32 Neoplasms – Surgery, Thermotherapy and Photodynamic Therapy Treatments

There are several types of cancer treatments.  Treatments that aim to physically destroy or remove the tumor that can be seen by the naked eye in a single session include surgeries, thermotherapy treatments and photodynamic therapy.

Cancer Surgeries

During surgery, the tumor is removed using a scalpel often removing a portion of healthy surrounding tissue as it may be embedded with microscopic malignant cancerous cells that would otherwise lead to a recurrence of the cancer.

Laproscopic (‘keyhole’) surgery is minimally invasive making use of a thin lighted tube and smaller incisions, which minimizes tissue damage and scarring, and improves recovery time

Thermotherapies – Cancer Treatment

Thermotherapy treatments is used to remove tumors and involves using heat or cold to kill the cancerous cells within a tumor.

Cryosurgery or Cryoablation uses extreme cold to freeze and destroy cancer cells.  Cryosurgery is often used in treating skin cancer, but also some internal cancers.  Liquid nitrogen is swabbed or sprayed on skin cancers to kill the cells quickly.  On freezing, intracellular ice crystals rupture plasma membranes causing cytolysis on thawing.  For internal cancers, a small incision is made and imaging (e.g., MRI or ultrasound) is used to guide the cryoprobe into the tumor.  The cryoprobe is then cooled to temperatures of -30ºC to -75ºC with circulating liquid nitrogen or argon gas

Radiofrequency Ablation utilizes a high-frequency radio frequency current is passed through a needle or probe that has been inserted into the tumor.  An imaging device (e.g., CT scan or ultrasound) is used to guide the needle or probe into place.  The radio frequency energy (i.e. an electromagnetic radio wave) is used to heat the needle to high temperatures killing the cancerous cells.

Laser surgery or Photoablation uses a laser (intense beam of light) to heat and destroy cancer cells.

Photodynamic Therapy

Photodynamic Therapy involves a 2 step procedure.  In the first step, a photosensitizer drug is first administered that cancerous cells absorb.  In the second step, a laser emitting a specific wavelength is directed at the tumor to activate the drug which becomes toxic to the tissue by producing free radicals (i.e. Reactive Oxidative Species, ROSs) which disrupt and destroy the tumor’s cells.  Photodynamic Therapy is limited to treated small tumors that are superficial (e.g., skin cancer, esophageal cancer) as the light used can not penetrate that deeply.

Benefits and Potential Side-Effects of Cancer Surgery and Thermotherapies

There are benefits and potential side-effects of all medical treatments and for those listed above the following would hold true:

Potential Benefits:  In addition to removing the cancer, local problems associated with its mass can be alleviated.  For example cancer removal can help with any pressure, obstruction inflammation or damage it was causing to surrounding tissue.

For procedures that are minimially invasive, there are the added benefits of the procedure causing minimal damage to surrounding tissue, which can reduce any pain or bleeding.  Additionally, minimally invasive procedures often require only local anesthesia, can be performed in a quick session, and do not require a hosptial stay.

Potential Side-Effects:  In order to ensure all of the cancerous cells are removed there will be some loss of some healthy tissue that surrounds the tumor.  Any loss in functionality may be temporary or permanent depending on how regenerative the tissue is.  Surgery always carries the risk of infection, though sterile procedures, suturing and wound care minimize this risk.  The after-effects of these procedures can depend on the location and extent of surgery required as well as any underlying health concerns.  All of these treatments will be monitored as they can result in some pain, bleeding, swelling, scarring, sensory nerve damage can cause temporary or permanent loss of feeling, or numbness, tingling, or loss of feeling; motor nerve damage can cause muscle weakness or fatigue.  Wound care and medications (e.g., anti-inflammatories or analgesics) that are put in place after the procedures will help to reduce many of these problems.

Limitations of Surgery:  Unfortunately, some tumors (particularly within the brain or spinal cord) are not readily accessible without causing severe damage making surgery impossible. Other cancers (e.g., leukemia, lymphoma, multiple myeloma) are spread throughout the body and are also deemed inoperable.