"" Ralph Moss—Cancer Consultant: THE SURPRISING HISTORY OF CRYOTHERAPY

Tuesday, December 1, 2015

THE SURPRISING HISTORY OF CRYOTHERAPY

Dr. James M. Arnott of Brighton, England


Have you heard about the "new" treatment for cancer called cryotherapy? This is the use of extreme cold to destroy tumors, and hopefully cure the disease. I put the word "new” in quotes because cryotherapy is actually an old treatment. A mid-nineteenth century surgeon named James Arnott (1797-1883) began using "cryo" in Brighton, England in 1845 and even published a book on the subject six years later (Arnott 1851). Arnott exhibited his apparatus at the Great Exhibition in London—the famous Crystal Palace Exhibition of 1851. 

 
The famous Crystal Palace, home of the 1851 Great Exhibition in London, England


Arnott's work would thus have been accessible to tens of thousands of visitors, including such famous Britons as Prince Albert, Charles Dickens and Charles Darwin. James Arnott was assisted in his work by his older brother, Neil Arnott, FRS, of Baker Street, who (among many other things) invented the waterbed.

That’s right—“cryo” was already well-known and practiced ten years before the American Civil War! For cancer, Arnott used salt solutions containing crushed ice to attain temperatures of -18º to -24º C (i.e., - 0.4º to – 11º F). He used this apparatus to freeze advanced cancers of the breast and cervix. This resulted in a decrease in the size of the tumor, a reduction of drainage and an amelioration of pain (Gage 1998).

At the time, Arnott wrote these prophetic words:

“Congelation [freezing, ed.] arresting the accompanying inflammation, and destroying the vitality of the cancer cell, is not only calculated to prolong life for a great period, but may, not improbably, in the early stage of the disease, exert a curative action.”

Arnott was certainly ahead of his time. Freezing a tumor seems intrinsically safer than removing it by surgery. What then happened to cryotherapy? Why wasn’t it instantly and universally adopted as a superior method of destroying tumors. First of all, Arnott’s apparatus was bulky and cumbersome. Second, a tumor had to be essentially external in character to be successfully treated in the era before asepsis and anaesthesia. Finally, the temperatures that were attained by the Arnott apparatus were probably not cold enough to thoroughly destroy the tissues in question. A historian of this question has stated:

“Though the usefulness of cold application was acknowledged by Arnott’s contemporaries and physicians of the time began to use local freezing techniques, further development of cryosurgery had to await advances in technology, especially the development of better cryogenic agents.”

The use of cryotherapy to treat cancer of the prostate gland only began in earnest in the 1960s (Wilson 1966). Drs. Ward A. Soanes and Maurice J. Gonder of Kenmore, NY, are credited with developing modern apparatus for the trans-urethral freezing of the prostate gland. In 1966, these two Upstate urologists told the American Urological Association (AUA) that they had treated 150 patients with "no mortality and minimal morbidity” (JAMA 1966). It was the beginning of a new era in prostate cancer treatment, although progress has been undeniably slow over the past few decades.

Cryotherapy continues to be an option for many cases of prostate cancer and other malignancies and is offered at dozens of medical centers around the US and the world. To find an oncologist or urologist who uses this technique one can conveniently consult the Web site of the Endocare company:


References

Arnott J. On the treatment of cancer by the regulated application of an anesthetic temperature. London: J. Churchill, 1851.

 JAMA. Cryosurgery on prostate reported. JAMA. 1966;196(13):29-29. doi:10.1001/jama.1966.03100260019007.

Gage AA. History of cryosurgery. Semin Surg Oncol. 1998;14(2):99-109. doi:10.1002/(SICI)1098-2388(199803)14:2<99::AID-SSU2>3.0.CO;2-1.

Wilson CB, Winternitz WW, Bertan V, Sizemore G: Stereotaxic cryosurgery of the pituitary gland in carcinoma of the breast and other disorders. JAMA 1966; 198:587–S90.