Single session ablation relieves misery of cancer that has spread to the bones
The radiofrequency ablation probe’s tip, with positive and negative contacts, produces a larger, more predictable area of ablation. Credit: Brian Donohue
(Medical Xpress) -- Radio frequency ablation (RFA) enables doctors to destroy abnormal growths, quell arrhythmias and halt nerves transmission of pain signals.
Needlelike RFA probes generate heat that chars tissues within a millimeter or two of the probes tip. This is fine for small targets but the technology has been limited by its short range the charred tissue impedes more distant ablation and by somewhat unpredictable heat patterns caused by single-polarity probes (two or more probes have been needed to conduct energy).
Recent advances have overcome these challenges, thereby increasing RFAs utility against cancer.
The range increases to a sphere about the size of a ping-pong ball. If you need to ablate a malignant tumor, this type of device is effective, said Dr. Michael Gofeld, a specialist at the UWMedicine Center for Pain Relief at UW Medical Center-Roosevelt.
New probes are internally water-cooled, which dissipates the heat around the needle such that tissue is ablated but without residual char. This extends the instruments reach. Also, the placement of positive and negative conductors on one probe creates a predictable zone of ablation.
Real-time CT scans of the spine (here depicting one of four planes) confirm that the probe follows its planned entry angle and depth. Credit: Michael GofeldCancer specialists typically refer patients to Gofeld to relieve pain after chemotherapy and multiple external-beam radiation therapies have failed against the metastases. A metastases is cancer that has moved to another part of the body from its original location. Gofeld frequently treats people whose lung, kidney or breast cancer has spread, excruciatingly, to the pelvis or spine. Metastatic prostate cancer is most prone to invade bone but its accompanying pain is more diffuse, he added.
Patients with a bone metastasis receive radiation therapy as the standard of care, he said, but a large portion of them are not candidates because of vital organs located nearby or because they have exceeded the maximum radiation dose. About 30 percent of patients dont respond to radiation at all. Others cannot lie still for the treatment because of pain.
This video is not supported by your browser at this time.For these patients, some cancer specialists may perceive hospice care and high-dose opioid painkillers as the lone remaining options. Gofeld instead would propose RFA and as an earlier consideration, too.
There are two goals here: first is palliation of disease. If we ablate the metastasis, we are slowing its potential invasion of other organs, so it is disease-modify ing. Second, we aim for symptom palliation, that is, the pain, Gofeld said.
Cooled RFA is approved by the Food and Drug Administration but strictly to relieve pain. Employing it to combat cancer currently constitutes off-label use. In Europe RFA is approved for both goals. Gofeld thinks similar U.S. approval is inevitable. He is advocating for a patient registry that would support such an application.
The big-picture aim is to improve life quality for the 300,000 Americans each year diagnosed with bone metastasis, a population surviving longer by dint of more effective chemotherapies. Metastatic growth that causes vertebral compression or collapse in the spine, however, would leave an otherwise able patient incapacitated.
External-beam radiation cannot prevent vertebral collapse; it creates sclerosis of the bone, Gofeld said. [With RFA] you can reduce the pain and halt the spread of disease in the spine, and then deliver glue in the same procedure to reinforce the vertebra and prevent imminent fracture. This helps people retain their autonomy in a way that standard-of-care therapy cannot.
He contrasted a single, 40-minute RFA procedure with a typical 10-session course of radiation therapy that might spur side effects of fatigue, hair loss and skin and nerve damage.
RFA is primarily palliative but can be a complementary treatment for patients with an isolated metastasis. If a patient is a legitimate candidate for an external beam radiation, do that, Gofeld said, but patients who fail or are not candidates for external beam radiation, or who dont want that they have another option.
Provided by University of Washington
- Radiofrequency ablation safe and effective for reducing pain from bone metastases Jan 04, 2010 | not rated yet | 0
- Targeting tumors may help stop spread of breast, other cancers Feb 03, 2012 | not rated yet | 0
- Ablation proved as effective as traditional surgery in treating kidney cancer Jun 02, 2010 | not rated yet | 0
- Freezing bone cancer tumors reduces pain, study shows Nov 28, 2007 | not rated yet | 0
- 99-year-old woman regains mobility following spinal procedures Dec 23, 2011 | not rated yet | 0
- Motion perception revisited: High Phi effect challenges established motion perception assumptions Apr 23, 2013 | 3 / 5 (2) | 2
- Anything you can do I can do better: Neuromolecular foundations of the superiority illusion (Update) Apr 02, 2013 | 4.5 / 5 (11) | 5
- The visual system as economist: Neural resource allocation in visual adaptation Mar 30, 2013 | 5 / 5 (2) | 9
- Separate lives: Neuronal and organismal lifespans decoupled Mar 27, 2013 | 4.9 / 5 (8) | 0
- Sizing things up: The evolutionary neurobiology of scale invariance Feb 28, 2013 | 4.8 / 5 (10) | 14
Why is zone 1 in liver more prone to ischemic injury?
May 23, 2013 Hi, Is it because around central vein, there is only deoxygenated blood from the vein where as in the periphery there is hepatic artery. Also why...
How can there be villous adenoma in colon, if there are no villi there
May 22, 2013 As title suggest. Thanks :smile:
How can there be a term called "intestinal metaplasia" of stomach
May 21, 2013 Hello everyone, Ok Stomach's normal epithelium is simple columnar, now in intestinal type of adenocarcinoma of stomach it undergoes "intestinal...
Pressure-volume curve: Elastic Recoil Pressure don't make sense
May 18, 2013 From pressure-volume curve of the lung and chest wall (attached photo), I don't understand why would the elastic recoil pressure of the lung is...
If you became brain-dead, would you want them to pull the plug?
May 17, 2013 I'd want the rest of me to stay alive. Sure it's a lousy way to live but it beats being all-the-way dead. Maybe if I make it 20 years they'll...
MRI bill question
May 15, 2013 Dear PFers, The hospital gave us a $12k bill for one MRI (head with contrast). The people I talked to at the hospital tell me that they do not...
- More from Physics Forums - Medical Sciences
More news stories
In recent years, microRNAs (miRNAs) and other non-coding RNAs are small molecules that help control the expression of specific proteins. In recent years they have emerged as disease biomarkers. miRNA profiles have been used ...
Cancer May 24, 2013 | not rated yet | 0
Cancer cells spread and grow by avoiding detection and destruction by the immune system. Stimulation of the immune system can help to eliminate cancer cells; however, there are many factors that cause the immune system to ...
Cancer May 24, 2013 | 5 / 5 (1) | 0
Researchers from London's Kingston University have begun a two-year study which could help prolong the lives of people with colorectal tumours.
Cancer May 24, 2013 | 5 / 5 (1) | 0
Transformative research from Western University has identified new hormones in the body which may suppress breast cancer and stimulate the regression of breast tumors.
Cancer May 24, 2013 | 5 / 5 (2) | 0
(Medical Xpress)—Curtin University researchers have found evidence that targeting specific cells in the body can reverse the effects of cancer on the immune system.
Cancer May 24, 2013 | 5 / 5 (4) | 0
Coenzyme Q10 decreases all cause mortality by half, according to the results of a multicentre randomised double blind trial presented today at Heart Failure 2013 congress. It is the first drug to improve heart failure mortality ...
20 hours ago | 5 / 5 (6) | 5
Heart failure accelerates the aging process and brings on early andropausal syndrome (AS), according to research presented today at the Heart Failure Congress 2013. AS, also referred to as male 'menopause', was four times ...
20 hours ago | 5 / 5 (1) | 1
(HealthDay)—Animals make great companions for senior citizens, but elderly people who always drive with a pet in the car are far more likely to crash than those who never drive with a pet, researchers have ...
12 hours ago | not rated yet | 1
(Medical Xpress)—A research team, led by Jeremy Barr, a biology post-doctoral fellow, unveils a new immune system that protects humans and animals from infection.
May 20, 2013 | 4.8 / 5 (31) | 9 |
Mortality and length of stay are highest in heart failure patients admitted in January, on Friday, and overnight, according to research presented today at the Heart Failure Congress 2013. The analysis of nearly 1 million ...
20 hours ago | not rated yet | 0
(AP)—Department of Justice lawyers have again asked a federal appeals court in New York to delay lifting age restrictions and prescription requirements on an emergency contraceptive popularly known as the morning-after ...
20 hours ago | not rated yet | 0