Lung nodule Ablation. What is this?

Hello dgulovsen- I did not have radiation, I had a segmentectomy. Left upper lobe. My nodule grew from 8mm to about 22 mm in 9 years. I was VERY lucky it was very slow growing because I didn’t know it was there. (Long story about that!). When I went to Mayo I said I wanted the pinpoint radiation. They said the nodule was too small for that and to get it all surgery was the best option. They take some lymph nodes along with the section of cancer and a little larger area to get any cells that may have traveled.
My Aunt who was 78 at the time of her findings, (left lower lobe) had the “Cyberknife” pin point radiation and it seemed to have killed her cancer. She could not have surgery because of a heart issue, so that was her only option. With either one you will get scar tissue. Radiation seems to be “easier” but there are still risks. You want to do the best option for getting rid of ALL the cancer. I had the VATS surgery done at Mayo in Phoenix and I am so very happy I listened to the thoracic surgeon. I am 2 years clear now and very active. I am 61 as of yesterday! The best advice I can give is to talk to the surgeon and the radiation oncologist. Between the 3 of you, you will be able to come up with the best way for you to get the treatment you want and need. Good Luck and God Bless you!🙏

Hi @dgulovsen—great question. “Ablation” is a minimally invasive way to destroy a small tumor when surgery isn’t the best option. A radiologist places a thin probe into the spot under CT or ultrasound guidance and then either heats the area (radiofrequency or microwave ablation) or freezes it (cryoablation) to kill the cancer cells.

It’s commonly used when lesions are small and in locations where focused treatment is feasible. Your care team will consider the size and location to decide if ablation is a good fit.

In answer to your question, "Does it get everything?" The short answer is the same as radiation: often, but not always. Like radiation, they'll target what's there and a small surrounding volume of tissue.

MD Anderson has a general page about ablation: https://www.mdanderson.org/cancerwise/how-is-ablation-therapy-used-to-treat-cancer.h00-159623379.html
Full disclosure, in the 5 years since my lung cancer metastasized to my brain, I've gone to MD Anderson for a second opinion. Also, one of their doctors, a world-renowned expert on EGFR+ mutations, is currently on my care team along with my local doctors. Best of luck to you!

I had a 2.6 cm lung tumor destroyed with microwave ablation. 2 probes thru my back. Face down on CT table for 2 hours because I had to go in CT repeatedly to adjust placement of the probes till just right then maybe 15-20 min for the actual ablation. Didn’t really hurt. Was successful with complete destruction 4.5 years ago. I need two more ablations now from tumors blocking airways. 50+ nodules scattered thru both lungs. Very slow growing neuroendocrine cancer with low risk of metastasis. Worked great for me. I might be more concerned if I had something like NSCLC that is more aggressive. My non-smoking brother had that and his cancer journey was all about metastasis and nothing like my very long term but easier journey. Praying they destroy whatever it is you have.

Hello Zebra
Your reply is very timely. I'm having ablation of two tumours in my right lung this week followed by two in my left lung later in October, using microwave tech. The largest is 19mm (measured on 26 August) so could be a bit larger.
I'm wondering what to expect. It's being done under local anaesthetic and I'm due to be discharged the same day. Will I experience any pain afterwards and how long will the recovery be before I'm back on my bike and walking lots?
Your advice would be much appreciated. Thanks.

@martin77
I just had a local anesthetic too. I was told there are not many nerve endings in the middle of the lung so that’s why it didn’t really hurt. More nerve endings on the periphery but then they use cryoablation. They can give IV NSAIDS and Tylenol if needed but I didn’t need it. My procedure was also outpatient hospital. It was mostly just hard for me to lie down on my stomach with my bad back and neck. Next time I want a face donut and will order one off Amazon if they won’t supply it. That way I can be face down instead of having my head turned to the side. Once in position you have to stay still until they are done. I had an unexpected complication of a partially collapsed lung so my lung ached and I was short of breath after a day or two because of that. Not unbearable. I can’t take any kind of pain med, but NSAIDS probably would have handled it. The same thing happened with my lung biopsy. They think because I had a chronic cough that didn’t allow proper healing. So that had me in my recliner for a week. If not for that, I think the recovery would have been really quick and I don’t think I would have had any pain. Since it was 4.5 years ago the details are fading. I think you’ll be really happy with ablation compared to surgery.

So you’re having ablation of 4 tumors. Are there just four? What type of cancer or are they benign?

Thanks for your reply. Sounds like a successful outcome for you, and hopefully for me too. I'll try and get a face doughnut before Thursday - thanks for the tip as my neck has been quite painful recently.
My cancer started in the colon in November 22. I had a successful op followed by 3 months of chemo and then diagnosed with liver cancer in July 24 and another successful op in August 24. Lots of cycling, walking and skiing since but diagnosed with lung tumours in Feb this year. The good news is that the colon and liver are both clear and so hopefully the lungs will follow suit after the ablation tech.
Thanks again!

@martin77
Prayers for a good outcome for you. Your body sounds very receptive to treatment. You’re doing everything right and have a great attitude. Keep up the good fight. You’re winning! 😊

@californiazebra
Thanks. A positive attitude is I'm sure half the battle!
Today’s ablation of two spots in my right lung appears to have gone well. Back home now, tired but not too much discomfort.
Take care.
Martin

@martin77
Great news! Now you’ll feel better about doing the other two. Glad it went well.

@martin77
I spoke too soon! By 1.30am on Friday I was in significant pain and was admitted to my local hospital in Cambridge UK where at long last I seem to be on the mend, after a diet of morphine, other painkillers, lots of Xrays and blood tests.
It seems that minimally invasive procedures like RFA don't always go to plan!
Has anyone else had the same experience?