The interventional radiology team from the Department of Radiology at Hospital de Clínicas (HC) at Unicamp removed a liver tumor using the microwave ablation technique. The method, already consolidated in the main cancer centers worldwide, has high potential for the treatment of cancer patients and arrived in Brazil in 2019. It has already been used successfully in private hospitals, but this was the first procedure carried out in a public hospital from the interior of the State of São Paulo.
The surgery took place at the end of March, on a 57-year-old patient living in Americana (SP) who has been monitored at HC since 2017. The procedure lasted two hours. The patient had no subsequent significant complaints and was discharged after 24 hours.
According to radiologist Thiago Penachim, coordinator of the Interventional Radiology group at HC Unicamp and leader of the team that performed the procedure, microwave ablation is indicated for some types of primary or secondary cancer of the liver, kidney, lung, adrenal glands, bone and musculodipose, being an excellent option for less invasive and faster treatment of injuries, without the need for incisions.
“For some types of cancer, ablative techniques have results similar to those obtained in surgery, with the advantage of preserving the function of the organs in which the tumor is housed and the patient's rapid recovery, with discharge after one day of hospitalization in most cases. cases. As it is less invasive, the procedure can be repeated in situations such as the reappearance of lesions or residual tumors”, explains Thiago.
Therapeutic arsenal
Since 2010, other thermal tumor ablation methods have been used at Unicamp, such as heat treatment, such as radiofrequency ablation, and cryoablation, which uses cold. These techniques are mainly applied to patients who cannot be operated on or when surgery represents a high risk. Microwave ablation, however, is one of the recent developments in the field of ablation.
“Microwave ablation is an alternative to optimize the therapeutic arsenal of interventional radiology at Unicamp HC, and can be more effective and faster in selected cases, such as larger lesions”, says Thiago.
The procedure is performed with the patient under general anesthesia or conscious sedation. The interventional radiologist is guided in real time by imaging methods such as ultrasound and computed tomography, allowing him to visualize the needle that he introduced to reach the lesion, and whose end must be positioned inside the tumor.
After confirming the precise positioning, a generator is activated, causing microwaves to be emitted at the tip of the needle. This causes the movement of water molecules, raising the local temperature above 70ºC and destroying the lesion in a few minutes, without the need for surgical removal.
Although the indications for ablative procedures are quite broad, not all cancer patients can benefit from the technique. The type and nature of the tumor, its size and location determine the choice of oncological therapy.
“The choice of the best type of therapy must be made through multidisciplinary discussion between the specialties involved in the treatment – oncologist, surgeon, radiotherapist and interventional radiologist – and, mainly, by the patient”, highlights Thiago.
Procedure is not available by SUS
Despite being part of the procedures authorized by the National Health Agency (ANS) in the private health sector, microwave ablation is not yet regulated by the Unified Health System (SUS). The procedure carried out at Unicamp's HC was only possible due to the donation of the material by the company Angiodynamics. They also participated in the surgery Luiz Felipe Rodrigues and Bruno Renan Linard, residents of the Interventional Radiology discipline at Unicamp.
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Original article published on the Hospital de Clínicas da Unicamp website.
