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Effective Options for Cancer Treatment

An Important Advance in Cancer Treatment

Donald F. Denny, Jr., M.D.
Radiation Medicine
Princeton Radiology

When most people think of cancer treatment, they think of surgery, chemotherapy and traditional forms of radiation. But those therapies aren’t right for every situation. Fortunately, we now have a varied arsenal of innovative treatments that lets us choose the safest, most effective way to address each patient’s specific needs.  

These innovations are a great advance in cancer care because treatment gets the best results when it’s tailored to the type, location and origin of a tumor and the sensitivity of an area of the body to radiation.

One of these procedures, radiofrequency ablation, kills a cancerous tumor by subjecting it to intense heat. In a basic sense, this treatment is similar to cooking food in a microwave oven.

Usually, this procedure is used for cancer of the liver, lung, kidney or spine. For this treatment, the physician refers to an ultrasound or computed tomography (CT) scan to guide a needle into the tumor and monitor the results. The tip of the needle emits heat from microwave energy that reaches temperatures greater than 100 degrees Farenheit. Heating the tumor kills it by disrupting the proteins in its cells.   

Freezing a tumor—a process called cryotherapy—accomplishes the same goal. In the past, the only way to freeze tumors was by performing surgery. Now we can precisely insert a needle into a tumor and release liquid nitrogen or argon gas to lower its temperature to -40 degrees Farenheit or less. 

Freezing affects a tumor the same way frostbite affects a person’s fingertips. As the tumor is frozen, the water inside its cells turns to ice crystals. The crystals damage walls in the cells called cell membranes, which kills the tumor.  

For liver tumors, chemotherapy is still the first line of attack, but an effective alternative weapon is radioembolization. This treatment is usually used for tumors that have spread to the liver from another place in the body such as the colon, breast or lung.

Radioembolization delivers radiation to the liver in an innovative way. The physician inserts a catheter into an artery in the patient’s groin and threads it up into the liver. Small plastic spheres carrying a radioactive substance—each sphere is the size of a speck of dust—are injected into the catheter and carried by blood flow into the liver. The spheres become lodged inside the liver and deliver radiation to the tumor.    

The procedures I’ve described have four advantages. First, they give doctors a way to target treatment very accurately, and this precision makes treatment  effective and safe.

Second, they give physicians choices for treatment that fits the patient’s situation. For example, most brain tumors are treated effectively with radiation, but it’s not appropriate to use radiofrequency ablation or cryotherapy to kill a brain tumor with heat or cold. On the other hand, the liver doesn’t handle radiation well, so targeted techniques that use a needle to emit heat or cold can give the same benefits as radiation without damaging normal liver tissue and causing side effects.   

The third advantage of these methods is that after treatment, if a new lesion or tumor develops in the treated area, it can be re-treated—that usually isn’t possible with radiation.

And lastly, the treatments I described are less stressful for patients. Since the treatment is precisely targeted, there is minimal damage to healthy tissue. They are outpatient procedures—most patients go home the same day—and they cause minor side effects, usually just mild discomfort or slight fatigue, or none at all.   

As more innovative treatments are developed, cancer is becoming a condition that can be effectively managed rather than one that must be completely cured. Through these innovations, we are better equipped to manage complex cancer cases and provide positive outcomes for our patients.