Ablation therapy can be used to reduce or remove bone tumours. The procedure can be performed using heat energy, cold temperatures, or chemical agents. The heat is produced using microwave, radiofrequency, ultrasound, or laser. Cryoablation, on the other hand, is the procedure that uses extremely cold temperatures. The treatment is performed using advanced imaging technologies, such as computed tomography (CT) or magnetic resonance imaging (MRI).
Ablation therapy is one of the more recent developments in cancer treatment. It is non-surgical and minimally invasive. Its goal is to destroy tumours completely. If this is not possible, the volume or number of tumour cells is reduced as much as possible.
Ablation therapy is the treatment of choice for many types of bone tumours. This is because when compared to other bone tumour treatment options, ablation therapy:
Ablation therapy can be recommended for patients who suffer from malignant or benign tumours that grow on or have spread to the bones. These bone lesions typically produce various symptoms, including bone pain, fractures, and spinal cord compression.
A large percentage of bone tumours are malignant metastatic cancer that spread to the bones from somewhere else in the body. Bone metastases occur when cancer cells enter the bloodstream and reach the bone marrow.
Ablation therapy is effective for most types of bone tumours including osteoid osteomas, osteolytic metastatic lesions, and myeloma. The treatment is also effective for benign conditions, including giant cell tumour, chondroblastoma, and osteoblastoma. It destroys tumour cells, relieves symptoms (especially the excruciating pain associated with some bone tumours), and strengthens the bone.
The procedure is often used in cases where conventional treatment options have already been attempted without success. It is also sometimes combined with other treatment methods, such as cementoplasty.
The success of the procedure is influenced by several factors, including:
Patients who are undergoing tumour ablation therapy for the reduction or eradication of one or more bone tumours will generally go through the following steps:
For radiofrequency ablation therapy using heat energy, the procedure is performed as follows:
For cryoablation therapy, the tumour is frozen, causing its cells to die. During the procedure, the doctor uses a cryoprobe that delivers argon gas into the tumour. The gas will result in rapid cooling. It can reach negative temperatures in just a few seconds.
After the procedure, patients will stay at the hospital for 24 to 48 hours. It is normal for them to experience some discomfort, fatigue, and muscle pain at the site where the ablation needle was inserted. The pain may be less for patients who have undergone cryoablation. Some patients may also get a low-grade fever. These symptoms occur a few days after the procedure. Once they go away, however, patients will experience a rapid recovery.
They are also given a follow-up schedule. During follow-up visits, the patient will undergo MRI scanning to check whether all tumour cells were destroyed or the treatment goals were met.
Not all bone tumour patients can undergo ablation therapy. For example, the treatment is not recommended for patients who have cardiac pacemakers.
The treatment also has some potential risks and complications, including:
Thermal damage to nerves
Santiago FR, Garcia MdMC, Montes JLM, Garcia MR, Fernandez JMT. “Treatment of bone tumours by radiofrequency thermal ablation.” Curr Rev Musculoskelet Med. 2009 Mar; 2(1): 43-50. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2684952/
Callstrom MR, Charboneau JW. “Percutaneous ablation: Safe, effective treatment of bone tumors.” Oncology Journal. 2005 Oct 1. http://www.cancernetwork.com/oncology-journal/percutaneous-ablation-safe-effective-treatment-bone-tumors