What is ablation?

Ablation is a lung cancer treatment that does not involve surgery. It uses either heat or extreme cold to destroy cancer cells. The cancer cells die and the treated area slowly shrinks and becomes scar tissue.

Ablation has been available since the 1990s and has been successfully used in Europe and America. It is now being used increasingly in the UK.

There are three main methods of ablation available at our hospitals:

• Cryo ablation – a probe produces very low temperatures that freeze the tissue and kill cancer cells
• Radiofrequency ablation – an electrode produces high-energy radio waves that kill the cancer cells
• Microwave ablation – a probe that produces microwaves (heat) that kill the cancer cells

Your doctor will choose the type of ablation depending on the exact type and location of your tumour. Some patients need to have further treatment on the lung and, for many patients, ablation can be repeated if needed.

When is ablation used?

Ablation can be used to treat primary or secondary cancer in the lung. Primary cancer means the original cancer. A secondary cancer means that cancer cells have spread to another part of the body and made a new tumour there.

Ablation can be used alone as a treatment, or it can be used together with other treatments, such as surgery, radiotherapy or chemotherapy. You and your hospital doctor can discuss the best course of treatment for you.

Ablation may be the right treatment for you if:

• surgery is not an option
• there are a small number of secondary tumours in your lungs
• the tumour is in an area of the body where it is difficult to operate

How is ablation carried out?

Ablation is carried out in the CT scanning department and not in the operating theatre. It is usually performed under a general anaesthetic. However, you can have a local anaesthetic to numb the area of your body that is to be treated, and medication to make you drowsy instead.

The probe is put into the middle of the tumour. This produces heat or freezes the tumour and destroys the cells. The procedure usually takes between one and three hours.

Will it be painful?

It is likely that you will have some pain in the part of your body where the treatment is being carried out. The doctor will prescribe painkillers for you to have after the procedure.

What are the benefits of having ablation?

• Ablation does not involve a surgical operation.
• Side effects and complications from ablation are less common and less serious than with surgery.
• The procedure can be repeated.
• You can go back to your normal activities within a few days.

What are the risks of having ablation?

Pneumothorax (collapsed lung)

This is caused by the build-up of air in the space around the lung. The risk of having a collapsed lung is low and it is not usually serious. Our clinical staff can help the lung to expand quickly and easily by inserting a tube to drain away the air from around the lung. If this occurs you may have to stay in hospital for between two and four days.

Infection

Any procedure where the skin is broken carries a risk of infection. After the treatment, you will be given antibiotics to prevent infection. This is usually for up to seven days but, on some occasions, patients need a longer course of antibiotics.

Haemoptysis (coughing up blood)

Occasionally, patients cough up a small amount of blood. This is normal after an ablation treatment. If this persists or develops more than 24 hours after treatment, you should contact the hospital for further advice.

What happens when I go home?

Normally, you will be able to go home the day after your procedure. Before you go home, we will discuss your follow-up treatment with you. It is likely you will be off work for one week after your treatment.

Signs to look out for when you are at home:

• shortness of breath and pain when breathing in
• pain that is not controlled by regular painkillers, such as paracetamol
• a raised temperature or pain one to two weeks after the treatment

If you have any of these symptoms, please contact the hospital – either the lung cancer nurse specialist or the ward where you were admitted.