Seniors Matter(s): Medical innovations

Wow! I am excited.

In many of my articles, I have shared my thoughts on the incredible frontiers that are being conquered in medicine.
This an example of a few of many innovations that are happening in the world.

I intend to talk about cloning for organ replants in a future article so let’s just focus on a few of the outstanding steps happening right now.

I have received numerous freezing of benign and malignant skin cancer cells right in my dermatologist’s office. He is very aggressive in keeping me ahead of these growths that are a result of decades of not using sunscreen.
A few of them have had to be cut out, but still at an early stage.

Now, that same freezing is going inside the body with tremendous results, in breast, colon, prostate, liver, kidney, bladder and pancreatic cancer.

Cryosurgery is technology that uses a probe to channel liquid nitrogen to flow within a precise area of the needle so that it creates a freeze zone. This creates what is called an “iceball” around the tumour that freezes and kills it.

It offers a safe, effective option for women with early-stage breast cancer (typically with a tumour size of 1.5 centimetres or smaller), especially when they are not good candidates for standard treatments (for example, if they have other medical conditions that would make surgery risky). It is also less likely to disfigure the breast and the after-effects are “minimal.” Patients receive imaging every six months after the treatment as follow-up.

Laser therapy uses a narrow beam of light to remove or destroy cancer cells. This approach is sometimes used for cancers that involve only the outer layer of skin. It is now being used to treat small, early-stage kidney cancers less than four centimetres across. For some people, it can cure the cancer without a kidney being removed.

The treatment occurs under local or general anaesthetic. The surgeon finds the cancer using an x-ray or ultrasound scan. He makes a cut in the skin over the kidney or uses keyhole surgery. Keyhole surgery uses smaller cuts, and the doctor uses a camera (laparoscope) to see inside the body.

The surgeon may take a small sample of tissue from the cancer. Then he puts one or more cryotherapy needles through the skin. These go into the kidney close to the cancer. Once in position, the needles use liquid nitrogen to freeze and destroy the cancer cells.

The treatment area can be painful after the anaesthetic wears off. The patient may need to take painkillers for a few days.
Research studies have shown there have been no major complications in patients treated with cryotherapy through a cut in the skin (incision). Complications in people who had cryotherapy through keyhole surgery are very rare. They have included bowel injury, breathing difficulties and an abnormal heart rate.

Candidates for cryoablation to freeze kidney tumours as of now, usually have small tumours, only one kidney, or advanced age or medical conditions that would prevent traditional surgery. The percentage of freezing treatment is increasing exponentially yearly.

A new treatment out of the State University of New York at Binghamton (a.k.a. Binghamton University) for pancreatic cancer involves using both, with the result being more of a whole tumour being destroyed.

Robert Van Buskirk and John Baust, professors of biological sciences and directors at the school’s Institute of Biomedical Technology, and Kenneth Baumann, a graduate student studying biology, conducted the research. The new process, called dual thermal ablation, could be used when current technologies are no longer effective. Cells were subjected to heating (45-50 degrees Celsius/ 113-122 degrees Fahrenheit) and then freezing (minus-10 to minus-20 degrees Celsius/14 to minus-four degrees Fahrenheit) and then assessed over a seven-day recovery period.

The whole idea is, can one come up with a different surgical intervention that’s less invasive and more effective?

Not only is pancreatic cancer one of the most difficult to diagnose in its early stages, but it is also one of the most tenacious. Standing research suggested the stroma, a dense mix of cells and proteins surrounding the actual cancer cells, protects and nourishes the tumour. Sometimes making up to 90 per cent of the tumour mass, the stroma acts as an effective wall, allowing the cancer within to proliferate.

Researchers heated and froze cancer cells in the lab and looked at the effect, using various technologies to determine the level of cell death, on regrowth as well as which cell stress pathways were activated. Like any living creature, cells (and those of cancer, in particular) “want” to survive and take steps at the molecular level to ensure it. Called the cellular stress response, researchers can observe how a cell withstands a hostile element in order, paradoxically, to kill it.

In addition to the cell molecular research, several members of the study team are working on developing new catheter technologies to deliver this ablative therapy to patients. “If a very thin catheter can be developed to target the tumour, and if we understand how pancreatic cancer responds to ablation at the molecular level, then we may be able to develop a new therapy to approach something that has been completely unapproachable, the targeted killing of a tumour in a very difficult place: the pancreas.

Claiming a world first, Israeli doctors have removed cancer tumours from the bladder by freezing them instead of cutting them out.

Doctors at the Rambam Health-care Campus in Haifa say that the method has great potential to reduce bleeding, infection risk and pain. They have conducted the operation four times, and all patients were discharged without side effects. Over the coming weeks, they will be monitored to see how effectively the operations banished cancer, and several more patients will receive the surgery.

“Here we are actually spraying liquid Co2 instead of cutting out the tumour, a process that causes scarring of healthy tissue,” said Dr. Isaac Hoffman, who operated with his colleague, Professor Gilad Amiel. “We are very happy that we succeeded in freezing the tumour, after which the cancerous cells die off without them needing us to cut them out.”

With current methods, bladder cancer patients are often prone to recurrence, but Hoffman said he expects freeze therapy to remove cancer cells and reduce the chance of recurrence more effectively. Until now, doctors haven’t been able to use it on bladder cancer, which affects more than two-million people worldwide, because of the nature of the tumours. “Normally, the tumours are frozen by injecting the freezing agent using needles, but this can’t happen with bladder cancer,” said Hoffman.

An Israeli company, Vessi Medical, developed the process to adapt cryotherapy for bladder cancer, which hinges on the use of a specially developed spray to administer the freezing agent. After it is sprayed, ice forms between and inside the cancer cells, without harming the bladder muscles.

The innovation will lead to patients spending less time in hospital. The aim is to release the patient from the hospital on the same day as the procedure.

I am amazed, and extremely encouraged by the advancements that are already happening and a slew of even more medical procedures that will help us live longer, healthier years.

Follow your heart and your soul will follow you.

‘Till next time!

If it is to be, it is up to me.