What is Focal Ablation Therapy?
Focal ablation therapy is a minimally invasive treatment for cancer or other symptomatic soft tissue or bone lesions. It is an image-guided technique that utilizes small, percutaneously placed electrodes (needles) or probes to destroy cancer cells using chemical (ethanol), thermal-based (radiofrequency ablation, cryosurgery), or non-thermal (irreversible electroporation) techniques.
Radiofrequency Ablation and Cryoablative Surgery
In both radiofrequency ablation (heat) and cryosurgery (cold), imaging techniques such as ultrasound, computed tomography (CT) or magnetic resonance imaging (MRI) are used to help guide needle-like electrodes into a cancerous tumor or symptomatic lesion. Precisely localized heat or cold is then applied at the desired location and margins, which destroys the abnormal cells, all without the need for invasive surgery. Advantages of this form of therapy include decreased pain, less complications, faster recovery times and may potentially be done on a same-day outpatient basis.
What are some common areas of treatment?
Focal ablation is used to treat many different cancers, including:
• Liver - primary liver tumors, colon or other cancers that spread to the liver (ie. breast, pancreas, neuroendocrine, melanoma)
• Lung - primary and metastatic lesions
• Kidney - primary tumors
• Bone - cancers for pain palliation, osteoid osteomas
How Do I Prepare for the Procedure?
You should report to your doctor all medications that you are taking and if you have any allergies, especially to certain medications or intravenous contrast dye (x-ray dye).
You may be advised to stop taking aspirin, non-steroidal anti-inflammatory drugs (NSAIDs) or any blood thinners you may be on for a specified period of time before your procedure.
Prior to your procedure, you may require a blood test to determine how well your liver and kidneys are functioning and whether your blood clots normally. An EKG may also be ordered.
Women should always inform their physician or x-ray technologist if there is any possibility that they are pregnant.
You may be instructed not to eat or drink anything after midnight before your procedure.
Your doctor will tell you which medications you may take in the morning.
You should plan to have a relative or friend drive you home after your procedure.
Where will the procedure be performed?
In most cases, procedures will performed in a CT procedural suite by a professionally trained minimally-invasive specialist. Most procedures will be performed under general anesthesia. However, some patients may qualify for deep sedation only.
What happens after the procedure?
Bone Tumor Ablation and Cementoplasty
Patients will continue to follow-up with their referring physician, as well as, the performing interventionalist post-procedure. During routine clinic visits, blood tumor markers and other surveillance imaging will be reviewed, based upon standard protocol. Stringent follow-up is vital as residual or recurrent tumors may be detected when they are small and may be treated early with repeat focal ablation.
Certain individuals with bone tumors/metastases outside of the spine may also benefit from combination tumor ablation and cementoplasty in order to debulk the bone-eroding and painful tumor, while stabilizing the adjacent bone with cement injection. This process is performed in a similar fashion as with Vertebroplasty and Kyphoplasty and may offer palliative relief to qualified individuals.
• Interventional Radiology Treatments for Liver Cancer