Cryotherapy for kidney cancer

Cryotherapy kills cancer cells by freezing them. It can treat small, early stage kidney cancers.

What is cryotherapy?

Your doctor puts small needles into the cancer. A cold gas is put down the needles to freeze the cancer cells. This kills the cells.

This treatment is also called freezing therapy, cryosurgery or cryoablation. It is normally done through the skin into the kidney (percutaneously). Sometimes you might have cryotherapy as keyhole (laparoscopic) surgery. 

When can you have cryotherapy?

Cryotherapy is usually used to treat small, early stage kidney cancers that are less than 4cm across. The aim is to cure the cancer without having to remove part or all of the kidney.

If your kidney cancer comes back after cryotherapy you may be able to have the treatment again. You may also have it again if your doctor is unable to kill all the cancer cells with the first treatment. 

The specialist urological cancer multidisciplinary team (MDT) assess you for this treatment. It's mainly available in specialist hospitals. Your doctor will explain the possible risks and benefits to you. 

Before cryotherapy

Your doctor or specialist nurse explains what happens and how they do the treatment. They ask you to sign a consent form saying that you agree to have the procedure. You can ask them any questions that you have. Tell them about any medicines that you are taking.

You might need to stop any blood thinning medicines before your treatment. Your doctor or nurse will let you know. They will also tell you when to stop eating and drinking before the treatment.

Speak to your doctor, nurse specialist (CNS),or the department where you are having the procedure, if there are any changes to your health or medicines before the procedure. Or if you have any questions or concerns.

Having cryotherapy

You normally have cryotherapy through tiny cuts in the skin over the kidney. This is called percutaneous cryotherapy. Less commonly you can have cryotherapy as keyhole surgery. This is called laparoscopic cryotherapy. Your doctor will talk to you about which type of cryotherapy is best for you. You may not be able to have percutaneous cryotherapy if the cancer is too close to other organs, like your bowel.

Your doctor puts one or more cryotherapy needles into the kidney close to the cancer. A cold gas is put down the needles to freeze and destroy the cancer cells.

You may have had a sample of tissue (biopsy) taken from your kidney cancer already. If not, your doctor may take it just before they start giving the cryotherapy. This is to confirm the type of kidney cancer you have.

Percutaneous cryotherapy

You may have this under general anaesthetic. This means you will be deeply asleep and won't feel anything. Or you may have an injection into your skin near the kidney. This is called a local anaesthetic and numbs the area.

If you have a local anaesthetic you may also have some medicine to make you relaxed and drowsy (sedation). You will need a small tube into your vein (cannula) to have the general anaesthetic or sedation.

To have the cryotherapy, your doctor first finds the cancer using a CT or ultrasound scan. They inject a special dye (contrast) into your bloodstream. This lets your doctor see the kidney better on the scan.

When your doctor has finished giving you the cryotherapy they will put a small dressing over the cuts. You don't need stitches.

Laparoscopic cryotherapy

You have laparoscopic cryotherapy under a general anaesthetic. Your doctor puts a small tube into your vein (cannula) to have the general anaesthetic.

To give you the cryotherapy your doctor makes small cuts in your tummy (abdomen). They put a thin telescope (laparoscope) with a camera on the end into one of the cuts. This lets them see the kidney to put the cryotherapy needles in.

After the treatment your doctor may close the cuts with stitches. They will tell you how to care for them and if they need removing.

After cryotherapy

After the procedure you go back to the ward to recover. You normally stay in bed for 4 hours afterwards. After an hour you may be able to eat and drink.

Your nurse will give you painkillers if you have any pain. Sometimes you may have an injection of blood thinning medicine.

You can usually go home later the same day or the next. But you might need to take it easy for a week and avoid strenuous activity or driving. Talk to your doctor and nurse about recovery time and returning to normal activities.

You can normally remove the dressing 48 hours after the procedure.

If you had to stop some of your normal medicines before the procedure, your doctor will tell you when to start taking them again.

Side effects of cryotherapy

As with any medical procedure there are possible side effects or complications. Your doctor will make sure that the benefit of the treatment outweighs these risks.

Everyone is different and side effects can vary from person to person. You may not have all the effects mentioned. Side effects can include:

• pain in the treatment area after the anaesthetic wears off - you may need to take painkillers at home for a few days afterwards
• a burning or prickling sensation in your side
• a temporary weakness or loss of sensation between the ribs and hip (flank) - this is caused by minor damage to a nerve

Major complications are rare in people who have cryotherapy to treat kidney cancer. Complications can include:

• injury to the bowel, lungs or other parts of the body near the kidney
• bleeding that means you need a blood transfusion
• a small leak of urine around the kidney

Your healthcare team will monitor you closely during treatment. They will tell you who to contact if you have any problems when you go home.