Radiofrequency ablation now used to treat lung cancer tumors

Surgeons at Boston Medical Center are pioneering the use of radiofrequency ablation (RFA) to treat patients with lung tumors. More frequently associated with the treatment of heart disease and liver tumors, RFA is now being used as a minimally invasive method to treat lung tumors in patients who could be appropriately treated by surgery, but are unable to have an operation because of medical co-morbidities or refusal.

With the number of new cases approaching 174,000 per year, lung cancer is the most common cause of cancer-related death in the United States. Traditional approaches to treating lung cancer utilize complete resection, radiation therapy or the resection of pulmonary metastasis. In patients with primary lung cancer or patients who are medically inoperable, RFA is a viable alternative, particularly when tumors are 5 cm or less in size and peripherally, rather than centrally, located.

RFA involves three components: a generator, an active electrode and dispersive electrodes. RF energy is an alternating current that moves from the active to the dispersive and then back to the active electrode. This movement heats the tumor tissue. When the temperature of the tumor tissue rises above 60o C, tumor cells begin to die, with minimal damage done to surrounding normal lung tissue. RFA is usually performed with CT scan guidance to place the active electrode (probe) into the tumor. In most cases, a standard incision is not required.

When lung resection is performed, some normal lung surrounding the tumor is always removed. With RFA, no surrounding lung is removed so there is better preservation of lung function in high-risk patients. This minimally invasive approach allows a faster recovery and a quicker return to normal activity.

The long-term effectiveness of RFA in controlling cancer is still unknown. Therefore, resection of a cancer should be performed whenever possible. Before a patient undergoes RFA, however, he or she should first be evaluated by a thoracic surgeon to exhaust any surgical options. Reflecting its commitment to providing minimally invasive surgical options, Boston Medical Center is pleased to offer RFA as an option for lung cancer patients for whom it is an appropriate treatment. Hiran Fernando, M.D., MBBS, FRCS, Director of Minimally Invasive Thoracic Surgery at BMC, and Associate Professor of Cardiothoracic Surgery at Boston University School of Medicine (BUSM), is a leader in the use of this procedure. Dr. Fernando has recently joined Benedict Daley, M.D., Clinical Director of General Thoracic Surgery at BMC, and Professor of Cardiothoracic Surgery at BUSM.

To learn more about RFA in the treatment of lung tumors, or to refer a patient for evaluation, call Dr. Fernando at (617) 414-7246. (number is for Carl Reynolds)