Microwave Ablation Erases Cancer in Patient with Terminal Prognosis on Arkansas Medical News Inc.

Microwave Ablation Erases Cancer in Patient with Terminal Prognosis

By: BECKY GILLETTE

Paul Jones of Camden received a sobering prognosis when he was referred to a specialist in El Dorado after X-rays following a car accident revealed a tumor in his lungs. The specialist said he couldn’t perform a biopsy without Jones’ lungs collapsing.

Jones was told his cancer was spreading rapidly, and to put his house in order and say goodbye to his loved ones.

His daughter Erica Clemons wouldn’t leave it at that.

“My daughter said, ‘We aren’t going to accept that, Daddy,’” Jones said.

Clemons arranged for her father to get a second opinion at the University of Arkansas for Medical Sciences (UAMS) Medical Center from interventional radiologist Mollie Meek, MD.

Meek recommended Jones undergo microwave ablation, a procedure available in Arkansas only at UAMS. Microwave ablation is done with a CT scanner to treat many types of cancer including tumors of the lung, liver and kidney. It can be used for primary tumors and metastatic disease where the cancer has spread from the primary tumor.

“You put patients to sleep, usually, and put what looks like a needle into the tumor,” Meek said. “You turn on the microwave, and it essentially just cooks the tumor. The tumor turns into scar tissue. You have some cells that eat up the stuff that is dead. The scar tissue won’t disappear completely, but it will shrink and slow down. If the tumor starts to grow again in six months to a year, we can go back and do it again.”

Often with metastatic cancer, the first place breast or colon cancer spreads is the liver. Meek said that is especially threatening because the liver performs so many critical body functions.

“Even with metastatic cancer, if you reduce the tumor burden in the liver or other organs, it can improve life expectancy,” said Meek. “This procedure is less invasive than the old standard of care to cut out the tumors. If you are too old, too sick or have heart conditions that mean you don’t want major surgery, you don’t have to. Mr. Jones’ lung function was so bad he would never have tolerated having part of his lung removed. You can have microwave ablations without having part of the lung or liver cut out.”

Advantages of the procedure include a shorter recovery time. Patients usually just stay one night. They don’t have a big incision from which to recover.

“Sometimes there is a little nausea, general malaise, and a low grade fever,” Meek said. “You just feel crummy like you have the flu. You are not quite as active as you normally would be. But you are not really sick, sick.”

Meek told Jones and his daughter that while a lung biopsy was likely to cause the lung to collapse, they could deal with that by putting in a chest tube. In cases like Jones’, insertion of a chest tube is part of their standard care. He successfully went through the biopsy, confirming the lung cancer.

A couple of weeks after the biopsy, he successfully went through microwave ablation.

“I went home the next day,” Jones said. “I had no pain at all. Four month later, I got tested again and Dr. Meek said the cancer was all gone. She’s the greatest doctor in the world. She saved my life.”

Meek will continue to monitor Jones. If necessary, other treatment options could include intra-arterial chemo or radiation.

“So far he hasn’t needed any chemo or radiation,” Meek said. “That is a huge thing.”

It is possible that microwave ablation could have far greater usage in Arkansas if more people knew about it.

“That is the problem in Arkansas,” Meek said. “Here at UAMS and some of the other larger medical centers in Arkansas, physicians are well informed about non-surgical treatments for cancer. It is difficult for smaller medical centers and busy physicians to stay current on all of the available treatments. It is especially difficult for them to know what we are doing at UAMS unless we UAMS physicians make a better effort to educate our colleagues throughout the state.”

UAMS performs many new treatments that other centers are not doing. For example, they see patients with advanced liver cancer, and are essentially the only transplant center in the state.

“I’m happy to talk to physicians if they want to call,” Meek said. “I will tell them if there is any option we have that might be helpful for their patients. If patients have a complicated disease, or patients have no options left, we will be happy to help them figure out other solutions, if possible. Any of the doctors at UAMS would be happy to talk to them. I would love to go visit physicians in rural Arkansas and teach them whatever they want to know about.”

Cases referred to UAMS can be presented to the tumor boards UAMS maintains for almost any organ in the body. Those boards include specialists such as cardiothoracic surgeons, pulmonologists, medical oncologists and radiation oncologists. Teams are put together that also can include an interventional radiologist, transplant surgeons and a transplant coordinator.

Jones’ case also shows that a second opinion is always a good idea, particularly from a bigger medical center that sees more cancer patients or transplant patients.

“If I hadn’t gotten a second opinion, I would be dead now,” Jones said.