Upon hearing about the symptoms, a health care provider will
formulate a list of possible diagnoses. The doctor will ask questions about the
symptoms, medical and surgical history, smoking and work history, and other
questions about lifestyle, overall health, and medications.
Cancer of the lung, like all cancers, results from an abnormality in the body's
basic unit of life, the cell. Normally, the body maintains a system of checks
and balances on cell growth so that cells divide to produce new cells only when
new cells are needed. Disruption of this system of checks and balances on cell
growth results in an uncontrolled division and proliferation of cells that
eventually forms a mass known as a tumor.
Lung cancer is the leading cause of cancer deaths in women and men both in the
United States and throughout the world. Lung cancer has surpassed breast cancer
as the leading cause of cancer deaths in women for the past 25 years. In the
United States, there are more deaths due to lung cancer than the number of
deaths from colon and rectal, breast, and prostate cancer combined.
How is the procedure performed? Image-guided, minimally invasive procedures
such as ablation are most often performed by a specially trained interventional
radiologist in an interventional radiology suite or occasionally in the
operating room. Ablation is often done on an outpatient basis. You will be
positioned on the examining table. You may be connected to monitors that track
your heart rate, blood pressure and pulse during the procedure. A nurse or
technologist will insert an intravenous (IV) line into a vein in your hand or
arm so that sedation medication can be given intravenously. Your physician will
use CT scanning to precisely locate the tumor. Your skin will be marked at the
planned site of entry on the skin of the chest wall. The area where the needles
are to be inserted will be sterilized and covered with a surgical drape.
Your
physician will numb the area with a local anesthetic. Intravenous conscious
sedation and/or general anesthesia may also be used in addition to local
anesthetic. The type of anesthesia to be used will be determined during the
initial evaluation. A very small skin incision is made at the site. Ablation is
performed using one of three methods: Surgery. Percutaneous, in which needle
electrodes are inserted through the skin and into the site of the tumor.
Thoracoscopic, in which needle electrodes within a thin, plastic tube are
threaded through a small hole in the skin in a procedure called a thoracoscopy.
Using imaging-guidance, your physician will insert the needle electrode through
the skin and advance it to the site of the tumor. Once the needle electrode is
in place, energy is applied. For a large tumor, it may be necessary to do
multiple ablations by repositioning the needle electrode or by placing multiple
needles into different parts of the tumor to ensure no tumor tissue is left
behind. At the end of the procedure, the needle electrode will be removed and
pressure will be applied to stop any bleeding and the opening in the skin is
covered with a dressing. No sutures are needed. Your intravenous line will be
removed. A chest x-ray will be taken to make sure that the lung has not
collapsed from an air leak created during the procedure. If a moderate air leak
has occurred, it may be necessary to insert a small tube into the area to
remove the air and allow re-expansion of the lung. The tube may need to remain
in place for one to several days. Each ablation takes about 10 to 30 minutes,
with additional time required if multiple ablations are performed. The entire
procedure is usually completed within one to three hours.
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