Percutaneous tumor ablation procedures, performed through a small opening comparable to the tip of a pen, utilize sedation and local anesthesia. They include four main methods: radiofrequency ablation (RFA), microwave ablation (MWA), cryoablation, and percutaneous ethanol ablation (PEI). During the procedure, specialized imaging techniques like ultrasound, CT scan, or MRI guide an interventional radiologist in inserting a thin needle or probe directly into the tumor.
Radiofrequency Ablation (RFA) delivers a high-frequency electrical current through the needle, generating heat that destroys tumor cells. Microwave Ablation (MWA) uses electromagnetic waves to heat and destroy tumor cells more efficiently than RFA. Cryoablation freezes and destroys tumor cells by circulating a freezing gas through a cryoprobe inserted into the tumor.These techniques offer precise tumor localization and visualization, with MWA having the advantage of treating larger tumors effectively. Overall, percutaneous tumor ablation provides minimally invasive options for tumor treatment, offering reduced recovery times and improved patient outcomes.
Radioembolization, a form of radiation therapy, is recommended for liver cancer patients irrespective of its primary or metastatic origin. This treatment aims to retard liver tumor growth and alleviate associated symptoms. Particularly for hepatocellular carcinoma, often diagnosed in advanced stages where surgical options are limited, radioembolization offers the potential to shrink tumors, potentially rendering liver transplantation feasible.
Additionally, oncologists utilize radioembolization to address secondary cancers that have metastasized to the liver, such as those originating from the colon or breast. Combining radioembolization with chemotherapy has demonstrated promising outcomes in tumor response.
Before the procedure, patients undergo blood tests to assess clotting and kidney functions and adjust medications. An angiogram maps upper abdominal arteries, aiding in pinpointing tumor-feeding vessels to minimize healthy tissue damage. Sedation or general anesthesia is administered during the angiogram, with occasional discomfort from local anesthetic and warm sensations due to contrast dye injection.
Hepatic radioembolization, also known as selective internal radiation therapy (SIRT), involves angiography to map liver blood vessels, followed by preparing and delivering radioactive microspheres directly into tumor-feeding arteries. These microspheres emit concentrated radiation to cancerous cells while sparing healthy tissue. Real-time imaging techniques guide catheter placement and monitor microsphere delivery.
Post-procedure, monitoring and observation are conducted, potentially requiring an overnight stay. Patients receive discharge instructions and schedule follow-up appointments for monitoring tumor response. Common side effects include fatigue, mild pain, nausea, and appetite changes. Imaging follow-ups assess treatment effectiveness, with ongoing monitoring and additional treatments recommended as necessary.
Effective communication and adherence to follow-up appointments are essential for long-term care and optimal patient outcomes.
Renal ablation is a minimally invasive treatment for small kidney tumors using extreme temperatures. It's particularly beneficial for those with limited kidney function or who opt out of surgery. Compared to surgery, renal ablation preserves more kidney tissue, making it suitable for patients with a solitary kidney or inherited kidney cancer.
Although renal ablation generally entails fewer side effects and quicker recovery than surgery, there's a slight risk of residual cancer remaining in the kidney. Therefore, patients must carefully weigh the benefits against this risk with their oncologist.
Before surgery, renal ablation may be used to shrink or eliminate tumors, facilitating subsequent surgical procedures. It's especially recommended for larger tumors or individuals unfit for immediate surgery due to health issues.
Intraoperative renal ablation, performed simultaneously with kidney surgery, treats the tumor directly during surgery, potentially reducing the extent of surgical resection required.
Post-surgery, renal ablation can target any remaining tumor cells to reduce the risk of recurrence, particularly beneficial for those at higher risk. Overall, renal ablation offers a less invasive treatment option with the potential to preserve kidney function while effectively managing kidney tumors.