With cancer cases rising sharply across India, the search for more precise, less invasive and patient-friendly treatments has intensified. From robotic surgery to genomic profiling and immunotherapy, oncology is undergoing a paradigm shift. Among the emerging techniques drawing global attention is MRI-guided cryoablation, an advanced procedure that destroys tumours and cancerous tissues by freezing them. Dr Somashekhar SP, chairman of medical advisory board at Aster DM Healthcare and global director of Aster International Institute of Oncology, talks about how advanced cancer care is evolving and whether cryoablation can redefine treatment in India in an interview with Hemant Kumar Rout. Edited excerpts:
What significant advancements have transformed cancer care over the last decade?
Earlier, cancer treatment followed a ‘maximum tolerable treatment’ philosophy with aggressive surgery, intensive chemotherapy and prolonged radiation, often at the cost of quality of life. Today, the shift is towards effective, precision-driven personalised care. Genomic profiling has changed the way we treat cancer. Immunotherapy and targeted therapy have dramatically improved outcomes in selected cancers. Minimally invasive and robotic surgeries have enabled organ preservation. Artificial intelligence is further enhancing diagnostics and treatment planning. These advancements have improved cure rates while reducing complications and treatment duration.
Recently, a hospital in Sydney has made claims about breakthrough in MRI-guided cryoablation as a potential transformative cancer therapy. How strong is the evidence supporting cryoablation?
Cryoablation is a minimally invasive technique that destroys cancer cells using extreme cold. Like extreme heat that kills cancer cells, extreme cold also destroys cancer cells. It causes ice crystals inside the cancer cells, leading to ischemia (inadequate blood supply) and apoptosis (cell death). The procedure is image-guided using CT, MRI, or ultrasound to precisely target tumours. Cryotherapy has long been used in precancerous cervical lesions and even benign conditions like haemorrhoids. Its application is now expanding to solid tumours. Currently, cryoablation does not have level-one evidence comparable to conventional surgery. It is not a universal replacement for surgery, chemotherapy, or radiotherapy. However, evidence is steadily building.
How does cryoablation compare to conventional surgery in terms of local tumour control, recurrence rates and long-term survival?
For fit patients with localised tumours, surgery offers the best long-term cure rates and local control. Cryoablation offers advantages such as minimal invasiveness, faster recovery and lower immediate complications. It is particularly effective in small kidney tumours, selected liver tumours, small lung nodules, prostate cancer, bone metastases etc. Recently, I had a patient who had cancer in the right kidney, which was removed somewhere else. The patient was later diagnosed with cancer in the precious left kidney. Now, obviously, I cannot do surgery and remove the kidney leaving the patient on permanent dialysis. So, I did a cryo to control the cancer.
Given rising cancer burden with limited specialist resources in India, could cryoablation have a role in bridging gaps in accessibility and cost?
Yes, particularly in resource-limited settings. Take the example of cervical cancer, a leading cancer among women. Screening followed by immediate cryotherapy for precancerous lesions has been adopted under public health programmes. The World Health Organisation has supported such screen-and-treat strategies. For elderly patients, medically unfit individuals, or early-stage localised tumours, cryoablation reduces hospital stay and surgical risks. If combined with strong early detection programmes, it can significantly strengthen cancer control in India.