ Sipuleucel-T ( Provenge ) that is able to sensitize Dendritic Cells with prostatic Antigens and is used as therapeutic vaccine for cancer of prostate “. And, for those cells who can scape the surveillance of the Immune System, “ At present it can be prevented by Immune Check- Points Inhibitors, allowing the patient own Immune System to attack their cancer cells.
Better times are ahead to treat our cancer patients, more effective and with less toxicities.
