INTERVENTIONAL RADIOLOGY IN LUNG TUMORS / CANCERS
Normally, cells grow and divide to form new cells as the body needs them. When cells grow old, they die and new cells take their place. Sometimes this orderly process goes awry–that is, new cells form when the body does not need them, and old cells do not die when they should. These extra cells can form a mass of tissue, or tumor. Cancerous tumors are abnormal and divide without control or order.
The lung is the most common site for primary cancer worldwide, and smoking tobacco is the leading risk factor. The lung is also a common site of metastases for various malignancies.
Interventional radiology offers many minimally invasive diagnostic and therapeutic procedures for cancer patients, performed on an outpatient basis or during a short hospital stay. contrary to the open surgery.
- Are less painful and less debilitating for patients
- Result in quicker recoveries
- Have fewer side effects and complications.
There are a number of tests that can help in the diagnosis of cancer, including blood tests, physical examination and a variety of imaging techniques. Usually, however, the final diagnosis cannot be made until a F.N.A.C/ Biopsy is performed. In a fnac/biopsy, a sample of tissue from the tumor or other abnormality is obtained and examined by a pathologist. By examining the biopsy sample, pathologists and other experts also can determine what kind of cancer is present and whether it is likely to be fast or slow growing. This information is important in deciding the best type of treatment. f.n.a.c./biopsy would avoid the open surgery to obtain a tissue sample.
Needle fnac /biopsy is typically an outpatient procedure with very infrequent complications; less than 1-2 percent of patients develop bleeding or pneumothorax . In about 90 percent of patients, needle biopsy provides enough tissue for the pathologist to determine the cause of the abnormality.
Sometimes referred to as RFA, is a minimally invasive treatment for cancer. It is an image-guided technique that heats and destroys cancer cells. In RFA, imaging techniques such as ultrasound, computed tomography (CT) or magnetic resonance imaging (MRI) are used to help guide a needle electrode into a cancerous tumor. RFA is used to treat early-stage lung cancer and tumors that have spread to the lungs from other cancers. RFA offers a nonsurgical, localized treatment that kills the tumor cells with heat, while sparing nearby healthy lung tissue. In this procedure, the interventional radiologist guides a small needle through the skin into the tumor. From the tip of the needle, radiofrequency energy is transmitted to the tip of the needle, where it produces heat in the tissues. Therapeutic RFA aims to heat tissues to 60-100 °C, which leads to near instant cell death through protein denaturation. The dead tumor tissue shrinks and slowly forms a scar. The FDA has approved RFA for the treatment of tumors in soft tissue that includes the lung.
Efficacy of RFA
Depending on the size of the tumor, RFA can shrink or kill the tumor. Because it is a local treatment that does not harm much healthy tissue, the treatment can be repeated as often as needed to keep patients comfortable. It is a relatively safe procedure, with low complication rates.
By decreasing the size of a large mass, or treating new tumors in the lung as they arise, the pain and other debilitating symptoms caused by the tumors are often relieved. While the tumors themselves may not be painful, when they press against nerves or interfere with vital organs, they can cause pain. RFA is effective for small to medium-sized tumors and emerging new technologies should allow the treatment of larger cancers in the future.
Post treatment, most people can resume their usual activities in a few days. It is a safe, minimally invasive tool for local pulmonary tumor control with negligible mortality, little morbidity, short hospital stay, and positive gain in quality of life.
- Vascular work:we use minimally invasive techniques to place stents, stop bleeding and block the flow of blood to or from tumor tissue to support chemotherapy and radiation therapy response.
- Drainage catheters:Fluid retention is a common side effect of some types of cancer. Catheters are used to drain excess fluid and relieve uncomfortable symptoms.
- Port and PICC Line Placement:Many patients are given temporary ports and PICC lines to minimize the number of needle pricks during chemotherapy treatment or diagnostic blood work.
- Bone and joint pain management:A variety of bone and joint injections, nerve blocks and fracture management techniques provide relief from pain.
Interventional Radiology procedures Benefits
- Can be used to treat primary lung cancer and tumors that have metastasized (spread) from other areas in the body to the lung
- Usually does not require general anesthesia
- Relatively low cost
- Is well tolerated: most patients can resume their normal routine the next day and may feel tired for a few days
- It can be repeated if necessary
- It may be combined with other treatment options
- It can relieve pain and suffering for many cancer patients
- It has a short hospital stay
- It has few complications
- can also be done in patients not suitable for surgery
RFA is also used to:
- reduce the size of a tumor so that it can be more easily eliminated by chemotherapy or radiation therapy.
- provide relief when a tumor invades the chest wall and causes pain.
DR. BALAJI PATEL KOLA
M.D RADIO DIAGNOSIS, F.V.I.R.
CONSULTANT INTERVENTIONAL RADIOLOGY,
APOLLO HOSPITAL, JUBILEE HILLS, HYDERABAD.