A pioneering two-in-one lung cancer treatment is being used to both diagnose and destroy hard-to-reach tumours in just half an hour – allowing thousands of NHS patients to avoid the need for invasive, life-changing surgery.
Doctors zap the tumour with a hot needle – a treatment called radiofrequency ablation – and at the same time carry out a biopsy, where a tiny piece of the cancer is removed for testing to see whether it is aggressive and likely to have spread.
Most lung-cancer patients currently undergo repeat procedures to have a tiny piece of the tumour cut out for examination (a biopsy), followed by radiotherapy or more surgery to remove the cancerous tissue.
The new treatment slashes the time it takes to get biopsy results to about two weeks and sometimes days,
easing patients’ anxiety, and means tumours previously almost impossible to treat without major surgery can now be tackled under local anaesthetic in minutes.
This type of rapid treatment has been shown, in studies, to be just as effective as conventional treatments for both diagnosing and destroying tumours.
Lung cancer is the third most common UK cancer, with almost 50,000 Britons diagnosed every year. It is often deadly if not caught and treated quickly: only five per cent of patients live longer than ten years. Patients diagnosed early are usually offered invasive surgery to remove their tumours or radiotherapy to shrink them.
But up to a third of them are unable to have operations due to co-existing illnesses such as emphysema and chronic bronchitis which may cause fatal post-surgical complications.
Although effective, radiotherapy typically involves multiple trips to hospital and can result in side effects such as nausea, sore skin and trouble swallowing.
Furthermore, multiple sessions of radiation are not recommended because of the risk of permanently damaging healthy tissue and organs as well as triggering other cancers. It means that those with recurrent tumours may be refused further radiotherapy, dramatically reducing their chance of survival.
The huge advance of the hot-needle treatment is that it is safe to be performed several times over.
During the procedure, the patient is sedated before being given a dose of local anaesthetic to the chest. The patient lies under a CT scanner, enabling the doctor to watch surgical movements in real time.
A fine needle, 1.5mm wide, is inserted into the chest, between the ribs, at a site closest to the tumour.
Then the radiologist puts a needle just 0.9mm in diameter through the first one, using it to take a 2cm sample of the tumour to be sent for analysis.
A third microscopic needle is then inserted with an electrode at its tip. This needle is connected to a generator that delivers radiofrequency energy to the heart of the tumour, heating it 60 to 70C and destroying it.
Once the needle is removed, a small plaster is placed over the entry site and patient is sent home within a few hours.
A recent report in the journal Radiology showed that half of patients who underwent the hot-needle treatment survived at least five years, compared to just ten per cent of those who didn’t have it.
‘This new way of both sampling and destroying small lung tumours at the same time is a very effective way of treating lung cancer,’ says consultant chest radiologist Dr Sam Hare of the Royal Free Hospital, who pioneered the procedure at Barnet Hospital.
‘We can now destroy even more small tumours without surgery in a single session, before they can spread. Patents go home the same day.’
The two-in-one procedure is now being taught to other radiologists around the country.
Retired printer Ellinor Cobb, 80, had the therapy in April 2017 after her lung cancer returned following five radiotherapy sessions.
The mother-of-three says: ‘It was very comfortable and I went home that day.
‘They’ll need to keep monitoring me but scans show I’m clear of cancer. It’s marvellous – I’d recommend it to anyone who needed it.’