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Lung Cancer

Condition

What is lung cancer?
Lung cancer starts when abnormal cells grow out of control in the lung. They can invade nearby tissues and form tumors. Lung cancer can start anywhere in the lungs and affect any part of the respiratory system.

The two main types of lung cancer are non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). About 85% of all people diagnosed with lung cancer have non-small cell lung cancer. Small cell lung cancer is a more aggressive type of lung cancer that appears in about 15% of all lung cancer diagnoses.

The cancer cells can spread, or metastasize, to the lymph nodes and other parts of the body.

Treatment

What type of treatment is available for lung cancer?
The standard method for treating cancer of the lung is either surgery or chemotherapy. Recently, advances in minimally invasive techniques have been developed which can assist in treating these lesions. Radiofrequency Ablation (RFA) is a procedure that destroys tumor cells by heating them using a needle electrode and high frequency electrical currents. Ultrasound or CT Imaging may be used to help the radiologist guide the needle into the tumor.

While there are other methods of heating tumors, RFA, to date, is the most common of all thermal treatment methods. Over the last few years, developments in tumor ablation have allowed large volume tissue ablation to be performed safely on selected patients with lung cancer. While other minimally invasive methods of tumor ablation have been used, at this point in time, RFA has been the most commonly used method.

When should I consider RFA?
Radiofrequency ablation is a viable and effective treatment option if you:
  • wish to avoid conventional surgery
  • are too ill to undergo surgery
  • have a small number of metastases in your lungs, or tumors that have spread from a cancer located elsewhere in your body, such as the kidney, intestine or breast
  • have a large tumor that is too large to be removed surgically
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


What should I expect BEFORE RFA?
You should report to your doctor all medications that you are taking, including herbal supplements, and if you have any allergies, especially to anesthesia or to contrast materials (also known as "dye" or "x-ray dye"). Your physician may advise you to stop taking aspirin or a blood thinner for a specified period of time days before your procedure.

Prior to your procedure, your blood may be tested to determine how well your kidneys are functioning and whether your blood clots normally.

Women should always inform their physician or x-ray technologist if there is any possibility that they are pregnant. Many imaging tests are not performed during pregnancy because radiation can be harmful to the fetus. If an x-ray is necessary, precautions will be taken to minimize radiation exposure to the baby.

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 RFA procedure.

You will be given a gown to wear during the procedure.

What should I expect DURING RFA?
Image-guided, minimally invasive procedures such as RFA are most often performed by a specialty trained interventional radiologist in an interventional radiology suite.

RFA is often done on an outpatient basis.

You will be positioned on the examining table.

You will be connected to monitors that track your heart rate, blood pressure and pulse during the procedure.

A nurse or technologist will insert an intravenous (IV) line into a vein in your hand or arm so that sedation medication can be given intravenously.

The radiologist will use CT scanning to precisely locate the tumor. Your skin will be marked at the proper chest wall site.

The area where the electrodes are to be inserted will be shaved, sterilized and covered with a surgical drape.

The radiologist will numb the area with a local anesthetic.

A very small nick is made in the skin at the site.

Using imaging-guidance, the radiologist will insert the needle electrode through the skin and advance it to the site of the tumor.

Once the needle electrode is in place, radiofrequency energy is applied. For a large tumor, it may be necessary to do multiple ablations to ensure no tumor tissue is left behind.

At the end of the procedure, the needle electrode will be removed and pressure will be applied to stop any bleeding and the opening in the skin is covered with a dressing. No sutures are needed.

Your intravenous line will be removed.

Each radiofrequency ablation treatment takes about 10 to 30 minutes. The entire procedure is usually completed within three hours.

What should I expect AFTER RFA?
You will remain in the recovery room until you are completely awake and ready to return home.

You should be able to resume your usual activities within a few days.

Pain immediately following radiofrequency ablation can be controlled by pain medication given through your IV or by injection.

Afterward any mild discomfort you experience can be controlled by oral pain medications. A few patients feel nauseous, but this can also be relieved by medication.

Only about two percent of patients will still have pain a week following radiofrequency ablation.

Our Service

The Division of Thoracic Imaging provides a full range of diagnostic and image-guided interventional studies of the chest. This Division consists of 10 full-time radiologists, all of whom are board certified in general radiology and fellowship trained with additional specialization in thoracic imaging procedures. In addition, each has extensive training in the use of x-ray equipment, x-ray dye and image interpretation. Our radiologists are the only specialists in the region to use bioimagery, an advanced molecular imaging approach to delineate areas of tumor activity following primary chemotherapy and better inform decisions about surgery.

Please see below for our thoracic imaging radiologists who specialize in performing RFA of the lung:

Where is RFA of the lung performed?

Massachusetts General Hospital
Division of Thoracic Imaging
55 Fruit Street, Founders House 202
Boston, MA 02114

How to schedule RFA of the lung
A referral from a physician is necessary to schedule RFA of the lung.

To schedule a RFA of the lung please call our Nurse Coordinator at 617-724-4254

To assist with scheduling, please have the following information when calling:

  • Name and phone number of the physician ordering the RFA of the lung
  • Indication for RFA of the lung
  • Patient Medical Record Number (MRN)

Additional Information and Resources

For further information about the risks and benefits of RFA of the lung

MGH Radiology Rounds E-Newsletter

MGH Collaborative Care








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