A head-and-neck surgeon who pioneered RFA for thyroid cancer in the U.S. explains how radiofrequency ablation destroys small tumors directly and may trigger local immune activation. The challenge: ultrasound can show the tumor is gone, but microscopic cancer cells might remain, requiring years of follow-up to confirm it actually worked.
Chapters
I was the first head neck surgeon to use RFA for cancer in the United for thyroid cancer in the United States. And we did a clinical trial that found that we can get small cancers to disappear a lot of the time on ultrasound. But the question about that is, if it disappears on an ultrasound, does that actually mean that the cancer is fully gone? And we don't know the answer to that question. That's going to take years before we figure it out. International data seems to suggest that there are some situations where, even though we can't see it on an ultrasound, if you do surgery, there's still some cancer cells there. That's not for everybody. And the smaller it is, and the better location, the more we can treat a margin, the better results we can have. But a lot of these small cancers, you don't need to do surgery for right now, we're doing active surveillance for small cancers as well. And so for patients who are eligible for active surveillance, the idea of doing radiofrequency ablation may provide some peace of mind. You're certainly going to kill some cancer cells, activate the immune system in that area so that they come in and try and clean up the cancer that's in there and hopefully cause some peripheral damage that helps with cancer control. And so a lot of these things, we think, at the. At a minimum, would provide some peace of mind for patients who would be eligible to not have surgery. And best case scenario, we're going to look back 10 or 20 years from now and say, hey, guess what? We actually got rid of their cancer completely.
