What is percutaneous tumor ablation?
Tumor ablation is the application of heat or intense cold to destroy cancer cells and tumors.
These procedures are done through a small hole in the skin the size of a pen tip. Tumor ablation can be divided into three types based on the type of energy used: radiofrequency ablation (RFA); microwave ablation (MWA); and cryoablation.
Radiofrequency ablation (RFA) uses a high-frequency electrical wave to heat and "burn" the tumor. CT or ultrasound imaging is used to place the probe into the tumor.
Microwave ablation (MWA) is a similar technique that uses microwaves, delivered via a small antenna inserted directly into the tumor. MWA heats or burns the tumor within minutes and is much faster than RFA, although both have similar results.
Cryoablation uses liquid nitrogen or argon gas to cool a large needle and freeze tumor cells. Cryoablation is often used to treat kidney tumors and it is able to kill cancer cells without damaging or affecting kidney function. It is often used in patients with a single kidney or in those with decreased kidney function in order to avoid the need for dialysis.
What types of cancer can be treated with tumor ablation?
Several types of cancer can be treated with tumor ablation, including liver, kidney and lung cancer. Patients with cancer that has started in another part of the body and has spread (metastasized) to the liver, lung, and kidney may also be candidates for tumor ablation. In addition, patients with metastatic bone lesions that are causing pain may also benefit from ablation.
Percutaneous ablation is FDA approved for treatment of certain solid organ tumors and has the potential to be curative.
How is percutaneous ablation performed?
Percutaneous ablation is performed by specially trained physicians called interventional radiologists. These procedures are usually performed under general anesthesia, but sometimes conscious sedation can be used.
During the procedure, the radiologist uses CT or ultrasound imaging to insert the ablation probes into the tumor. The tumor is then ablated using heat or freezing. A CT scan is usually performed after the ablation to assess the ablation zone.
The treatment normally takes about 60 to 90 minutes. Patients are carefully monitored throughout and after the procedure. After the procedure, you will be placed on bed-rest for two to six hours after the procedure. Most patients are discharged home the next day.
What are the risks?
All of the tumor ablation modalities are safe and effective and may be repeated multiple times. Some patients may experience flu-like symptoms and some soreness for a few days after the procedure. These symptoms are easily treated with medication.
The risk of serious complications, such as significant bleeding depends on the organ being treated, is low and occurs in less than 1 percent of patients.
How will I get my results?
The interventional radiologist will be able to inform you whether the procedure was technically successful.
Your oncologist will order follow-up imaging to determine the clinical success of the procedure and whether or not additional procedures or treatments may be necessary.
How should I prepare for the procedure?
Before the procedure, you may have blood tested to determine how well your kidneys and your blood clotting are functioning. You should inform your doctor of all medications you are taking, including any herbal supplements. Inform them of any allergies, particularly to local or general anesthetic medications or to contrast materials (sometimes called X-ray dye) or to latex gloves. Always inform your doctor if you are or may be pregnant.
Eat a light meal the evening before. You will be instructed not to eat or drink after midnight before the procedure, and if you are diabetic you should receive instructions from your doctor about adjusting medications and insulin dose on the day of the procedure. You will likely be asked to remove your clothing and wear a gown during the procedure. You will need a ride home with a friend or relative.
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