Ablation, Embolization, and Supportive Procedures for Lung Neuroendocrine Tumors

RFA uses high-energy radio waves. A thin, needle-like probe is put through the skin and into the tumor. Placement of the probe is guided by an ultrasound or CT scan. The tip of the probe releases a high-frequency electric current which heats the tumor and destroys the cancer cells.

Microwave thermotherapy is similar to RFA, except it uses microwaves to heat and destroy the cancer cells.

Arterial embolization, also known as transarterial embolization or TAE, puts a catheter (a thin, flexible tube) into an artery through a small cut in the inner thigh and threads it up into the hepatic artery (a main artery in the liver) feeding the tumor.

Blood flow is blocked or reduced by injecting materials to plug up that artery. Most of the healthy liver cells will not be affected because they get their blood supply from a different blood vessel, the portal vein.

Chemoembolization, also known as transarterial chemoembolization or TACE, combines embolization with chemotherapy. TACE can also be done by giving chemotherapy through the catheter directly into the artery, then plugging up the artery.

Radioembolization, also known as transarterial radioembolization or TARE, combines embolization with radiation therapy. This is done by injecting small beads, called microspheres, that are tagged with a radioactive substance, called yttrium-90, into the hepatic artery.

The beads lodge in the blood vessels near the tumor and give off small amounts of radiation to the tumor site for several days. Since the radiation travels a very short distance, its effects are limited mainly to the tumor.

In rare instances, fluid can build up inside the chest (outside of the lungs), press on the lungs and affect breathing. Usually, a thoracentesis is done, where a hollow needle is put through the skin and into the pleural space to remove the fluid.

For most people, removing the fluid can relieve breathing problems right away, but the fluid will often build up again quickly if nothing else is done.

If fluid builds up in the chest, doctors sometimes do a procedure called pleurodesis to remove the fluid and keep it from coming back. A small cut is made in the skin of the chest wall, and a hollow tube is placed into the chest to remove the fluid.

Either talc or other drugs, such as doxycycline or bleomycin, are then put into the chest cavity. This causes the linings of the lung (visceral pleura) and chest wall (parietal pleura) to stick together, sealing the space and limiting further fluid buildup.

The tube is often left in for a day or two to drain any new fluid that might collect.

This is another way to control fluid buildup. One end of the catheter (a thin, flexible tube) is placed in the chest through a small cut in the skin, and the other end is left outside the body. This is done in a doctor’s office or hospital.

Once in place, the catheter can be attached to a special bottle or other device to allow the fluid to drain out on a regular basis.