When I was diagnosed with Stage 4 melanoma over 38 years ago, I didn’t know about all the various therapies available. Back then, I was searching for anything that could offer hope beyond conventional treatments. Cryoablation wasn’t a term I had ever heard of, but the idea of using extreme cold to target cancer cells fascinates me now as I reflect on the vast advancements in cancer therapy. Today, therapies like cryoablation offer powerful alternatives, and they represent the kind of innovation I wish I had known about during my own journey.

Cryoablation has a fascinating history that dates back thousands of years. While the modern form of cryotherapy for medical treatments began in the mid-20th century, the practice of using cold for healing can be traced to ancient civilizations, including the use of extreme cold as far back as 3000 BC.

Ancient Origins of Cryotherapy

• Egypt and Mesopotamia (3000 BC): Historical records suggest that early civilizations like the Egyptians and Mesopotamians used cold as a therapeutic tool. They applied cold compresses or ice to injuries to reduce swelling and inflammation. Though rudimentary, these early forms of cryotherapy laid the foundation for more advanced uses of cold in medicine.
• Hippocrates (circa 400 BC): The father of modern medicine, Hippocrates, recognized the power of cold therapy. He recommended using cold to alleviate pain, control bleeding, and treat inflammation. This was a major leap in understanding the medicinal value of cold temperatures, marking its place in ancient Greek medicine.

The Evolution of Cryotherapy

• 19th Century: In the 1800s, more scientific approaches to cold therapy emerged. Dr. James Arnott, a British physician, is credited with developing one of the first forms of modern cryotherapy. He used a salt and ice mixture to freeze tumors, particularly in breast and skin cancers. Arnott observed that cold not only relieved pain but also shrank the tumors, introducing the idea of using freezing temperatures for cancer treatment.
• Early 20th Century: The 1900s saw more targeted applications of cold therapy. Liquid nitrogen, which could achieve much colder temperatures than ice, began to be used in the treatment of various medical conditions. The development of cryogenic technology during this period paved the way for modern cryoablation.

Modern Cryoablation

• 1940s-1950s: In the mid-20th century, cryotherapy advanced significantly with the introduction of liquid nitrogen, which can cool to temperatures as low as -196°C (-320°F). In 1961, Dr. Irving Cooper, a neurosurgeon, popularized the use of liquid nitrogen to treat Parkinson’s disease by freezing certain brain structures. This was the first major medical use of cryogenic temperatures for a specific condition, marking a pivotal moment in the field of cryotherapy.
• 1970s: The concept of cryoablation, or the targeted destruction of tissue using extreme cold, was refined in the 1970s. It became a viable treatment for certain cancers and was applied in dermatology for removing skin lesions, warts, and early-stage skin cancers. Around this time, cryoablation also began to be used for liver, kidney, and prostate cancers, marking its spread to internal organs.

Cryoablation for Cancer Treatment

• 2000s-Present: In the last few decades, cryoablation has gained popularity as a minimally invasive alternative to traditional cancer treatments. With technological advancements in imaging (such as ultrasound, CT scans, and MRI), doctors can now precisely guide cryoablation probes to target tumors without damaging surrounding healthy tissue.

Today, cryoablation is widely used for treating various types of cancer, including breast, prostate, liver, kidney, and lung cancer. It works by freezing the cancer cells, which are destroyed when ice crystals form inside them. This process also triggers an immune response that helps the body fight off remaining cancer cells.

How Is Cryoablation Administered?

Cryoablation is a minimally invasive procedure that uses extreme cold to destroy cancer cells. The process typically involves the following steps, guided by advanced imaging technologies to ensure precision:

1. Preparation and Imaging. Before the procedure, imaging techniques such as ultrasound, CT scans, or MRI are used to locate the tumor and plan the exact placement of the cryoablation probes. This step is crucial for targeting the tumor while minimizing damage to surrounding healthy tissues.
2. Probe Insertion. Once the target area is identified, thin, needle-like probes, also known as cryoprobes, are inserted through the skin and guided directly into the tumor. This is done under local anesthesia or light sedation, depending on the tumor’s location and the patient’s condition.
3. Freezing the Tumor. Liquid nitrogen or argon gas is circulated through the cryoprobes, cooling the surrounding tissue to extremely low temperatures, often as low as -196°C (-320°F). This rapid freezing forms ice crystals within the cancer cells, causing them to rupture and die.
4. Thawing and Repeat Cycles. After the tumor is frozen, the tissue may be allowed to thaw naturally or with the help of warming cycles. The freeze-thaw cycle may be repeated multiple times to ensure complete destruction of the tumor cells.
5. Monitoring During the Procedure. Throughout the procedure, imaging technology is used to monitor the size of the ice ball forming around the tumor. This ensures the cancer cells are effectively targeted and that the surrounding healthy tissue remains unharmed.
6. Post-Procedure Care. After cryoablation, patients typically experience minimal discomfort and can often return home the same day. Follow-up imaging is scheduled to confirm the success of the treatment and monitor for any recurrence of cancer cells.

Cryoablation is particularly effective for patients with localized tumors or those who may not be candidates for surgery due to health or age-related concerns. Its precise and minimally invasive nature makes it an increasingly popular option for treating cancer with fewer side effects and quicker recovery times.

Resources:

Korpan NN. A history of cryosurgery: its development and future. J Am Coll Surg. 2007 Feb;204(2):314-24. doi: 10.1016/j.jamcollsurg.2006.11.006. PMID: 17254936.

Kwak K, Yu B, Lewandowski RJ, Kim DH. Recent progress in cryoablation cancer therapy and nanoparticles mediated cryoablation. Theranostics. 2022 Feb 14;12(5):2175-2204. doi: 10.7150/thno.67530. PMID: 35265206; PMCID: PMC8899563.

Tian Y, Qi X, Jiang X, Shang L, Xu K, Shao H. Cryoablation and immune synergistic effect for lung cancer: A review. Front Immunol. 2022 Oct 27;13:950921. doi: 10.3389/fimmu.2022.950921. PMID: 36389781; PMCID: PMC9647087.

Chen Z, Meng L, Zhang J, Zhang X. Progress in the cryoablation and cryoimmunotherapy for tumor. Front Immunol. 2023 Jan 25;14:1094009. doi: 10.3389/fimmu.2023.1094009. PMID: 36761748; PMCID: PMC9907027.

Gage AA. History of cryosurgery. Semin Surg Oncol. 1998 Mar;14(2):99-109. doi: 10.1002/(sici)1098-2388(199803)14:2<99::aid-ssu2>3.0.co;2-1. PMID: 9492880.

Gage AA. Cryosurgery in the treatment of cancer. Surg Gynecol Obstet. 1992 Jan;174(1):73-92. PMID: 1729758.

Gillams A. Tumour ablation: current role in the kidney, lung and bone. Cancer Imaging. 2009 Oct 2;9 Spec No A(Special issue A):S68-70. doi: 10.1102/1470-7330.2009.9028. PMID: 19965298; PMCID: PMC2797471.

Hinshaw JL, Lee FT Jr. Cryoablation for liver cancer. Tech Vasc Interv Radiol. 2007 Mar;10(1):47-57. doi: 10.1053/j.tvir.2007.08.005. PMID: 17980318.

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