Lung cancer

Medical procedures performed by interventional radiology experts are becoming all the more important in the management of patients with lung cancer.

One of the most useful medical procedures in the diagnostic algorithm of the disease is percutaneous biopsy under the guidance of axial tomography, so that a cytological and histological examination sample may be collected in cases of suspicious findings. This will lead to diagnosis and appropriate treatment selection.

Percutaneous biopsy is performed at the Department of Interventional Radiology of the Interbalkan Medical Centre and it isa quick and safe highly sensitivetechnique of diagnosing malignant neoplasias. Besides, in cases of pleural effusion, it is possible to use minimally invasive techniques of interventional radiology for percutaneous collection of a sample from the effusion to be sent for cytological examination or for placing a catheter to drain the fluid.

When it comes to the contribution of interventional radiology to the therapeutic treatment of lung cancer, thermal ablation is a relatively new but particularly promising treatment method.

Under the guidance of axial tomography, a fine needle is inserted transcutaneously; radiofrequencies (RF ablation) or microwaves (MW ablation) are applied through the needle onto the metastatic focus, so that controlled destruction is caused by high heat (coagulative necrosis).   

Although lung cancer is treated surgically at early stages, there are patients who are already essentially inoperable when the diagnosis is made. Furthermore, there are patients with advanced cancer who do not respond to chemotherapy or radiation, who seem to have medical indications for alternative treatment methods, such as transcutaneous thermal ablation.

Patients with limited metastatic disease in the lung may not be in a position to be operated on – due to their overall clinical condition – and present a difficult medical problem, which, however, may be resolved by transcutaneous thermal ablation of metastatic focus.

Regional transarterial chemotherapy of lung cancer or lung metastases is also an important treatment method in selected cases. In these patients, chemotherapeutic agents are locally administered to the tumour and its surrounding area through arterial catheterisation.

In this manner, lower medication doses achievehigh dosage at the cellular-tissue level and generalised toxic side-effects are avoided.  The method is applied at many centres abroad, although surgical treatment, chemotherapy and radiation therapy remain at the core of lung cancer treatment.

Interventional radiology methods keep evolving as alternative and complementary methods, mainly for patients who cannot have surgery or follow any other treatment; such methods are also fully applicable for patients who cannot or do not want to stay in hospital for a prolonged period of time.

Dr Ioannis Dedes has rich experience in managing lung cancer patients, both for diagnostic purposes (guided biopsy) and for therapeutic treatment purposes (ablation, transarterial chemotherapy, pleural effusion drainage).

These methods are very well tolerated by patients; they also have high success rates, increase life expectancy and maintain high quality of life for patients.