Ablation a real alternative to cancer surgery

Ablation a real alternative to cancer surgery

This article provides details on ablation, often a form of localised Hyperthermia, and its different forms - thermal ablation and cryoablation, and even the Nanoknife - including side-effects and applicability in its use as a treatment for cancer; it's a real alternative to surgery.

Ablation kills cancer cells and solid tumours

Ablation is a minimally invasive alternative to traditional cancer surgery. It can destroy solid cancer tumours in situ. Ablation is performed by inserting a special probe (a needle) through a tiny hole in the skin, often less than 3mm in size. The probe is then inserted into the tumour.

   * Thermal ablation - the probe heats the tumour to around 106 degrees C.

   * Cryoablation - the probe freezes the tumour to -40 degrees C.

Each methodology is proven to kill all the cancer cells.

Ultrasound Scanning, Computerised Tomography (CT) or even MRI scanning can guide the probe into place.

Thermal Ablation 

The probe can be heated traditionally by a generator, to provide Microwave Ablation (MWA) or Radio Frequency Ablation (RFA). Another possibility is to use sound waves - called High Intensity Focussed Ultrasound or HIFU.

A generator can also be used when the probe needs to be at low temperatures. 

What cancers can be treated with Thermal Ablation?

In theory any solid tumour can be treated. So ’deep seated tumours’ as in liver cancer or kidney (renal) can have already been treated by Ablation. In lung cancer multiple tumours can be treated, and similarly, there is little reason why any solid tumour could not join the list.

It can also be used where a small amount of cancer is causing pain, for example near a joint. 

At the moment Ultrasound ablation is increasingly being used for prostate cancer treatment (HIFU), and small numbers of people have been treated for breast cancer. Endometrial ablation is becoming more common, especially where small tumours are involved. Even fewer have been treated for bone cancer and bone mets.

Small tumours are usually treated with 100% success; and, although bigger tumours can be treated, it is harder to completely eradicate them. However, Ablation treatment can be repeated.

Go to: HIFU an effective treatment for prostate cancer

When the politics clears and the cost of the treatment falls, the potential is enormous.

Effectiveness of Thermal Ablation

This depends up the size of the tumour and the location. The nearer to the surface of the body, and the smaller the tumour, the easier the treatment. And the more successful.

How is Ablation performed?

The majority of patients only have local anaesthesia. The treatment can take anything between 30 minutes and two hours depending upon location and size of tumour. The ’surgeon’ can adjust the heat or cold depending upon the circumstances. The ’operation’ can be combined with other treatments - for example, it could be performed if just a few cancer cells are found at the time of a viewing probe looking for anomalies in the oesophagus, or it could be performed when conducting a laparoscopy, or during surgery.
Possible Side-effects

Complications are usually found in less than 5% of those treated. They could include infection, bleeding, cramping, perforation or even a collapsed lung. Most people, however, are usually out of hospital within two days.

Irreversible Electroporation (IRE)

This can also be called the ’Nanoknife’, although it is not a knife. Where IRE is helpful is when the tumour is wrapped around a blood vessel. IRE does not damage collagen, blood vessels or bile ducts and IRE is being used for bladder, pancreatic and liver cancers where blood vessels are involved. The procedure uses thermal energy to punch holes in cancer cells, and can be used for pancreatic, or liver resection.

Early days yet - Johns Hopkins are following patients using IRE to make some Clinical numbers available.

Go to: The Nanoknife

Cryoablation

In this instance, a hollow needle or cryoprobe, allows a very cold liquid or gas into the tumour to kill it. The procedure is also called cryosurgery or cryotherapy.

Cryosurgery has been used in the USA on cancers such as - lung, liver, kidney, prostate, cervical, eye and even bone (including metastases). 

In the UK there is a group of independent Doctors offering cryoablation - Cancer Ablation UK (CAUK), who claim to be ’the number 1 referral site for NHS patients, self-paying and international clients seeking ablation of small volume tumours of the kidney, lung, liver, prostate and bone’. 

Ablation for cancer - Summary

This are is potentially massive and it has grown enormously in just a decade. A decade ago in my best seller "Everything you need to know to help you beat cancer" I wrote about this: Imagine a world where we have genuine early diagnosis and so the tumours are small, and the expertise on ablation has doubled. Solid tumours could be eradicated in their infancy. No more drugs, radiotherapy or surgery. Now you understand the vested interest and politics.

Go to: Using Hyperthermia to fight cancer

 

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