Ablation, Freezing and Electric Treatment for Cancer
Cancer is the second most common cause of death in developed countries and there are many modern treatment methods available. Most of the cancer patients are afraid of surgery as much as fear the cancer itself. Image-guided treatment is one of the most important steps of cancer treatment; it provides valuable advantages in terms of patient comfort while destroying the cancerous cells in the most effective way. Liver, kidney, lung and some bone tumors are treated through destruction with ablation method. From Liv HOSPITAL Radiology Clinic, Interventional Radiologist Prof. Dr. Adem Ucar explained.
For liver, kidney, lung, soft tissue and some bone tumors, in patients who are ineligible for surgery or cannot be operated, the tumor area can be treated by heating, freezing or electrical current without surgical incision. Patients can be discharged one day after the procedure and return their normal life in a few days.
Which specialists decide interventional treatment?All these treatments are decided by multidisciplinary approach with not only the interventional radiology specialist, but also with a group of doctors who diagnose and regulate the treatment such as medical oncologist radiation oncologist, general surgeon, nuclear medicine specialist, urologist, chest diseases and gastroentrology specialists.
What methods are used?These methods can be classified in two: ablation and embolization. Ablation methods include radiofrequency, cryo, microwaves and electroporation. By using digital image-guided tomography or ultrasonography, special needles are placed inside the tumor tissue. Tumor tissue is completely destroyed by heating (in radiofrequency and microwave techniques) or by freezing (in cryoablation technique). And in electroporation procedure, a recent method, electrical current is applied to the tumor by using needles. Electrical current damages the tumor tissue by destroying the cell membranes. This treatment is especially used for cancers that are adjacent to vital tissues. The tumor can be completely destroyed while preserving the vessels, bile ducts and urinary canals. These ablation methods are performed in major cancer centers in the USA and provide similar results with surgical operations in tumors less than 5 cm in diameter.
There are embolization methods that extend the life expectancy and quality of life of liver cancer patients who are not eligible for surgery. Embolization is the process of slowing or stopping the tumor growth by occluding the vessels that feed the tumor. This method can be combined with chemotherapy drugs and its efficiency can be increased. In addition, life expectancy can be increased by combining with locally irradiating atoms in patients who are not responsive to chemotherapy. This method is very well tolerated.
It can be performed as ambulatory, without hospitalization.
How is it performed?In ablation procedure, after local anesthesia and pain drugs are administered, a needle is placed to the tumor location by using tomography or ultrasonography and the tumor is destroyed. Embolization procedure is performed by entering from the pelvic artery in angriography room and finding the portion that feeds the tumor inside the liver artery by using thin tubes. Occluding particles, chemotherapy drugs or locally irradiating atoms are injected.
What should patients expect after the procedure?The patients are followed up at the hospital for one day. And they can return their daily activities in a few days.
Which patients are eligible for this procedure?It can be used for liver, kidney, lung, soft tissue and some benign bone tumors (Osteidosteoma etc).
Who are most suitable for the treatment?Approximately 15-20% of liver cancer patients can be operated. This is due to the fact that the size or number of tumors is too high for surgery, or conditions that prevent surgery such as cirrhosis, lung, heart disease. Ablation methods are used for up to 5 tumors less than 4 cm in diameter, however, larger tumors require embolization methods. Tumor can be destroyed in these treatment or shrinked to a size that is suitable for surgical operation.
What are the advantages of these methods?
- No anesthesia is used
- No large surgical incision or wound
- Short procedure time
- Patients return their daily life after the procedure
- No severe pain
- Lower cost in comparison to conventional surgery