New treatments are changing the way in which tumors are treated with very exciting results. Developments in chemotherapy and radiation therapy have improved results and decreased side effects, while advancements in surgery with small instruments and television cameras inside the body have reduced the recovery time, without sacrificing quality of treatment. Over the past, the indications for these treatments have expanded, and the utilization of these treatments for a variety of diseases has increased.
Percutaneous techniques typically employ thermal energy delivered by a probe placed directly through the skin into a tumor. The probe is positioned with guidance from CT scan or ultrasound into the tumor, and then the thermal energy is administered. Techniques include Radiofrequency using heat energy, and Cyrotherapy using cold energy. Both techniques effectively kill tumors.
Since inception, Radiofrequency ablation (RFA) has been used as a technique to treat tumors of the liver, kidney, lung, and bone with outstanding results. One needs to remember that the results of RFA, while very encouraging in many studies, have not been directly compared with traditional therapies, and the indications for use vary tremendously in a given patient. However, there is increasing data in the medical literature to support the use of RFA in many patients, particularly in patients who are considered poor operative risks for the traditional surgical therapy. Over time, RFA may prove to be the first of many techniques to treat tumors directly by placing a small instrument through the skin.
Chemoembolization is a technique, which involves placement of a small tube through the skin into an artery (usually in the groin), and then advancing into an artery that feeds tumor. Medications are then administered into the feeding arteries, using combinations of chemotherapeutic agents as well as other materials, which alter the blood flow. This technique has been used in cases of primary liver cancer for many years, but the applications have expanded significantly. Chemoembolization now is used increasingly for treatment of liver metastases from colorectal cancer and endocrine tumors, as well as treating advanced malignancies of the head and neck.
All of these treatments are intended to halt the progression of cancer, and improve quality of life.
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