Cryoablation · NYC
Cryoablation for Prostate Cancer
Prostate cryoablation is a focal therapy that kills cancer cells by freezing them to about −40°C — using thin needles (cryoprobes) placed through the perineum under MRI/ultrasound fusion guidance, while a warming catheter protects the urethra.
Dr. Tan uses six ablation patterns to match the individual tumor and preserve healthy gland, nerves, and urinary function whenever possible. He also performs salvage cryoablation for men with biopsy-proven recurrence after radiation therapy — one of the situations where cryo is often preferred over surgery.
“Compelling evidence shows that prostate cancer can be eliminated through partial gland cryoablation with durable intermediate-term outcomes.”— Dr. Wei Phin Tan, MD, MHS, FACS
Dr. Tan's Cryoablation Protocol
- Intermediate-risk prostate cancer with a solitary MRI-visible lesion
- Six ablation patterns tailored to tumor location: quadrant, hemiablation, hockey-stick, subtotal
- Two-cycle rapid freeze to −40°C with thermocouple monitoring
- Urethral warming catheter to protect urinary function
- Follow-up: PSA every 6 months; MRI at 6–12 months, 2 years, 3.5 years, and 5 years
Ablation Patterns
Dr. Tan tailors the shape of the freeze zone to the tumor — ablating only what needs to be ablated and sparing the rest. The six illustrations below show representative examples of each pattern type. In practice, the same pattern can be rotated or mirrored to match the patient's own tumor location.
How to read these diagrams: each image is an axial (cross-sectional) view of the prostate. Top = anterior (pubic bone side). Bottom = posterior (rectum side). The gray extensions on either side are the neurovascular bundles. The central white oval is the urethra. The dark red shape is the tumor. The dashed line marks the planned ablation boundary.
Quadrant Ablation
Example: posterolateral quadrant. Treats one of the four quadrants when cancer is confined to a single corner of the gland.
Quadrant Ablation
Example: anterolateral quadrant. Same pattern applied to the anterior zone — a region often missed by transrectal biopsy but reliably mapped on MRI.
Hemiablation — Lateral
Ablates an entire left or right half of the prostate when cancer is lateralized to one side.
Hemiablation — Anterior
Covers the full anterior half of the gland when disease spans the front but spares the posterior zone and rectum.
Hockey-Stick
An L-shaped freeze zone that combines the anterior band with one lateral side — used when the tumor wraps across two zones.
Subtotal Ablation
Treats most of the gland while deliberately sparing a margin near one neurovascular bundle — used for larger, multifocal disease.
Note: these images are illustrative. Dr. Tan's planning software mirrors or rotates each pattern to match your own MRI and biopsy map, so the actual ablation conforms to your tumor — not the other way around.
Key Advantages
- Real-time ice ball monitoring — visualize the ablation as it happens
- Urethral warming catheter protects urinary structures
- Established platforms with decades of urologic data
- Surgery and radiation remain viable if the cancer recurs
Salvage Cryoablation
For men with biopsy-proven local recurrence after primary radiation therapy, salvage cryoablation is a minimally invasive alternative to salvage prostatectomy — with lower risk of rectal injury and faster recovery. Candidate selection is guided by MRI, biopsy mapping, and staging.