Using Heat or Cold to Kill Cancer
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Ablation is a minimally invasive procedure that destroys tumor tissue by either heat or cooling mechanisms. This process has been well established in liver tumors and kidney tumors, and experts in Mayo Clinic's lung ablation specialty group are investigating its use in lung tumors.
Why it's done
Although ablation is still relatively new and novel, it may potentially play a role in people who cannot tolerate surgical resection or alternate treatment techniques. Ablation also attempts to preserve as much lung function as possible by only destroying the tumor and a healthy rim of tissue around the tumor, subsequently not altering a person's breathing capacity post ablation.
Types of lung ablation currently available:
- Cryoablation — use of cold therapy and liquid nitrogen or argon gas to freeze and destroy tumor cells
- Microwave ablation — use of heat therapy to heat tumors of up to 100 watts to cause tumor swelling and destruction
A CT of the chest showing a left side lung cancer before and after a successful treatment with stereotactic body radiotherapy (SBRT).
Methods of lung ablation
- Percutaneous approach — Performed by radiologists trained in this procedure, percutaneous approach is used for tumors that started in another part of the body (colon, pancreas, breast, melanoma) and spread to the lungs. You are put under general anesthesia in the CT scanner, and a probe is deployed through the chest wall into the tumor and either frozen or heated. Real-time CT is used to visualize ablation as it is happening. You can generally expect a one-night stay in the hospital for observation.
- Bronchoscopic approach — Surgeons and pulmonologists at Mayo Clinic are currently working with scientists and technology to investigate the most appropriate methods to deliver heat therapy through a bronchoscope. You will still be under anesthesia, but delivery of the ablation would be through your natural airway rather than through the chest wall. This research is still experimental in nature, and physicians are working diligently to develop a clinical trial for people who may meet criteria for tumors that have either spread or originated within the lung.
Although the majority of people experience no post-procedural symptoms, your physician will counsel you on the risks of the procedure, which may include:
- Chest wall pain
- Low-grade fevers
- Pneumothorax(collapsed lung)
- Prolonged air leak requiring surgery
- Hemoptysis (coughing up blood)
July 14, 2020