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Cancer therapy leads to quick recovery

Imagine a cancer treatment that leaves you back on your feet in a day with no nausea, no hair loss or any equally adverse side effects.

Over the past three years, the Duke Comprehensive Cancer Center has started to use such a procedure--radiofrequency ablation, a non-invasive technique used to attack liver, kidney and lung cancers when standard tumor removal is not an option.

Dr. Rendon Nelson, professor of radiology, has performed over 100 radiofrequency ablations, primarily to treat liver cancer.

"It is easy on patients and results in no loss of function," said Nelson, the only surgeon at Duke who performs the technique. The procedure allows for a wider margin of error since it will not damage adjacent structures.

Doctors say the process is also faster and less invasive than traditional surgery. Physicians make a two- to three-millimeter incision in the tumor and insert a needle connected to an electrical generator. Using radio waves, a thermal zone of about 100 degrees Celsius is created around the tumor, destroying the malignant cells and surrounding tissue. Both a CT scan and ultrasound imaging are used to guide the needle placement, increasing the accuracy of the procedure. Treatment times range from less than 15 minutes to under an hour.

Carol Conner, a South Carolina resident who has been treated with radiofrequency ablation eight times, has had 34 lesions removed over the course of three and a half years after doctors ruled out surgery.

"I'm convinced it kept me alive," she said. "After suffering from breast cancer for over four years and watching it spread to my liver, you realize how scary cancer is. But with radiofrequency ablation, you know right then and there that the visible spots are gone."

Patients who suffer from frequent metastasis or poor liver function, or who may not otherwise be able to tolerate invasive surgery are the most likely candidates for radiofrequency ablation.

Although patients do not experience the adverse effects of chemotherapy and radiation, such as hair loss or nausea, they may suffer from fatigue, fever and pain for a few days following the procedure.

Conner said that after her surgery, she noticed only a band-aid and "what looked like a snakebite." She was discharged the same day as the procedure and said the effects of the anesthesia were more severe than those of the operation itself. A few days later, Conner returned to work without any painkillers.

Despite its apparent success, rare complications include bleeding, infection, shoulder pain, skin injury and bile leakage. Nelson said that complications occur infrequently. In addition to the pre-operative screening, radiofrequency ablation also requires frequent follow-up visits. MRIs and CT scans are repeated six to eight weeks after the surgery to monitor the possible development of additional tumors.

Nelson said the future of radiofrequency ablation is promising. As technology advances, experts hope to create needles producing larger thermal zones to remove more massive tumors. Doctors also hope that if the process can be guided by magnetic resonance imaging, they will be able to better regulate needle temperatures. Nelson said the procedure has additional applications, including the ability to burn nerve endings and help alleviate cancer patients' pain.

The first radiofrequency ablations were performed in the U.S. about seven years ago, and today nearly fifty centers nationwide are equipped to offer the treatment.

"There is no other treatment like it, and I know that the tumors can always be taken care of," Conner said. "I like to stay one step ahead in this roller coaster ride."


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