Interventional Oncology

Interventional oncology is a relatively new field of image guided, minimally invasive therapy in which tumours are destroyed using heat energy. These new techniques have the advantage of being able to treat multiple tumours, on different occasions and also recurrent tumours even in those considered unfit for major surgery. The procedure is performed under sedation or general anaesthetic. The hospital stay is short, usually one night, and most patients make a rapid recovery

The first thermal ablation treatment to a liver tumour in a patient with colorectal cancer was performed by Prof Bill Lees in 1989. The treatment was performed under sedation using ultrasound guidance. A single bare-tip laser fibre was inserted into the tumour, the laser activated and the tumour heated. For 18 years between 1994 and 2012, two consultants, Prof Bill Lees and Dr Alice Gillams, performed an average of 170 ablations each year, initially at The Middlesex Hospital and subsequently at University College London Hospitals. They were the first to report a possible survival benefit for patients with colorectal liver metastases treated with laser thermal ablation between 1993 and 1997. Ablation which started with laser treatment of liver tumours now largely features radiofrequency and more recently microwave ablation and is also applied to lung, kidney and bone tumours. Our knowledge and understanding of ablation techniques, the methods used for image guidance and monitoring and the ablation technology have all improved. Ablation is now a standard treatment modality offered in many hospitals in the UK and across the world.

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