Electrocautery is a procedure that uses heat from an electric current to destroy cancer cells. It’s a treatment for some people with non-small-cell lung cancer (NSCLC).
You might get electrocautery if your cancer is very small and it hasn't spread. Or it may be done to ease symptoms if the cancer is blocking one of your airways and causing breathing problems. It can sometimes be used during segmentectomy surgery to help the surgeon divide up the parts of your lung to remove.
How Does Electrocautery Work?
Electrocautery uses a probe or a needle that's heated to a very high temperature. When the probe is placed in the area of cancer, it burns off the cancer cells.
This procedure isn't the same as electrosurgery, even though the two terms are often confused. Electrosurgery passes an electrical current through tissue to cut the tissue or stop bleeding during surgery. Electrocautery uses a current to heat a wire and directly burn off tissue.
When Would You Get Electrocautery?
Electrocautery has a few different uses in NSCLC treatment.
To treat early-stage NSCLC
Stage 0 NSCLC means the cancer is only in the lining of your airways or in your air sacs (alveoli). Another name for stage 0 is carcinoma in situ. The cancer hasn't spread deeper into your lungs or to other parts of your body.
Electrocautery is one of a group of treatments called endobronchial therapies. Other endobronchial therapies include photodynamic (light) therapy, cryotherapy (cold therapy), and laser therapy. The electric current, light, cold, or laser is passed through a tube called a bronchoscope into your lung. Brachytherapy is a type of radiation treatment that places radioactive material into the body. Endobronchial therapies can sometimes cure very early-stage lung cancers. But the preferred treatment at this stage is surgery if you are healthy enough for surgery.
During lung surgery
Some surgeons use electrocautery during segmentectomy. That’s surgery to cut out part of the lung. Segmentectomy is a treatment for early-stage cancers (stage 0 or I) that are only in a small area of the lung. It's also an option for people who aren't healthy enough to have more extensive lobectomy surgery, which removes a whole lobe of the lung.
Electrocautery helps surgeons divide up the segment of the lung they are going to remove. It's an alternative to using staples during segmentectomy.
To open a blockage in your airway
Late-stage NSCLC isn't curable with surgery, but surgery can help with symptoms. You might get electrocautery to help you feel better. It's one of many treatments to relieve cancer symptoms, called palliative therapy.
Electrocautery may be an option if the tumor blocks one of your airways and makes it hard for you to breathe. This treatment is fast, safe, and can open up a lung blockage and relieve symptoms.
How Do I Prepare for Electrocautery?
Your medical team will tell you how to prepare for the procedure. You might have to stop eating and drinking 4 to 6 hours before your surgery.
You may also need to stop taking certain medicines, including blood thinners such as aspirin or clopidogrel (Plavix), a few days or weeks before your procedure.
If you smoke, quitting before your surgery will lower your risk of complications and help your lung heal faster afterward. Ask your doctor what other things you can do to get ready for surgery.
What Should I Expect During Electrocautery?
This treatment is done in the endoscopy unit or operating room of a hospital. You'll be asleep or deeply relaxed during the procedure.
If you have electrocautery to treat early-stage NSCLC, the doctor will first numb your throat and place a bronchoscope into your airway. That’s a flexible tube with a camera at the end. A probe goes down into the scope. An electrical current passes down the probe. The current creates heat that destroys the cancer cells.
Electrocautery can be used in segmentectomy to divide the lung along a line called the intersegmental plane to remove as much of the cancer as accurately as possible. Segmentectomy can be done through thoracotomy, where the surgeon makes one large cut in your chest. Or it can be done through one or more smaller openings using video-assisted thoracoscopic surgery (VATS). A video camera and surgical instruments go into the openings. The surgeon watches the procedure on a video monitor.
What Happens After Electrocautery?
If you had the procedure with bronchoscopy, you may have a mild sore throat, a cough, or a hoarse voice afterward. Gargle with warm water or suck on a lozenge to help ease the discomfort. Eat soft foods until your throat stops hurting.
It's possible for the cancer to grow back after the procedure. If your cancer does come back, you can have electrocautery again.
Recovery after segmentectomy can take weeks or months. Your doctor will tell you how soon you can go back to work and do other activities again.
What Are the Success Rates for Electrocautery?
If you aren’t healthy enough for surgery, stereotactic body radiation therapy (SBRT) is usually the recommended treatment since electrocautery may not work as well. SBRT focuses very intense beams of radiation on the tumor. The average overall survival after SBRT is just over 40 months, compared to a little over 30 months for electrocautery and other endobronchial treatments like laser or cryotherapy.
Electrocautery during segmentectomy helps surgeons divide up the lung more precisely, which can lead to better outcomes. In one study, 80% of people who had electrocautery survived for 5 years without their cancer growing, compared to 71% of those who had surgery with staples.
What Are Electrocautery’s Risks?
Electrocautery is safe, but it can have risks just like any other medical procedure. Your doctor can tell you what to expect before you have the procedure.
The most common risks from electrocautery are:
- Bleeding or blood in your phlegm
- Trouble breathing
- Infection
Electrocautery that's done during segmentectomy increases the risk for air leaks, a complication that happens when air escapes from your lung into your chest. An air leak can cause an infection, a blood clot in the lungs, breathing problems, or pain.
The bronchoscope has risks of its own, which include:
- A hole in the lung that leads to a collapsed lung
- Fever
Call your doctor right away if you have any of these symptoms after your procedure:
- Coughing up blood
- Coughing up green or yellow phlegm
- A fever of 100.4 degrees Fahrenheit or higher that lasts for more than 24 hours
- Chest pain that gets worse
- Trouble breathing or pain when you breathe
