July 29, 2002
A Minimally Invasive Technique For Treating Cancer
Jason R. Williams MD
Radiofrequency ablation is a relatively new therapy for cancer in which tumors are destroyed using heat energy. A needle is placed through the skin and into the tumor. A radiofrequency is sent through the needle which heats and destroys the tumor. This procedure is performed under conscious sedation and most patients can go home the same day.
There are many advantages of radiofrequency ablation over an open surgical procedure. Patients with multiple lung lesions are often unable to be treated with surgery because too much healthy lung tissue would have to be removed in order to rid the patient of all of the cancerous tissue. Radiofrequency ablation can be used to destroy the tumor while the remainder of the lung is spared. This means that patients can have multiple tumors in both lungs and can still be successfully treated with RF ablation. The same idea also holds true for liver lesions. The other advantage is that RF ablation can be performed multiple times on different occasions. It is very devastating when a tumor recurs after surgical resection. Recurrence after surgery may require another large surgery or may signal the end of the patient's battle with the cancer. RF ablation can be easily performed to treat recurrent tumors.
RF enables treatment of multiple tumor types in various locations that are unable to be successfully treated with surgery. Ablation of liver tumors (including metastatic) has FDA approval and is actually preferred over surgery in many cases. The ablation of lung tumors is an emerging treatment. Radiofrequency ablation of metastatic bone disease has demonstrated significant improvement of pain from the lesions.
Radiofrequency ablation of metastatic disease should improve survival of the cancer patient. Patients with metastatic disease to the lung, liver or bone are usually treated conservatively. The chance for a cure is minimal in these patients. Radiofrequency ablation can be used to treat the metastatic lesion and surgery could be used to treat the primary tumor. For example: A patient with breast cancer and multiple lung metastases would have a very poor prognosis. A mastectomy may treat the breast, but the lung lesions would generally be treated with chemotherapy. Radiofrequency ablation allows physicians to treat the lung metastases while the primary breast lesions are abolished by mastectomy. This would significantly improve the prognosis of the patient.
Radiofrequency ablation is not intended to replace surgery and/or chemotherapy. RF is designed to work in conjunction with these modalities. Chemotherapy causes tumors to be more sensitive to RF treatment and RF ablation can be used to debulk large tumors which allows chemotherapy to be more effective. Surgery can be performed to remove breast and colorectal tumors and RF ablation can treat associated liver and lung metastatic disease.
In summary RF ablation is a minimally invasive method used to treat multiple types of cancers. RF ablation is ideal for treating multiple tumors of the liver and lung and for relieving the pain of those with metastatic bone lesions. RF ablation is ideal for patients that have too many lesions for surgical removal or who are poor surgical candidates because of other coexisting medical conditions.
Jason R. Williams M.D.
University of South Alabama
Department of Radiology