Lung Thermal Ablation Program

Overview

Massachusetts General Hospital has treated early-stage lung cancer since 2003, making us one of the first hospitals to use the technique for this purpose. The Lung Ablation Program is a joint effort between thoracic surgery and thoracic radiology.

We are dedicated to furthering the medical field's understanding of this promising technique. Our division took part in a national clinical trial studying the outcomes of radiofrequency ablation for medically inoperable stage I lung cancer.

Physicians in the Lung Ablation Program at Mass General are subspecialized thoracic radiologists and thoracic surgeons with expertise in radiofrequency ablation (RFA), microwave ablation (MWA) and cryoablation. Eligible patients include those with lung metastases, as well as early-stage or recurrent lung cancer from whom ablation is deemed more beneficial than resection or radiation. Patients who choose Mass General for lung ablation receive specialized care at a world-renowned institution with an outstanding reputation.

At Mass General, we have a long tradition of treating lung cancer and lung metastases using both traditional methods and minimally-invasive techniques including:

• Robotic thoracoscopy
• Thermal lung ablation with either radiofrequency, microwave or cryoablation
• Video-assisted thoracoscopy (VATS)

Surgical removal remains the ideal approach for treating early-stage malignant non-small cell lung cancer (NSCLC). However, some patients may wish to avoid conventional surgery or, in some cases, may be too ill to undergo surgery due to other conditions such as emphysema, vascular disease and/or heart disease. In these cases, radiation or thermal ablation may represent an effective alternative. Lung ablation may also be appropriate for patients with inoperable lung nodules suspicious for lung cancer or spread of disease from other organ sites (lung metastases).

All candidates for lung ablation should:

• Be capable of walking
• Have a tissue diagnosis of tumor
• Have a tumor less than three centimeters in diameter

During lung ablation, computed tomography is used to provide guidance for placement of one or more thin needles in or around the targeted tumor. Energy is delivered through the needles to create either intense heat or cold to ablate, or destroy, the cancerous cells. For most patients at Mass General, we can ablate tumors that are smaller than three centimeters. In some cases, we may consider combining external beam radiation and thermal ablation to treat larger tumors. The procedure causes minimal pain, has a very short recovery period and is a viable option for patients with limited lung function.

Patient Experience

For patients for whom a chest X-ray or cardiothoracic (CT) scan identifies an abnormality, a diagnosis of lung cancer is usually confirmed via one of three methods:

• Examining the airway via bronchoscopy
• Passing a needle into the lung with the help of CT guidance
• Taking a biopsy from abnormal or enlarged lymph nodes adjacent to the windpipe

To determine the extent of tumor, we perform a complete assessment called staging. Patients with lung cancer are first seen at the Multidisciplinary Thoracic Oncology Clinic and are evaluated by thoracic surgeons, oncologists and radiation therapists. A treatment plan is developed that might include surgery, radiation, chemotherapy and/or lung ablation.

Clinical studies have demonstrated that lung ablation can be an effective treatment for local control of early-stage lung cancer or limited metastatic disease to the lung. Patients with pain from spread of tumor to chest wall may also benefit. Lung ablation is typically conducted under conscious sedation or general anesthesia in our radiology suite. A patient who is deemed a good candidate by a consulting team of physicians to undergo lung ablation meets with a thoracic radiologist and an interventional radiology nurse to discuss the procedure, possible complications and plan for follow-up.

After the procedure, patients are admitted overnight for monitoring and usually go home the next day. Most patients return quickly to normal activities.

At Mass General, we're committed to following lung ablation patients closely to gauge their long-term health. We perform follow-up imaging studies at scheduled intervals between one and 24 months. If patients cannot travel to Mass General, the studies can be obtained closer to their home and sent to the hospital for review.

Schedule an Appointment

For questions about lung ablation or to schedule an appointment, please call:

• Department of Surgery, Division of Thoracic Surgery: 617-726-6751
• Department of Radiology, Division of Thoracic Imaging and Intervention: 617-724-4254