Ablation Therapy in Cancer

Ablation Therapy in Cancer

Interventional oncology is a medical field that uses minimally invasive (small interventional) procedures along with radiological methods. It deals with the diagnosis, treatment, and alleviation of cancer and cancer-related issues. Interventional oncology is one of the newest branches of interventional radiology. Treatments in the field of interventional radiology are also performed by interventional radiologists who have been trained in this area.

Interventional Oncology works alongside Medical, Surgical, and Radiation Oncology. In cancer treatment, surgical intervention on tumors is generally considered the best and long-term solution. However, due to the size, number, or location of the tumor, this treatment may not be possible in every case. In such cases, Interventional Oncology therapies can be applied to shrink the tumor. This makes it possible to perform surgical operations on the reduced tumor. In some cases, the patient may be too weak for open surgery. In such complex cases, interventional oncology techniques may be preferred for effective treatment. These techniques can also be used to enhance the effectiveness of treatment alongside other cancer fields.

Specialist physicians trained in Interventional Oncology use tools such as needles or catheters (long, thin tubes) equipped with micro instruments. The insertion of these tools into the body through small incisions made in the skin constitutes the interventional part of the job. Imaging techniques such as X-ray, ultrasound, CT (Computed Tomography), or MRI (Magnetic Resonance Imaging) are used as guides in interventional applications. Thanks to these imaging techniques, the interventional oncology tools reach the necessary parts of the body and deliver cancer treatment directly to the tumor.

What is Ablation? What are the Treatment Methods?

Interventional oncology procedures are used for diagnosis in tissues suspected of cancer and for treatment in cancerous tissues. Therapeutic interventional oncology applications include ablation techniques that destroy cancerous tissues using various methods. Ablation techniques destroy cancerous tissues through heat, cryo, or electromagnetic energy. It is a minimally invasive method. This means that ablation can be performed solely through the skin (medically known as percutaneous) without making any incisions in the skin or requiring another form of open surgery. Therefore, most minimally invasive interventional oncology treatments can be performed today on an outpatient basis or as day treatments. This allows cancer patients to access treatment more quickly.

What is Ablation?

Ablation allows for the removal of tumors without surgery. Ablation techniques can be used on tissues such as the lungs, liver, kidneys, prostate, breast, bone, and similar tissues. Additionally, the ablation procedure is performed under the guidance of imaging techniques. There are various types of ablation that use different methods. Some of these methods can be listed as follows:

• Chemical Ablation: The ablation process is applied by injecting substances such as ethanol or acetic acid into the tumor to cause protein denaturation (protein breakdown) and cell death. It is one of the oldest techniques used.
• Radiofrequency Ablation: Electricity produced through ionic fraction is applied to the tumor tissue, causing destruction there.
• Irreversible Electroporation: Ablation is performed by transmitting electric fields. These fields disrupt cellular membranes and cause cell death. Alternatively, it can trigger the process of cell death (apoptosis). This ablation method is also used to enhance targeted drug delivery.
• Cryoablation: Tissue temperature is reduced to -20 degrees Celsius using this method. Thus, tissue freezing leads to immediate cell death.
• Microwave Ablation: Electromagnetic energy affects water molecules, similar to how microwave ovens work. Cell death occurs due to the heating of the tissue.
• High-Intensity Focused Ultrasound: Focused ultrasonic waves are used in the form of a targeted beam. This beam is filled with high energy and performs the ablation process by burning the tissue.
• Laser Ablation (Interstitial Laser Therapy): Ablation is performed by causing coagulation in the tissue using laser beam technology.

Each ablation uses different techniques, and the most ideal and accessible technique may vary for each case. You may consider consulting your specialist physician about any questions you have regarding ablation therapy and interventional oncology.

How is Ablation Performed?

The ablation procedure, an effective treatment method in interventional oncology, is mostly performed on an outpatient basis. When the patient arrives for their appointment, they are prepared for the procedure. A nurse or health worker will establish an intravenous line in one of the patient’s hand or arm veins for sedation medication.

During this time, imaging technology such as computed tomography (CT) is used to determine where the catheter will rest on the vein. This allows for the identification of the tumor’s location. The identified area is numbed using a local anesthetic. The specialist physician makes a very small incision in this area.

After the incision, the specialist physician uses ultrasound or CT images to perform 3D calculations. Depending on the ablation method to be performed, the physician directs the probe that heats or cools the tumor area to the position determined by the calculations. After placing the probe, the ablation process begins. For this, the physician either heats and burns the surrounding cancer cells or cools and freezes them. Which method will be used varies according to the technique employed by the physician. In cases where the tumor is large, multiple ablations may be necessary. When the tumor is large, to ensure that no tumor tissue remains after ablation, the specialist physician may reposition the probe and use it again.

The duration of the ablation procedure may vary depending on the method used. A standard ablation takes about 10 to 30 minutes. However, in cases where the tumor is large and multiple ablations are required, the procedure duration may be extended. Even in the longest cases, the procedure is expected to be completed within one to three hours. When the treatment is completed, the exit site of the probe is bandaged, and the patient can return home on the same day.

As with any hospital procedure, it is not possible to give a precise time for the ablation process. You may consider consulting your specialist physician about how the procedure is performed, how long it will take, and any questions you may have afterward.

What are the Advantages of Ablation?

Generally, tumor ablation is used alone or in conjunction with other cancer treatments. With this procedure performed under the guidance of imaging methods, the tumor can be significantly reduced. The effectiveness of this reduction process is determined by the initial size of the tumor. Depending on the initial size, especially for tumors with a diameter of 3 cm or smaller, the ablation process can be curative. According to some studies, tumor ablation in treatment has sometimes been regarded as equivalent to surgical removal of the tumor. The interventional oncology physician examines whether tumor ablation is suitable for their patient when deciding on the best treatment option and collaborates with the patient to determine the appropriate treatment.

In Which Diseases is Ablation Preferred?

Thanks to tumor ablation, various types of cancers can be treated, including liver, kidney, and lung cancer. Cancer cases that start in one part of the body and later spread to other organs (medically known as metastasis) can also benefit from tumor ablation. Additionally, patients with bone lesions caused by the spread of cancer that result in pain can also benefit from tumor ablation.

Frequently Asked Questions About Ablation

Ablation is one of the treatment methods used in interventional oncology. Many questions can be asked about this rapidly developing field and ablation therapy. You can find the most frequently asked questions about ablation therapy in the continuation of this article.

You may consider consulting your specialist physician about your concerns and questions regarding ablation therapy and cancer processes.