Thermal Ablation Destroys Tumors

Alberto Araneda considers himself a lucky man, despite the fact that he has battled cancer three times in the past four years.

Diagnosed with colon cancer after a routine colonoscopy in 2013, the now 53-year-old Woodbridge, Virginia, resident had surgery to remove the cancer and was relieved to hear that it had not spread. A year later, however, he was back in his oncologist’s office after routine lab work indicated a problem. Sure enough, doctors found a new tumor in his liver. More surgery followed, with chemotherapy added to the treatment plan. Still, Araneda remained optimistic. Then a follow-up CT scan in the spring of 2016 revealed multiple small nodules in both of his lungs. “It was another shock,” he recalls. He had finished chemotherapy just six months prior to the scan. “At this point, it felt like I was on a psychological roller coaster.”

After receiving confirmation that the new nodules were, in fact, metastases from the original colon cancer, Araneda’s oncologist recommended that he try thermal ablation therapy followed by more chemotherapy. He was eventually referred to Andrew Akman, MD, a Johns Hopkins interventional radiologist at Suburban Hospital.

“I left a message for Dr. Akman and was shocked when he personally called me back,” recalls Araneda. “From the first time I spoke with him, he was so professional and gave me confidence that he could help me. I also felt that he really cared.”

“Mr. Araneda was a very healthy, active man who was in fantastic shape and was not limited by any other condition,” says Dr. Akman. “The recurrent cancer was confined to his lungs. While a thoracic surgeon had removed a small part of one lung, based on the number and distribution of the remaining nodules, additional surgery was not an option. That left just chemotherapy or chemotherapy plus local therapy, which in this case, was thermal ablation. His oncologist wanted to clear the field of disease before Mr. Araneda started another round of chemotherapy. We came up with a plan to perform treatment sessions roughly every three weeks until all the lesions were treated.”

Microwave ablation is a type of thermal ablation, a minimally invasive outpatient procedure that has a low risk of complications and a relatively quick recovery. The procedure is performed using CT guidance. “We advance an ablation probe, which is similar in size to a biopsy needle, through the skin, across the lung and into the tumor,” explains Dr. Akman. “The probe heats up the area around the tip of the needle and burns the tumor. In most cases, the patient can go home after the procedure. The advantage of ablation therapy is that you can selectively target each spot, thereby treating a minimal amount of normal lung. You can also treat multiple spots in every lobe of the lung. In patients with a single lung lesion, ablation can be performed during the same procedure as the initial biopsy, enabling near simultaneous diagnosis and treatment.”

Typically used as an adjunct to chemotherapy, thermal ablation can be performed throughout the body. While there are different kinds of ablation therapy, microwave ablation is one of the newer technologies and is not available everywhere. It has been offered to Suburban Hospital patients for approximately six years.

Araneda tolerated the ablation procedures extremely well, having to spend just one night at Suburban during the course of all four treatments. “My experience at Suburban Hospital was amazing,” he says. “I was very fortunate that I had no major complications so it was easy to get back to work and my normal activities. What’s more, Dr. Akman personally checked on me after every procedure.”

Four months after Araneda’s last thermal ablation treatment, a CT scan finally revealed some good news. “In conjunction with the chemotherapy, it appears that the treatment eliminated all detectable disease in Mr. Araneda’s lungs,” declares Dr. Akman. Today, the married father of three is back to his active lifestyle. He feels grateful for his strong support system that includes family, friends, coworkers and Dr. Akman.

Even after multiple battles with cancer, Araneda remains confident that no matter what the future holds, he will be in good hands.

Interventional Oncology Targets Tumors Throughout the Body

Interventional oncology includes a variety of minimally invasive procedures that allow physicians to precisely target tumors throughout the body. At Suburban, procedures include three types of thermal ablation: microwave ablation, cryoablation and radiofrequency ablation.With ablation therapy, special probes are guided through the skin to the site of tumors, which are then burned or frozen to kill the cancer cells. Each of these therapies can be performed throughout the body, although they are primarily performed in the liver, lung, kidney and bone.The procedures require tiny incisions and most patients go home the same day.

Patients with cancer involving the liver also have access to embolization, including chemoembolization and radioembolization (also called Y90). During embolization, a small catheter is placed through an artery in the arm or leg and guided to the diseased portion of the liver. Radioactive particles or particles mixed with chemotherapeutic medications are infused through the catheter and into the tumors. Radioembolization patients go home the same day, while chemoembolization patients usually are observed overnight.

After a patient is referred to a Suburban Hospital interventional radiologist for a consult, the team determines which individualized treatment option is best. “Suburban is part of Johns Hopkins Medicine, so our patients greatly benefit from the Hopkins treatment protocols and multidisciplinary discussions,” says Dr. Akman.

TO LEARN MORE | For more information, visit suburbanhospital.org/ir.