Radiofrequency Ablation to Treat Solid Tumors Korean 환자교육방사선 / 이미징서비스 고형종양의치료를위한고주파열치료 본자료용지는고주파열치료가무엇이며, 고형종양의치료를위해시술받을때기대할수있는내용을설명합니다. 왜이치료가필요한가? 귀하

Radiofrequency Ablation to Treat Solid Tumors Korean 환자교육방사선 / 이미징서비스 고형종양의치료를위한고주파열치료 본자료용지는고주파열치료가무엇이며, 고형종양의치료를위해시술받을때기대할수있는내용을설명합니다. 왜이치료가필요한가? 귀하의담당의사가귀하의신체기관 ( 대개간, 신장또는폐 ) 에서종양 ( 또는종양들 ) 을발견했기때문입니다. 종양을위한치료는많이있지만, 그사람에게가장적합한치료가있을수있습니다. 저희전문가팀은열탐침을사용하여종양의제거 ( 파괴 ) 가현재귀하를위한최상의선택이라고생각합니다. 경우에따라서이치료는종양을파괴할것입니다. 이치료이후에다른옵션들 ( 화학요법, 화학색전술또는수술등 ) 도귀하에게제안할수있습니다. 고주파열치료는어떻게이루어지는가? 열을사용하여암세포를파괴시킬수있습니다. 고주파열치료 (RFA) 에서는, 특수탐침을피부를통해종양안으로삽입합니다. 이탐침을 CT 스캔이나초음파 ( 이미징기법 ) 를사용하여종양안으로유도합니다. 이탐침에는종양안과근처로향하는와이어들이있습니다. 전류가탐침을통해흐르며, 이로써발생하는열이암세포를파괴시킵니다. 종양자체그리고그주위에있는작은경계부위만이파괴됩니다. 그에따라생기는상흔은시간이지나면줄어듭니다. 와이어가달린열탐침이종양으로

2 페이지 방사선 / 이미징서비스고형종양의치료를위한고주파열치료 이시술은어떻게이루어지는가? 이시술은이러한유형의시술의전문가인중재적방사선전문의가실시합니다. 귀하는수술도중절대적으로움직이지않아야하기때문에, 전신마취를실시하여잠들게합니다. 이시술은중재적방사선실또는전산화단층촬영 (CT) 스캐너에서이루어집니다. 치료하는종양의크기와숫자에따라 1 시간에서 3 시간이걸립니다. 잠이들면, 방사선기술자가시술하는부위의피부를특수비누로깨끗하게닦아냅니다. 알러지가있다면이분에게알리십시오. 이기술자는의사가시술하는부위의털을면도해야할수있습니다. 간종양안으로들어가는탐침 의사가탐침을종양안으로삽입합니다. 탐침을같은종양에여러번삽입해야할수있습니다. 종양이여러개인경우 1 세션에여러개를치료할수있습니다. 종양이파괴된후에탐침을제거합니다. 치료의유일한흔적은탐침이놓였던피부에생기는 4 분의 1 인치크기의작은오목한자국입니다. 부작용이있는가? 모든침습성의료시술에는어느정도의위험이있습니다. 대부분의환자들은이시술후커다란문제없이상태가매우좋아집니다. 바늘부위에약간의통증과멍이있을수있습니다. 이것은며칠지속될수있습니다.

3 페이지 방사선 / 이미징서비스고형종양의치료를위한고주파열치료 가장흔한심각한문제는탐침의배치에의한복부로의출혈입니다. 매우드문경우, 중요기관 ( 창자등 ) 에상처가날수있습니다. 이것은매우심각할수있습니다. 담당의사는이러한유형의상처를피하기위해매우주의할것입니다. 담당의사가시술하기전에이러한위험을귀하에게설명합니다. 반드시모든질문과염려되는내용에대한설명을듣도록하십시오. 시술전 마취과에의한시술전평가를받아야합니다. 이방문의약속은저희가잡을것입니다. 간호사조정담당자가시술전오후에귀하에게전화합니다. 만약시술예정일이월요일이면, 간호사는그전금요일에전화하게됩니다. 간호사는최종지침을제공하며귀하의질문에답변합니다. 만약이시술에관한지침이나세부내용을이해할만큼영어에익숙하지않다면, 가능한빨리알려주십시오. 저희가도와드릴병원통역자를알선해드립니다. 가족이나친구는귀하를위해통역할수없습니다. 이시술후 14 일이내에혈액검사가필요할것입니다. 때에따라서는귀하가시술을위하여도착시에할수도있습니다. 만약시술전에혈액샘플이필요한경우에는알려드릴것입니다. 만약혈액을희석시키는약 ( 예 : 쿠마딘, 로베녹스, 프라그민, 플라빅스 ) 을복용하고계신다면, 시술전 3 일에서 9 일동안그복용을중단해야할수있습니다. 에에관한설명이제공될것입니다. 당뇨병이있어서인슐린이나메트포민 ( 글루코파지 ) 을복용하는경우, 시술당일에용량을유지하거나조절하는데대한설명이제공됩니다. 시술전날 시술전에다음지시를최대한따라야합니다 : 시술전날에는평상시와같이식사할수있습니다. 시술 6 시간전부터는맑은액체 ( 물, 스프라이트, 크랜베리주스, 약한차와같이투명한액체 ) 만을마실수있습니다. 시술 2 시간전부터는 : - 아무것도먹거나마시지마십시오. - 만약약을반드시복용해야한다면물한모금으로만드십시오. - 비타민이나다른건강식품은들지마십시오. 빈속을아프게할수있습니다.

4 페이지 방사선 / 이미징서비스고형종양의치료를위한고주파열치료 외래환자인경우, 집까지운전해주고당일에같이있어줄책임있는어른이반드시있어야합니다. 스스로운전해서집에가거나버스, 택시또는셔틀을탈수없습니다. 시술당일날 시술당일에는다른평상시복용약들을드십시오. 의사나간호사가달리지시하지않는한약을거르지마십시오. 복용중인약의목록을지참하고오십시오. 이날은병원에서대부분을보낸다는계획을세우십시오. 만약시술시작이지연되는경우, 대개는예기치못한응급문제가있는사람들을치료해야하기때문입니다. 이러한경우귀하의협조를부탁드립니다. 달리지시가없다면, 병원 3 층 ( 메인 ) 에있는수납 (Admitting) 에서체크인하십시오. 수납은로비에있는안내데스크의오른쪽뒤에위치합니다. 직원이귀하를시술전장소로인도할것입니다. 그곳에서는간호사가건강평가를실시합니다. 가족이나친구가함께있을수있습니다. IV( 정맥주사 ) 라인이시작됩니다. IV 를통해서액체와약이공급됩니다. 중재적방사선전문의가시술에관해설명을하게되며승락서에이미서명하지않은경우서명을요청할것입니다. 귀하는이때질문을할수있습니다. 시술내용 간호사가귀하를방사선실로인도합니다. 이간호사가시술이끝날때까지귀하와함께있게됩니다. 의사가엑스레이로귀하의신체를볼수있도록귀하는평평한테이블에눕게됩니다. 와이어들이귀하의몸에부착됩니다. 이것으로심박율을측정할수있습니다. 팔에는커프를차게됩니다. 때때로팽창되어혈압을측정하는데사용됩니다. 마취전문의가잠듣게하는약을투여하게됩니다. 이의사는시술동안그리고시술후회복동안귀하를체크할것입니다.

5 페이지 방사선 / 이미징서비스고형종양의치료를위한고주파열치료 시술후 깨어난후에는병원의단기체류유닛으로이동합니다. 그곳에서는다른간호사가체크할것입니다. 여기서는먹고마실수있을것입니다. 그리고가족이방문할수있습니다. 완전히깨어나서식사와화장실사용및보행이가능하게되면, 집에갈수있습니다. 합병증은매우드뭅니다. 만약발생하는경우, 귀하를체크하거나치료할수있도록, 저희는귀하가병원에하루밤머무르도록할수도있습니다. 병원을떠나기전에, 간호사가할수있는활동, 수술부위를관리하는방법그리고다른중요한지시사항을알려줄것입니다. 집에도착한후 그날은집에서편안히지내십시오. 가족이나친구또는간병인이귀하를도와주도록해야합니다. 졸리거나일시적인기억상실이있을수있습니다. 24 시간동안은, 다음을하지마십시오 : - 차의운전이나기계사용 - 음주 - 중요한개인적인결정이나법적문서의서명 - 다른사람을보살피는책임지기 열치료후에는대개경미내지중간정도의통증이있게됩니다. 의사가아세트아미노펜 ( 타일레놀 ) 의복용을허락하면, 이약으로모든불편함을없앨수있습니다. 만약의사가더심한통증을예측하는경우, 보다강력한진통제의처방을받게됩니다. 식사와동시에약의복용을다시계속하십시오. 의사가처방하거나승인한약만을복용하십시오. 감염이나위궤양의예방에도움이되는약을받을수있습니다. 처방받은약은모두없어질때까지계속복용하십시오.

6 페이지 방사선 / 이미징서비스고형종양의치료를위한고주파열치료 질문? 귀하의질문은중요합니다. 만약질문이나염려사항이있으시면저희의사나의료제공자에게연락하십시오. UWMC 임상직원도도와드릴수있습니다. 방사선 / 이미징서비스 : 206-598-6200 연락해야할때 다음의경우저희에게즉시전화하십시오 : 복부의통증 101 F (38.3 C) 를초과하는열또는오한 어지러움 구토 연락할곳 중재적방사선과의간호사조정책임자...206-598-6897 시술일정책임자...206-598-6209 업무시간이후 ( 오후 5 시부터오전 7 시 ) 그리고주말과휴일에는중재적방사선과의당직수련의를요청하십시오...206-598-6190 응급상황이있는경우 가장가까운응급실로직접가거나 9-1-1 로전화하십시오. 저희직원과의연결을기다리지마십시오. Box 357115 1959 N.E. Pacific St. Seattle, WA 98195 206-598-6200 University of Washington Medical Center Radiofrequency Ablation to Treat Solid Tumors Korean Published/Clinician Review: 03/2012 Reprints on Health Online: http://healthonline.washington.edu

Patient Education Radiofrequency Ablation to Treat Solid Tumors This handout explains what radiofrequency ablation is and what to expect when you have it done to treat solid tumors. Why do I need this treatment? Your doctors have found a tumor (or tumors) in an organ in your body (usually the liver, kidney, or lung). There are many treatments for tumors, but certain ones work best for certain people. Our team of experts believes that ablation (destruction) of the tumor with a heat probe is the best option for you at this time. In some cases, this treatment will destroy the tumor. After this, other options (such as chemotherapy, chemoembolization, or surgery) may also be advised for you. How does radiofrequency ablation work? Heat can be used to destroy cancer cells. In radiofrequency ablation (RFA), a special probe is inserted through your skin into the tumor. The probe is guided into the tumor using CT scans or ultrasound (imaging techniques). The probe has wires that pass into and near the tumor. An electric current is passed through the probe, which heats and destroys the cancer cells. Only the tumor itself and a small border of normal tissue around it will be destroyed. The scar that is formed will shrink over time. The heat probe with wires going into a tumor

Page 2 Radiofrequency Ablation to Treat Solid Tumors How is the procedure done? The procedure is done by an interventional radiologist, a doctor who specializes in this type of procedure. Because you must be perfectly still during the treatment, we will give you general anesthesia to make you sleep. The procedure is done in an interventional radiology suite or a computed tomography (CT) scanner. It takes about 1 to 3 hours, depending on the size and number of tumors being treated. Once you are asleep, a radiology technologist will clean your skin around the area of your procedure with a special soap. Tell this person if you have any allergies. The technologist may need to shave some hair in the area where the doctor will be working. A probe going into a liver tumor Your doctor will insert the probe into your tumor. The probe may need to be inserted more than once into the same tumor. If you have many tumors, several of them may be treated in 1 session. The probe is removed after the tumor is destroyed. The only sign of the treatment will be small quarter-inch nicks in your skin where the probes were placed. Are there any side effects? All invasive medical procedures involve some risk. Most patients do very well after this procedure, without any major problems. You may have some pain and bruising around the puncture site. This may last for several days.

Page 3 Radiofrequency Ablation to Treat Solid Tumors The most common serious problem is bleeding into the abdomen from the probe placement. Very rarely, an important organ (such as the bowel) can be injured. This can be very serious. Your doctor will take great care to avoid this kind of injury. Your doctor will talk with you about these risks before the procedure. Please be sure that all of your questions and concerns are addressed. Before Your Procedure You will need a pre-procedure assessment by the Anesthesia department. We will schedule this visit for you. A nurse coordinator will call you the afternoon before your procedure. If your procedure is on a Monday, the nurse will call you the Friday before. The nurse will give you final instructions and answer any questions you have. If you do not understand English well enough to understand these instructions or the details of the procedure, tell us as soon as possible. We will arrange for a hospital interpreter to assist you. A family member or friend may not interpret for you. You most likely will need blood tests done within 14 days of your procedure. Sometimes, we do this when you arrive for your procedure. We will let you know if we need a blood sample before that day. If you take any blood-thinning medicines (such as Coumadin, Lovenox, Fragmin, or Plavix), you may need to stop taking the medicine for 3 to 9 days before the procedure. You will receive instructions about this. If you have diabetes and take insulin or metformin (Glucophage), you will receive instructions about holding or adjusting your dose for the day of your procedure. Day Before Your Procedure You must closely follow these instructions before your procedure: The day before the procedure, you may eat as usual. Starting 6 hours before the procedure, you may only have clear liquids (liquid you can see through, such as water, Sprite, cranberry juice, weak tea) Starting 2 hours before your procedure: - Take nothing at all by mouth. - If you must take medicines, take them with only a sip of water. - Do not take vitamins or other supplements. They can upset an empty stomach.

Page 4 Radiofrequency Ablation to Treat Solid Tumors If you are an outpatient, you must have a responsible adult drive you home and stay with you the rest of the day. You may NOT drive yourself home or take a bus, taxi, or shuttle. On the Day of Your Procedure Take all of your other usual medicines on the day of the procedure. Do not skip them unless your doctor or nurse tells you to. Bring a list of all the medicines you take with you. Please plan to spend most of the day in the hospital. If there is a delay in getting your procedure started, it is usually because we need to treat other people with unexpected and urgent problems. Thank you for your patience if this occurs. Unless told otherwise, check in at Admitting on the 3rd (main) floor of the hospital. Admitting is to the right and behind the Information Desk in the lobby. A staff member will take you to a pre-procedure area. There, a nurse will do a health assessment. Your family or friend can be with you there. An IV line will be started. You will be given fluids and medicines through the IV. An interventional radiology doctor will talk with you about the procedure and ask you to sign a consent form if that has not already been done. You will be able to ask questions at that time. Your Procedure The nurse will take you to the radiology suite. This nurse will be with you for the entire procedure. You will lie on a flat table that allows the doctor to see into your body with X-rays. Wires will be placed on your body. These allow us to monitor your heart rate. You will have a cuff around your arm. It will inflate from time to time to check your blood pressure. An anesthesiologist will give you medicine to make you sleep. This person will monitor you during the procedure and while you recover afterward.

Page 5 Radiofrequency Ablation to Treat Solid Tumors After Your Procedure Once you are awake, you will go to a short-stay unit the hospital. A different nurse will monitor you there. You will most likely be able to eat and drink. Your family may visit you. When you are fully awake and are able to eat, use the restroom, and walk, you will be able to go home. Complications are rare. If they occur, we may need to keep you in the hospital overnight so that we can monitor you or treat you. Before you leave the hospital, your nurse will tell you what activities you can do, how to take care of your incision, and other important instructions. When You Get Home Relax at home for the rest of the day. Make sure you have a family member, friend, or caregiver to help you. You may feel drowsy or have some short-term memory loss. For 24 hours, do not: - Drive a car or use machinery - Drink alcohol - Make important personal decisions or sign legal documents - Be responsible for the care of another person There is usually only mild to moderate pain after an ablation. If your doctor says it is OK for you to take acetaminophen (Tylenol), this should ease any discomfort you have. If your doctor expects you to have more severe pain, you will receive a prescription for a stronger pain medicine. Resume taking your medicines as soon as you start to eat. Take only the medicines that your doctors prescribed or approved. You may be given medicines to help prevent infection or stomach ulcers. Take all of your medicines as prescribed until they are gone.

Page 6 Radiofrequency Ablation to Treat Solid Tumors Questions? Your questions are important. Call your doctor or health care provider if you have questions or concerns. UWMC clinic staff are also available to help. Radiology/Imaging Services: 206-598-6200 When to Call Call us right away if you have: Abdominal pain Fever higher than 101 F (38.3 C) or chills Dizziness Vomiting Who to Call Interventional Radiology nurse coordinator... 206-598-6897 Procedure Scheduling... 206-598-6209 After hours (between 5 p.m. and 7 a.m.), and on weekends and holidays Ask for the Interventional Radiology Fellow on call... 206-598-6190 If You Have an Emergency Go directly to the nearest Emergency Room or call 9-1-1. Do not wait to contact one of our staff. Box 357115 1959 N.E. Pacific St. Seattle, WA 98195 206-598-6200 University of Washington Medical Center Published/Clinician Review: 03/2012 Reprints on Health Online: http://healthonline.washington.edu