Lung cancer is the leading cause
of cancer deaths in U.S. men and women.
Lung cancer has a tremendous impact
on U.S. mortality, with an estimated 160,340 deaths
in 2012 in men and women combined.[1] Lung cancer
incidence and mortality rates increased markedly
through most of the last century, first in men
and then in women.
Lung cancer now accounts for
14% of new cancer cases and 28% of all cancer deaths
each year in the United States.[2] Lung cancer
accounts for more deaths than any other cancer
in both men and women. Death rates
for lung cancer in women surpassed those for breast
cancer in 1987, and lung cancer is now the leading
cause of cancer deaths in both genders. In 2012,
it is estimated that there will be 72,590 deaths
among U.S. women due to lung cancer, compared to
39,510 due to breast cancer. Estimates put
the number of deaths among U.S. men from lung cancer
at 87,750. [1]
The need for more effective treatment
for the majority of patients who are not candidates
for surgical resection has prompted investigators
to seek new methods to treat pulmonary malignancies
through a regional or local approach. Radiofrequency
ablation (RFA), a technique for local soft tissue
tumor therapy, is one such approach.
RF ablation is ideal for treatment of patients
with nonresectable primary lung tumors, multiple
lesions in one or both lungs. RF ablation of lung
tumors can preserve more lung function than surgery
which is extremely important in patients with diminished
lung capacity. The patient can potentially be made
free of disease, in some cases. In other cases
a significant reduction in tumor volume may be
achieved, allowing chemotherapy to be move effective.
RF ablation may be used in conjunction with chemotherapy
for added benefits. Tumor cells are made more sensitive
to heat with chemotherapy making ablation more
effective. Destroying the central portion of tumors
can be effectively achieved using RF ablation.
It is this area of tumors that does not respond
well to chemotherapy because of decreased blood
flow. Therefore, the ability to destroy the central
tumor using RF ablation is a tremendous advantage
in extending life.
References 1. American Cancer Society: Cancer Facts and
Figures 2003. Atlanta, Ga: American Cancer Society,
2003. Also available online. Last accessed January
30, 2003.
2. Wingo PA, Ries LA, Giovino GA, et al.: Annual report to the nation
on the status of cancer, 1973-1996, with a special section on lung
cancer and tobacco smoking. J Natl Cancer Inst 91 (8): 675-90, 1999.
[PUBMED Abstract]
Treatment
Options
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Percutaneous,
endoscopic guidance, or as part of an open surgical
procedure. Percutaneous RFA in patients with a limited
number of small metastases from other organ sites.
In most cases, patients who receive this form of
RFA are discharged within 24 hours of treatment.
RFA with CT guidance, endoscopic guidance, 3D fluoroscopic guidance
with or without navigation and ultrasonography are various methods
to localize the tumor(s) for RF ablation.
Few patients are eligible for resection due to
various factors including:
• Number, size, and location of tumors within the lung
• Extension of lung tumors into adjacent tissues and/or mediastinum
• Ability to withstand a major surgical procedure
• Cardiac
• Lung (empyzema, COPD)
• Other organ(s) dysfunction