Editors' ChoiceLung tumors

Roaming Cancers Are Cooked

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Science Translational Medicine  02 Nov 2011:
Vol. 3, Issue 107, pp. 107ec178
DOI: 10.1126/scitranslmed.3003372

The debunker Web site snopes.com has ruled that, no, an employee who stood too close to microwave radiation was not in fact cooked by the rays one cold Christmas eve. But when properly regulated, microwaves might be able to cook tumors. In a recent clinical study by Vogl et al., some subjects tasted success when microwave ablation was performed on 130 tumors in 80 patients.

Cancers such as breast, kidney, and colon have a rich venous drainage and thus tend to metastasize to the lungs. Surgical removal of these metastatic deposits from lungs can prolong the lives of these patients, but many are poor surgical candidates because of other health complications. For such patients, a possible alternative is to use microwaves to burn these tumors away. The basic technique for microwave ablation of tumors that have metastasized to the lung involves the use of computerized tomography (CAT scanning) imaging to accurately place a needle into the tumor and then activation of the microwave to locally heat the tumor in the region around the needle. Although the procedure is minimally invasive, it is not without complications, including lung collapse, which results from the introduction of air into the pleural space that surrounds the lungs, or bleeding around the tumor, which can cause the patient to cough up blood. These are complications that can easily be treated.

Vogl et al. successfully obliterated 95 of the 130 (73.1%) lung lesions, as assessed with postprocedural CT scans at 3, 6, 9, and 12 months. Treatment was most successful when the lesions were small (<3 cm in diameter) and located far (>5 cm) from the central lung vessels. The larger central lung vessels are thought to act as a heat sink, thus reducing the heating effects of microwave ablation and leading to technical failure of treatment. The authors also found that the tissue location of the primary tumor was irrelevant to the treatment effectiveness. Patients who underwent successful treatment had higher survival rates at 12 and 24 months than did those patients who did not have successful treatment.

These new findings highlight a use for microwaves beyond heating pizza in a dorm room, and cooking of lung tumors may become common. Stay tuned, because scientists and clinicians are cooking up other culinary cancer therapies, such as freezing of tumors with cryoablation.

T. J. Vogl et al., Microwave ablation therapy: Clinical utility in treatment of pulmonary metastases. Radiology 261, 643–651 (2011). [Abstract]

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