Focal cryotherapy is a minimally invasive treatment that uses controlled freezing to destroy a selected area of prostate cancer. “Focal” means the treatment is directed at the known cancer area rather than the whole prostate. “Cryotherapy” or “cryoablation” means using extreme cold (at least -40°C) to kill abnormal cells.

For selected men with localised prostate cancer (cancer that has not spread outside the prostate), focal cryotherapy may offer a balance between treating the mapped cancer focus and preserving quality of life, including urinary control and sexual function where clinically possible.

At SGH Urology Centre and Prostate Centre, patients are assessed by uro-oncology specialists with access to prostate imaging, prostate-specific antigen testing, targeted biopsy techniques and a range of prostate cancer treatments. This allows the team to recommend treatment based on the cancer’s size, location, risk profile and the patient’s priorities.

The prostate is a small gland below the bladder that helps produce semen. Prostate cancer can sometimes be limited to one part of the prostate. In carefully selected patients, focal cryotherapy treats only the area that contains the significant cancer, instead of removing or treating the whole gland.

During treatment, thin cryoprobes (freezing needles) are placed into the prostate through the perineum (the skin between the scrotum and anus). Imaging guidance helps the surgeon position the probes accurately. The targeted area is frozen and thawed in a controlled way, which damages and destroys cancer cells.

The surrounding urethra (urine tube), rectum and nerves are carefully considered during planning. A warming catheter or temperature monitoring may be used to help protect nearby structures where appropriate.

Focal cryotherapy is not a one-size-fits-all treatment. It may be discussed when the cancer is localised, visible or mappable on MRI and biopsy, and located in an area that can be treated safely.

Your urologist will consider:

• Prostate-specific antigen level (blood marker used in prostate cancer assessment and follow-up).
• MRI findings, including the size and location of the tumour.
• Biopsy results, including Grade Group or Gleason score (how abnormal the cancer cells look under a microscope).
• Whether cancer is found in one area or multiple areas of the prostate.
• Your urinary symptoms, sexual function, general health and treatment priorities.
• Whether focal cryotherapy would still allow safe monitoring and further treatment if needed.

Some men with low-risk prostate cancer may be better served by active surveillance (regular monitoring without immediate treatment). Men with more aggressive, extensive or high-risk cancer may need whole-gland treatment such as robotic prostatectomy or radiotherapy.

1. Treatment planning: MRI, biopsy information and clinical assessment are reviewed to confirm the cancer location and whether focal treatment is appropriate.
2. Anaesthesia: The procedure is usually performed under anaesthesia so you do not feel pain during treatment.
3. Probe placement: Thin cryoprobes are inserted through the perineum into the prostate under image guidance.
4. Freezing treatment: The machine sends freezing gas through the probes, creating a controlled ice zone around the targeted cancer area.
5. Protection of nearby structures: The care team monitors the treatment area and takes steps to reduce injury to the urethra, rectum and surrounding tissues.
6. Catheter and recovery: A urinary catheter (tube that drains urine from the bladder) may be placed temporarily while swelling settles.

At SGH, cryotherapy is performed as day surgery. Eighty-seven per cent of patients were discharged on the same day. The remaining patients were discharged within one to three days due to non-procedure-related matters.

For suitable patients, focal cryotherapy aims to treat the cancer focus while reducing treatment to healthy tissue. Potential benefits may include:

• A minimally invasive approach using small needle punctures rather than large surgical cuts.
• Potentially lower risk of urinary incontinence and erectile dysfunction compared with some whole-gland treatments, although risks remain.
• Shorter recovery for many patients compared with major surgery.
• The possibility of further treatment later if cancer recurs or new cancer is found elsewhere in the prostate.

The benefit depends on accurate patient selection, precise treatment planning and structured follow-up.

At SGH, post-one-year mandatory surveillance biopsies revealed that 80% of focal cryotherapy-treated patients had no detectable clinically significant cancer after treatment.

Focal cryotherapy is a cancer treatment and still carries risks. Your doctor will discuss these in relation to your cancer and overall health. Possible risks include:

• Pain, bruising, swelling or bleeding after the procedure.
• Urinary symptoms such as burning, frequency, temporary difficulty passing urine or urinary retention (being unable to pass urine).
• Urinary infection.
• Erectile dysfunction (difficulty getting or keeping an erection), especially if the treated area is close to nerves involved in erections.
• Less commonly, injury to the urethra, rectum or surrounding structures.
• Cancer persistence or recurrence in the treated area, or cancer being found in another part of the prostate later.
• Need for repeat focal therapy, surgery, radiotherapy or other treatments if monitoring shows further cancer activity.

Because prostate cancer can be multifocal (present in more than one area), follow-up is essential even after successful treatment of the known cancer focus.

Follow-up is part of the treatment. Your doctor may recommend prostate-specific antigen blood tests, MRI scans and, in some cases, repeat biopsy to check that the treated area has responded and to monitor the rest of the prostate.

Please contact your care team if you develop a fever, experience worsening pain, have heavy bleeding, are unable to pass urine or notice any pus.

SGH offers prostate cancer care across the diagnostic and treatment pathway, from prostate health assessment and targeted biopsy to focal therapy, robotic prostatectomy and care for advanced prostate cancer.

Patients at SGH may benefit from:

• Assessment by urologists experienced in uro-oncology and prostate cancer treatment planning.
• Access to prostate imaging, prostate-specific antigen assessment and advanced targeted biopsy techniques to map the cancer accurately.
• A centre that offers focal therapy for selected small cancers and men looking to maintain quality of life.
• The ability to discuss alternatives such as active surveillance, irreversible electroporation, robotic prostatectomy, radiotherapy and systemic treatments where appropriate.
• Coordinated care with radiology, pathology, radiation oncology, medical oncology, nursing and rehabilitation support when needed.
• A personalised treatment plan discussed by a tumour board, where an oncologist, radiologist and pathologist review your case and recommend a suitable course of action.
   

We monitor outcomes carefully so that patients understand not only whether the cancer has responded, but also how treatment has affected urinary control, sexual function and recovery.

• Your prostate-specific antigen results and dates, if available.
• MRI, biopsy and pathology reports from previous assessments.
• A list of urinary symptoms, such as frequency, weak stream or waking at night to pass urine.
• Current medications, especially blood thinners and supplements.
• Questions about cancer control, side effects, catheter use, recovery time, sexual function and follow-up biopsy or MRI.

Estimated Costs for Private and Overseas Patients

For information on Type A and overseas patient costs, please refer to the Ministry of Health’s fee benchmarks below.

Costs for Subsidised Patients

Type B and C patients may receive additional government subsidies. More information will be provided during your financial counselling appointment.

• Switch to Subsidised Medical Care | Singapore General Hospital
• Cost financing | Ministry of Health

Is focal cryotherapy the same as treating the whole prostate?

No. Focal cryotherapy treats the selected cancer-bearing area rather than the entire prostate. This may reduce side effects in suitable patients, but it also means the rest of the prostate must be monitored.

Does focal cryotherapy cure prostate cancer?

The aim is to destroy the mapped cancer focus. Whether it is the right treatment depends on your cancer risk, tumour location and follow-up plan. Some patients may need additional treatment later.

Will I need a catheter?

Many patients need a temporary urinary catheter after treatment because the prostate can swell. Your care team will explain how long it is expected to stay in place.

Will focal cryotherapy affect erections?

It can. The risk depends on your baseline erections, tumour location, treatment area and whether nerves involved in erections are close to the treated zone.

Can I still have surgery or radiotherapy later?

In some cases, yes. One reason careful planning matters is to preserve future treatment options where possible. Your urologist will explain how focal therapy may affect future treatments.

How will doctors know if the treatment has worked?

Follow-up may include prostate-specific antigen blood tests, MRI scans and sometimes repeat biopsy. Prostate-specific antigen alone may not be enough because part of the prostate remains after focal treatment.

What is the difference between focal cryotherapy and IRE?

Focal cryotherapy treats prostate cancer by freezing cancer cells, whereas irreversible electroporation uses electrical pulses to destroy them. The most suitable treatment depends on the location and characteristics of the tumour.

Medically reviewed date: 17 September 2026