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Thermal Ablation of Lung Cancer
Radio Frequency & Microwave Ablation

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Disease Overview | Inoperable Tumors and Lung Cancer

• Primary lung tumors
• Metastatic lung tumor

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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.

Current treatment options include:
• Resection (currently the preferred treatment option)
• Lobectomy
• Segmentectomy
• Wedge
• Chemotherapy
• XRT (radiation)

Limiting Factors to Resection

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

Watch Video - Who Cannot Have RFA? by Dr. Nielson
 
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