Cryoablation to rib mets?

[V10fanatic]

I met with my interventional radiologist today to go over the procedure. When discussing the possible side effects he brought up a chance of pneumothorax. He also told me that although he's performed many cryo procedures, he's never treated a rib. The thought of a collapsed lung makes me a bit nervous. Both my mom and mother-in-law suffered through them and they were no picnic.

I have the option of using radiation again to a previously treated area, but that increases the risk of fractures. Just wondering if anyone has been in this scenario before as I weigh out the 2 options.

[j-o-h-n]

Any danger in treating rib mets with Cryoablation?

AI - ChatGPT said:

Cryoablation can be an effective treatment for rib metastases (rib mets), particularly for pain relief and local tumor control. However, there are some potential dangers and risks associated with Cryoablation in this setting:

Potential Risks & Dangers:

Fracture Risk – Cryoablation can weaken bone structure, increasing the risk of pathological fractures in already compromised ribs.

Pain Flare – Temporary worsening of pain post-procedure is common due to inflammation from tissue necrosis.

Pneumothorax (Collapsed Lung) – If the lesion is close to the pleura, the procedure can damage the lung, leading to pneumothorax.

Soft Tissue Damage – Surrounding muscles, nerves, and skin can be affected, leading to complications such as nerve pain or loss of function.

Hemorrhage – Cryoablation can damage blood vessels, leading to bleeding.

Cryoshock (Rare but Serious) – A systemic inflammatory response to cryoablation that can lead to hypotension and multi-organ failure.

Incomplete Tumor Ablation – If the ice ball does not fully cover the tumor, residual cancer may persist and continue to grow.

Precautions:

Imaging Guidance (CT/US) – Essential to avoid damage to nearby structures.

Cryoprobe Placement – Proper probe positioning to ensure complete tumor coverage while minimizing complications.

Adjunctive Cementoplasty – In cases where structural integrity is a concern, bone cement injection may help stabilize the rib.

Careful Patient Selection – Patients with severe osteoporosis or poor respiratory function need extra caution.

While Cryoablation is generally safe and effective for palliation and tumor control, careful planning and expertise are needed to minimize complications. Are you considering this treatment for a specific case?

Good Luck, Good Health and Good Humor.

j-o-h-n

[Whitby2]

Hi. I had cryoablation of the prostate at MSK. I don't have any experience with the ribs. Best of luck.