This page contains information for patients (and their family and carers) who are considering having ablation for a lung tumour. It explains what is involved and the possible risks.
Your procedure will take place in the Radiology Department. The Radiology department may also be called the Imaging Department. It is the facility in the hospital where radiological examinations are carried out, using a range of x-ray equipment, such as CT (computed tomography) scanners, an US (ultrasound) machines or MRI (magnetic resonance imaging) scanners.
Interventional Oncologists are doctors specially trained to carry out image-guided cancer treatments. They work in partnership with radiographers who are experts in carrying out imaging procedures such as CT scans, and also with specialist nurses who are highly trained with assisting in these interventional procedures, and with providing sedation, recovery and patient support.
Ablation is a technique that destroys tissue using needle probes which are carefully inserted into the body through the skin, guided by a scanner (e.g. CT or US). The probes transfer thermal energy, heating or cooling to a temperature that destroys the tumour and a small amount of surrounding tissue, but sparing the rest of the organ.
In the lung, we generally use a microwave probe to produce heat to treat the area. We sometimes also use probes which cools the area to do this. Another older technique called
Radiofrequency ablation is very similar but is not normally used at UCLH.
Ablation is performed under general anaesthesia (you are asleep) so that any discomfort and movement of the lungs can be controlled.
Ablation may be used in patients with small lung cancers (primary lung tumours) or small numbers of lung tumours which have spread from other parts of the body (lung metastases). The aim of the ablation is to destroy the cancerous cells in these tumours.
This treatment can often be performed in patients who are unfit or unsuitable for other treatments such as surgery.
As there are few side effects, if necessary, the procedure can be repeated. Most people can resume normal activities within a few days.
All treatments and procedures have risks, and we will talk to you about the risks of ablation. Thousands of ablations have been performed worldwide, however there are unfortunately always risks involved. The UCLH team is very experienced in this procedure and risks will be minimised by making sure the procedure is appropriate in your circumstances.
There are recognised complications of the procedure both generic and unique to the specific tumour being ablated. The risk of certain complications also varies with the size and position of the tumour, and how close it is to other structures.
For most, ablation is a very successful method of focal tumour treatment and in skilled hands has a very low and acceptable complication rate, with significant morbidity and mortality of less than 2-5% (2 in 100 people) and 0.5% (1 in 200 people) respectively.
Problems that may happen straight away
- The lung is like a bag of air, and when punctured air can leak into the space around the lung causing the lung to deflate (pneumothorax). Having a small amount of air leak immediately after treatment is very common. In most cases your body will absorb the air by itself. In around 1/3 of cases, there is sufficient air around the lung to require a small tube to be inserted to drain it (the tube is soft and normally around 3-4 mm in diameter, or half the size of a drinking straw). If this happens the drain remains in place overnight and is removed the next morning after a scan to confirm that the lung has re-inflated.
- Bleeding from the needle insertion site or coughing up a small amount of blood in your spit (sputum). This is common, normally requires no treatment and will settle on its own.
Problems that may happen later
- Post ablations syndrome, which occurs in about 1 in 4 patients. This a flu-like illness that happens 3-5 days after treatment and is caused by your body’s immune system in response to the treatment. Paracetamol may be required if there is a low-grade fever.
- Infection of the ablation zone and surrounding lung. This can lead to fever, a productive cough, breathlessness and feeling generally unwell, and can require treatment with antibiotics.
Problems that are rare, but serious
- Very occasionally the lung takes a little longer to re-inflate. If this happens, we will leave your drain in and keep you in hospital until it does.
- Bleeding that does not settle by itself is very rare (>0.1%, or 1 in 1000 people) but may require further treatment.
- Very rarely (>0.1%, or 1 in 1000 people) during a lung procedure, air can enter the blood stream. This can be life threatening and require intensive care treatment or transfer to a specialist facility for high pressure (hyperbaric) oxygen treatment.
Your doctor will discuss with you the best course of treatment in your case and can outline any alternative treatments.
We will ask you to come for a pre-operative assessment appointment. At this appointment we will ask you about your medical history. We will carry out any necessary clinical examinations and investigations to make sure you are well enough for the procedure to go ahead. You may need an electrocardiogram (ECG) and a blood test. We will also check the functioning of your lungs.
We will also give you clear written information that tells you about eating and drinking before your procedure, what to bring with, when you should arrive and the need to have an escort home.
The nurse will ask you about any medicines or tablets that you are taking – either prescribed by a doctor or bought over the counter in a pharmacy. It helps us if you bring written details of your medicines with you to this appointment. We will tell you whether you need to stop taking any of your medicines before your procedure. When you come into the hospital for the procedure itself, please bring all your medicines with you.
Generally, the ablation procedure will take around 90 minutes, but on occasion it may take longer. This is variable depending on the complexity and size of tumour. You will then spend around an hour in recovery where we can make you comfortable after your anaesthetic.
We want to involve you in all the decisions about your care and treatment. If you decide to go ahead with treatment, by law we must ask for your consent and will ask you to sign a consent form. This confirms that you agree to have the procedure and understand what it involves. The Intervention Oncology (IO) doctor will have explained all the risks, benefits and alternatives before they ask you to sign a consent form. If you are unsure about any aspect of your proposed treatment, please do not hesitate to speak with the IO doctor again.
University College London Hospital is one of the top academic centres in the world. As such, it is likely that you will be invited to participate in research. This may involve new treatment techniques or new ways of imaging or assessing tumours. Involvement in research is entirely voluntary, and you will be provided with full details of any trials for which you may be suitable.
You will be taken into the CT scanner room and will be met with the anaesthetic team and the radiographers. You may be asked to lie on a trolley. The anaesthetist will place a cannula into a vein in your arm, so that the anaesthetic and any painkillers can be administered. You may have monitoring devices attached to your chest and finger and may be given oxygen.
After you are anaesthetised, you will not be aware of the procedure. A dose of antibiotic is usually given before we begin.
You will initially have a CT scan to plan the procedure, and the IO doctor will use this to identify the tumour. The needle probe is guided into the tumour and images are acquired to ensure the tumour is correctly targeted. The ablation is undertaken and then a completion scan is performed.
Every patient’s situation is different, and it is not always easy to predict how complex or how straightforward the procedure will be but it will usually take between 1 and 2 hours.
After the procedure, you will be taken into the recovery area. The nurse will check your observations regularly. Once you are comfortable and your observations are stable, you will be transferred to the ward and will stay overnight.
You will have a small dressing on your back at the site the needles were placed. There are small puncture marks on the skin but no cuts or stitches.
You will have an intravenous drip in your arm throughout your stay so that we can give you fluids or medications if needed. In recovery, you will slowly be allowed to drink water. If you can tolerate this, then on the ward you will be given something light to eat.
To be able to go home, we will need to ensure you are safe on your feet. When you get out of bed for the first time, you will have a nurse with you in case you feel faint or dizzy.
The IO doctor and clinical nurse specialist will then see you on the ward and will discharge you home if you are comfortable to do so. This commonly takes place on or before midday the following day. You will be given a discharge summary.
You are able to travel by bus or train after the procedure, but we advise that you do not travel by plane for 6 weeks. If you have planned travel plans, please discuss this with your doctor and clinical nurse specialist.
Normally, you will be able to go home the day after your procedure. Before you go home, we will discuss your follow-up treatment with you. You should expect to be off work for one week after treatment.
Signs to look out for:
- Worsening shortness of breath or pain on breathing in.
- Pain that is not controlled by regular pain relief, e.g. Paracetamol.
- Increasing fever or pain more than a few days after the procedure.
- Coughing up more than a teaspoon of blood. A little streaky blood in the spit is expected.
You will have an appointment to come back to the clinic 4 weeks after the procedure for a repeat scan and to check that you have made a good recovery.
If you have cause for concern following discharge, please contact our Clinical Nurse Specialist on 0790 467 4635.
If you are unable to contact our team out of hours, please contact the UCH 24-hour nurse led helpline on 0794 795 9020.
We will update your GP after your discharge, but immediately after the procedure they may not be aware of the details. If you see your GP after the treatment, please take your post discharge instructions with you.
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UCH Switchboard: 020 3456 7890
Address:
Interventional Radiology Imaging Department, University College Hospital, 2nd Floor, 235 Euston Road, London, NW1 2BU
Interventional Oncology Service
Email: uclh.
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Hospital Transport Services
Telephone: 020 3456 7010
Procedures
The Imaging Department, Level 2 Podium in the main University College Hospital building with the entrance on Euston Road (see map below).
Travelling to the hospital
No car parking is available at the hospital. Street parking is limited and restricted to a maximum of 2 hours.
Please note the University College Hospital lies outside, but very close to the Central London Congestion Charging Zone.
Tube
The nearest tube stations, which are within 2 minutes’ walk, are:
Warren Street (Northern and Victoria lines)
Euston Square (Hammersmith & City, Circle and Metropolitan lines)
Overground trains
Euston, King Cross & St Pancras and Kings Cross Thames link railway stations are within 10-15 minutes’ walk.
Bus
Further travel information can be obtained from http://
Hospital transport service
If you need (and are eligible for) transport, please call:
020 3456 7010 (Mon to Fri 8am-8pm) to speak to a member of the Transport Assessment Booking Team.
If you have a clinical condition or mobility problem that is unlikely to improve you will be exempt from the assessment process. However, you will still need to contact the assessment team so that your transport can be booked. If your appointment is cancelled by the hospital or you cannot attend it, please call 020 7380 9757 to cancel your transport.
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Page last updated: 17 April 2025