Using Heat to Kill Spinal Tumors Can Improve Quality of Life for Patients with Bone Metastasis
A procedure called radiofrequency ablation to heat and kill cancer cells. UCLA is among Pablo Villablanca, MD, director of the (RFA) is a reliable tool for the treatment a small number of major medical centers Interventional Spine Service and the of various pain conditions, as well as the nationwide offering the procedure, which Radiology Department Pain Service at destruction of some types of soft-tissue typically is performed in an outpatient UCLA. Opioid therapy often fails to fully tumors when conventional surgery is not setting with the patient under conscious alleviate metastasis-related spine pain and an option. RFA also has emerged as a sedation. The physician places a needle leaves patients heavily sedated, without the successful approach to alleviating the electrode through the skin to direct energy ability to engage with their families and intense pain experienced by cancer into the tumor to destroy it. friends or in activities they enjoy. “Narcotics are not very effective for pain caused by patients with bone metastases. “Image-guided RFA offers significant metastatic spinal lesions,” Dr. Villablanca Image-guided RFA is a minimally invasive advantages over persistent use of narcotics says. “Image-guided RFA provides an treatment that uses radiofrequency energy for patients receiving palliative care,” says opportunity to make a difference.”
UCLAHEALTH.ORG 1-800-UCLA-MD1 (1-800-825-2631) OBSTETRICS Continued from cover Breastfeeding Success May Depend on RFA can provide significant, durable pain relief to patients after a single session, Getting a Good Start reducing or eliminating the need for narcotics and providing patients with “It’s extremely common to have some “If you provide that good start, it will dramatic improvements in quality of life, kind of problem or challenges during prevent many of the common problems.” Dr. Villablanca says. Recent technological breastfeeding,” she says. “But women Women should take a breastfeeding class advances have boosted the precision, safety shouldn’t feel they’re alone or that they’re prior to giving birth, experts advise. and efficacy of RFA to the spine, enabling doing something wrong. The struggle is And it’s important for women who heat delivery to a tightly defined target. normal, but there are a lot of resources experience problems to seek help right Computed tomography-guided precision available to help them.” away, Dr. Nathan says. “Have a lactation navigation is critical to protecting the spinal Some problems can be avoided by getting consultant come out to your house.” cord and surrounding healthy tissue. off to a good start in the hospital. Ideally, “Simply persevering is the key,” Dr. Valle Spinal metastasis and removal of tumors breastfeeding should be initiated promptly adds. “It can take several weeks to get may result in a weakened spine and potential following childbirth. “Women who an optimal latch from the baby and to fractures, Dr. Villablanca notes. During the begin breastfeeding in the hospital have get adequate milk supply from the mom. RFA procedure, the system also can be used a much higher likelihood of continuing Utilize the resources available to you.” for kyphoplasty, a procedure to stabilize the nursing their children into the first year spine. Kyphoplasty minimizes the risk of of life,” says Leena Shankar Nathan, Breastfeeding confers many benefits. For compression fracture in a weakened spine. MD, a UCLA OB/GYN in Westlake mothers, that includes a decrease in the If a fracture and metastasis are present, Village. “We recommend six months risk of breast and ovarian cancers and RFA will treat the tumor and kyphoplasty of exclusive breastfeeding.” a reduced risk of metabolic syndrome, will stabilize the bone. which is a precursor to diabetes. Nursing At UCLA, mothers who wish to breastfeed also facilitates weight loss. For babies, Studies show RFA for spinal metastases follow a protocol to increase the chances breast milk strengthens the immune results in clinically significant pain relief of success, says Georgann Abraham, system and boosts the health of the for 90 percent of patients. Pain relief often RN, coordinator of the UCLA Health gastrointestinal tract. Babies who are is immediate, or pain subsides within a few BirthPlace. That means letting nature breastfed have a reduced risk of childhood days. The procedure takes about one hour. take its course. Immediately following allergies, obesity and high cholesterol Patients treated for metastases to the spine, childbirth, the infant is placed on the later in life and a lower risk of respiratory like those treated for lesions in the iliac or mother’s chest, skin-to-skin, to facilitate infection and childhood leukemia. sacrum bones, are typically released as early nursing. “When you put the baby on the as a few hours after the procedure. Adverse abdomen, within an hour the baby will “Breastfeeding is a secret weapon,” events are rare but can include bleeding, go through several instinctual stages — Dr. Nathan says. “When a baby is sick infection and damage to arteries or nerves. they will crawl up, massage the breast, or fussy, nothing will calm the baby as easily as nursing. Be persistent. Unlike many other cancer-pain-management smell it and latch on,” she explains. “The babies drive milk production.” The rewards will be great for mother treatments, image-guided RFA for bone and baby.” metastasis can be repeated, if necessary, In the hospital, new mothers are although most patients do not experience encouraged to breastfeed at least eight To view a video about lactation and the pain recurrence. While indicated for patients times in the first 24 hours, Abraham says. benefits of breastfeeding, go to: with bone metastasis who have failed uclahealth.org/breastfeeding conventional therapies, RFA also may be an option for patients who decline radiotherapy. However, RFA does not prevent patients from receiving chemotherapy or radiotherapy at a UCLA Recognized as Baby-Friendly Hospital later time. The procedure is contraindicated in patients with metastases that have Ronald Reagan UCLA Medical Center has been recognized as a Baby-Friendly extended into the spinal canal. Designated birth facility. The designation by Baby-Friendly To view a video about RFA for USA is based on criteria that are aligned with the WHO/ metastatic bone cancer, go to: UNICEF Baby-Friendly Hospital Initiative. It recognizes uclahealth.org/bonecancerablation hospitals and birthing centers that offer an optimal level of care and support for breastfeeding mothers and their babies.
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