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Many of these treatments will require authorization from the Ministry of Health (Spanish Agency for Medicines and Health Products) in order to be administered under the legal figure of ‘COMPASSIONATE USE’.
For this purpose, a dossier will be sent with all the necessary information about the patient, their pathology and the drug to be used, while awaiting authorization for its use.

CANCER: THE SURPRISING TRUTH

Cryoablation

This technique achieves ablation or destruction of the selected tumour by freezing. Tumour ablation can also be achieved through heat techniques such as radiofrequency and ultrasound.

But cold techniques such as cryoablation have shown better results and decrease or eliminate the risk of metastasis.

It can be performed under local anesthesia or general sedation depending on the size of the tumour and the patient's characteristics.

This technique is performed with special very fine needles that are introduced into the tumour under direct vision with ultrasound, X-ray or CT. A gas is pumped into the cryoprobe to freeze the tissue, after which the tissue is allowed to thaw. In the same session the freezing and thawing process is repeated several times.

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We use Argon gas to produce freezing of malignant or benign tumour tissue also if it is a breast fibroadenoma, for example.

With this technique we can reduce the spread of cancer cells, thus increasing life expectancy and reducing the impact of interventions.

The cryoablation technique is effective in the early stages of tumours, it helps us to slow down their development and the results are encouraging.

The cryoablation technique is used in the oncological treatment of breast, lung, kidney and liver tumours, intraperitoneal metastases, sarcomas and pleural tumours. The applicability of the method depends, of course, on the location, the size of the tumour and the patient's condition. Cryoablation also helps in palliative pain relief, especially in bone metastases.

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Cryoablation from the patient's point of view - How does it work?

The cryoablation procedure usually lasts between half an hour and two hours and, in the case of benign breast tumours, even 15 minutes. It is performed under local anesthesia and/or sedation, the patient does not feel any pain. The cold works as an analgesic.

The physician inserts a cryogenic probe into the tumour, turning the tumour into a ball of ice. The temperature inside the ball is -40°C, and the needle itself is at room temperature and does not burn the patient's skin. The refreezing and thawing cycle immediately destroys the diseased tissue, leaving the adjacent healthy tissue intact. Dead rests are absorbed by the body.

Cryoablation to treat lung cancer

Cryoablation in the treatment of lung cancer is a relatively safe option for stage I patients and as a palliative treatment for cytoreduction and symptom relief in advanced lung cancer.

“In 101 patients with stage T1N0M0 non-small cell lung cancer, we found the ProSense liquid nitrogen (LN2) system to be a promising treatment for tumours <1.8 cm. In addition, LN2 systems are more powerful than cryoablation systems using argon gas,” says Dr. Hiroaki Nomori, Kameda Medical Center, Japan.

In January 2022, Tomasz Sędziak, MD, PhD, a specialist in minimally invasive oncologic surgery, performed cryoablation of two pleural tumours: “It was a big challenge because it is the type of tumour where complications are easy to develop. You could have a pneumothorax or a hematoma. I decided on this procedure because the patient had already exhausted all treatment options. He is currently on palliative chemotherapy for which there is no response. However, I hope that after cryoablation there will be an immune reaction and the disease will stop, and maybe even reverse,” explains Dr. Sędziak.

Cryotherapy to treat kidney cancer

Cryotherapy of kidney tumours is a recognized and proven method of treatment. It allows you to maintain kidney function, with a low risk of damage to the surrounding organs.

Compared to a surgical procedure, it is also a significantly faster procedure: patients we treat in the morning go home in the afternoon,” says Professor Ofer Nativ, head of the Department of Urology at Bnai Zion Medical Center and Elisha Hospital in Israel.

Cryotherapy to treat liver cancer

Hepatic cryotherapy is effective and safe, as evidenced by a significant reduction in CEA concentration after the procedure and a low risk of complications. In the treatment of both, primary and secondary malignant liver tumours, it has been shown to significantly prolong life and relieve pain. It is of value in cases where resection is difficult due to proximity to vessels, extensive infiltration or cirrhosis.

Cryotherapy to treat breast cancer

“Cryoablation of breast tumours is a procedure that is safe, effective, cost-effective and yields better cosmetic results than surgical removal of the tumour. My patients are very happy with the short, painless procedure and the ability to return to normal activities immediately,” says Andrew Kenler, MD, FACS, a breast surgeon in Connecticut, USA.

“Cryoablation is a minimally invasive alternative to open surgery for the treatment of small, early-stage breast cancers, providing a more effective and targeted treatment to completely destroy the tumour in a quick, in-office procedure,” confirms Professor Eisuke Fukuma, president of the Center for Breast Diseases, Kameda Medical Center, Japan.

Bone tumours and palliative treatment

Cryoablation is also compatible with palliative treatment: in metastatic bone tumours it provides clinically significant pain relief. It is a painless, repeatable procedure and there are no restrictions on the amount - if the patient feels well and there are no contraindications.

“Computed tomography or ultrasound is a simple way to check and monitor the ablation zone and ice ball formation. This allows us to very safely freeze the tumour area without damaging nearby sensitive structures,” reports Prof. Franco Orsi, MD, Director of Interventional Oncology, European Institute of Oncology, Milan.

BIBLIOGRAPHY

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