What you’re about to read would have seemed like science fiction just a few years ago. That’s because the treatment of cancer has advanced farther in terms of patient survival and quality of life than perhaps any other area of medicine. Much of this progress is the result of minimally invasive procedures – spawned by the latest advances in technology – that treat cancer in ways that are more comfortable and convenient for the patient and often more effective at producing the desired outcome. “Minimally invasive procedures are helping us improve patient care,” says Doylestown Hospital interventional radiologist Steven C. Wagner, MD. “We’re able to deliver very targeted treatments to a wider range of patients than ever before. In many cases, these treatments are having a direct effect on the patient’s immediate as well as longer term quality of life.”

Radiofrequency Ablation
One of the procedures that Dr. Wagner performs is radiofrequency ablation (RFA), a treatment currently used primarily for tumors of the liver, kidney, lung, and bone. Radiofrequency (RF) energy is similar to microwave energy, and “ablation” connotes erosion or wearing away. Using ultrasound or CT scanning as a visual guide, Dr. Wagner inserts a small needle through the patient’s skin into the tumor. RF energy is then transmitted to the tip of the needle, producing heat and destroying the tumor without harming the surrounding normal tissue. According to Dr. Wagner, the procedure is most appropriate for small tumors that cannot, for a variety of reasons, be surgically removed. “Except for certain small primary tumors, RFA is typically not curative, but it can often help patients extend and improve their life,” he says.

Chemoembolization
A tumor must generate its own blood supply to keep growing – and that’s the basis for the use of embolization in the treatment of cancer. Doctors use microscopic gelatin particles, delivered by means of a catheter threaded into an artery in the groin and directed to the tumor site, to cut off the flow of blood to the tumor.

When chemotherapy is combined with embolization, it’s called chemoembolization. Cancer-killing drugs are first delivered to the tumor through a catheter in an artery, followed immediately by the gelatin particles. Chemoembolization then works in two ways. First, the particles keep the chemotherapy drugs at the tumor site by preventing their flow back into the bloodstream. And second, the particles block the forward flow of blood to the tumor. Without a source of nourishment and surrounded by cancer-killing drugs, the tumor begins to die. Chemoembolizaton is one of the techniques used at Doylestown Hospital to treat liver tumors.

Monoclonal antibodies
“In the past 18 months, we’ve seen monoclonal antibody therapy transition from use in only the most challenging cancer cases to use as adjuvant therapy [therapy used after primary treatment, such as surgery, to decrease the chance that the cancer will recur],” says Mitchell Alden, DO, program coordinator of the Doylestown Hospital Cancer Center. “It’s quite remarkable.”

Because monoclonal antibodies target very specific cells within the body, there are far fewer side effects compared to standard chemotherapy or radiation. However, depending on a person’s particular medical condition and cancer profile, chemotherapy and radiation may be used in conjunction with monoclonal antibody therapy.

According to Dr. Alden, monoclonal antibodies currently available have been shown to inhibit the proliferation of colon cancer, certain breast cancers, and lymphomas. For HER-2 positive breast cancer, monoclonal antibodies have become part of standard adjuvant therapy. In addition, antibodies with (and without) radiation attached appear to be especially useful in treating certain lymphomas. At present, Doylestown Hospital is participating in several clinical trials involving monoclonal antibody therapy, with more expected in the future.

“This is a very exciting time in cancer research and treatment,” says Dr. Alden. “Advances are being made every day. It’s both professionally and personally gratifying to bring those advances to patients at Doylestown Hospital.”