By Jo-Marie Brown
A prostate cancer operation which has never been performed in New Zealand before has been carried out for the first time using revolutionary new equipment in Tauranga.
The procedure, known as cryotherapy, involves freezing the prostate by lowering its temperature to -40C while it is still inside a man's body and then thawing the walnut-sized gland in order to destroy any cancerous tumours.
The prostate - which is found near the bladder and produces seminal fluid - is also killed off in the process.
But Tauranga urologist Peter Gilling said cryotherapy created fewer side-effects than traditional surgery, which removed the prostate altogether after radiation treatment.
"The complications associated with removing it after having radiation are really quite significant.
"Mainly impotence but incontinence is also a big problem.
"That's why cryotherapy is so attractive because you get similar results without the nasty side-effects," Dr Gilling said.
Prostate cancer is the most common form of cancer among New Zealand males and is responsible for about 500 deaths every year.
In the Bay of Plenty, prostate cancer is predicted to become the most common cause of cancer-related deaths by 2011.
The technology to freeze and then thaw parts of the body has been around for 40 years. The first machines used to treat prostate cancer in this way were invented in the mid-1990s.
However, because liquid nitrogen rather than gas was used, big thick needles had to be inserted behind a man's scrotum and the procedure was not regarded as particularly safe or sophisticated.
Now, a "third generation" cryotherapy machine was on the market and Tauranga's Promed Urology on 10th Ave is the first clinic in Australasia to offer the treatment to its patients.
Dr Gilling and his colleagues, Dr Mark Fraundorfer and Dr Andre Westenberg, are no strangers to cutting-edge technology.
In 1999 they, along with an Auckland clinic, were the first in New Zealand to offer "brachytherapy" to prostate cancer suffers - a process where radioactive seeds were implanted in the prostate gland.
And in 1996 they invented a specialised laser to treat non-cancerous prostate problems that is now used in hospitals all over the world.
"We like to stay ahead of the game," Dr Gilling said.
"We have quite a high profile internationally and we do a lot of research so we get these opportunities (such as cryotherapy) because of our relationships with people in various companies.
"Most new technology in our speciality comes to New Zealand via Tauranga."
Dr Gilling and Dr Fraundorfer travelled to Germany last December to learn how to perform the operation.
The surgeon who taught them, Dr Ulrich Witzsch, yesterday supervised Dr Fraundorfer who performed the first procedure at Norfolk Southern Cross Hospital on Grace Rd on Auckland company director Noel Thomson.
Mr Thomson was diagnosed with an aggressive prostate tumour five years ago and said he had no qualms about being New Zealand's "guinea pig" for the new cryotherapy equipment.
"It sounds great and it means I've got another chance," Mr Thomson told the Bay of Plenty Times before his surgery.
"The good thing about being first is that they'll be more careful about what they do," he laughed.
Three more cryotherapy operations were to be performed today in front of more than a dozen urologists and radiation experts from around Australia and New Zealand who have travelled to Tauranga to learn about the technique.
Despite the strong interest, Dr Gilling said the cost of the equipment involved and the fact that it was a specialised niche market, meant it was highly unlikely the treatment would be offered anywhere else in New Zealand other than Tauranga in the foreseeable future.
Operations will cost about $20,000 each and involve inserting up to 25 small needles that are 1.57mm wide into the prostate.
Argon gas was then pumped through the needles into the gland to freeze it, followed by high-pressured helium which thaws it out again.
The process was usually repeated several times to ensure the cancer cells were completely killed off.
"It's like giving the prostate frostbite. Freezing the tissue kills it off," Dr Gilling said.
"It can be used either as a first line of treatment or when other treatment options have failed.
"I think it's important to be able to offer that option to the men of New Zealand."
The operation was not suitable for men whose cancer had already spread to other parts of the body or who were not medically well enough to undergo surgery.
The Promed urologists plan to start using cryotherapy to treat kidney tumours from February next year.