https://www.theguardian.com/science/2018/aug/06/ablation-destroys-cancer-prolongs-lives-tumours

How ablation destroys cancer to prolong lives

Ablation, a minimally invasive tumour-destroying technique using focused radiation, is proving effective. So why is it not more widely known?

David Cox

Mon 6 Aug 2018 06.00 BSTLast modified on Tue 7 Aug 2018 17.17 BST

 Illustration: Thomas Paterson

Seven years ago, when Heather Hall was informed by her oncologist that her kidney cancer had spread to the liver, she initially assumed she had just months to live. “I’d been on chemotherapy for a while, but they’d done a CT scan and found three new tumours,” she says. “But they then said that, because the tumours were relatively small, they could try to lengthen my prognosis by removing them with ablation.”

Hall underwent a course of microwave ablation, a minimally invasive treatment where specialists known as interventional radiologists use hollow needles to deliver intense, focused doses of radiation to heat each tumour until it is destroyed. While ablation technologies – they also commonly include radiofrequency ablation and cryoablation, which destroys tumours using intense cold – are not tackling the underlying cause of the disease, their impact can be enormous as they relieve pain and often prolong survival for many years, all at a low cost.

Studies based on data gathered over the past 10 years show an increasing number of cases of terminally ill patients who have lived for well over a decade after being treated with repeated ablations. Hall’s treatment was successful, but two years later, another two tumours had appeared in her liver, in different locations. Once again they were removed with microwave ablation. Over the past seven years, she has had four separate treatments. “There’s some pain in the immediate aftermath and I’ve felt quite ill for a week afterwards,” she says. “But it seems to have slowed down the progression of the disease, and I still have full function of my liver. With surgery, they would have had to cut a section of it away.”

While there have been many breakthroughs in cancer treatment heralded by the media in recent years – most notably the advances in immunotherapy and combination therapies – the considerable advances in ablation technology and resulting impact on patient survival, have consistently slipped beneath the radar. Not so long ago, the only option for patients such as Hall would have been full or partial removal of an organ, greatly reducing quality of life. But now, with increasingly powerful and efficient devices, interventional radiologists are able to destroy drug-resistant tumours in a growing number of diseases ranging from sarcomas to prostate cancer.

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“When we were first using ablation we could only treat the simplest tumours – for example, the ones in the middle of the liver, away from the blood vessels, because the devices were less powerful and predictable,” says Matthew Callstrom, a professor of radiology at the Mayo Clinic, Minnesota. “But now, for example, with microwave ablation – which works by radiating an energy field out of the tip of the needle into the tumour, heating the water within the cancer cells until they are destroyed – you can tune the shape and diameter of that field to prescribe exactly how deep it goes into the tissue. This means we can safely go after more and more complex tumours.”

Major studies published in the past couple of years have confirmed the survival benefits. Last year, the results of the Clocc trial – a five-year study of 119 patients across 22 centres in Europe – showed that patients with colorectal cancer that had metastasised to the liver and who received ablation in addition to drug treatment lived significantly longer on average than those who received drugs alone.

“We work closely with oncologists to determine who is most likely to benefit from this and who isn’t,” says Andreas Adam, professor of interventional radiology at King’s College London. “But it can have huge benefits. For example, I had a patient with breast cancer that had spread to the liver. I ablated the tumours, destroyed them completely and every few months or years, another tumour would develop and I’d ablate again. She went on to live for almost 10 years.”

With ablation treatment allowing many patients to live for far longer, it has the potential to change the perspective on some diagnoses. Patients with metastatic disease who go on to live for another decade or more in relatively little discomfort, often come to view their condition as more like a chronic illness. “It’s a strange feeling because you are still living with an illness which is likely to be terminal sooner rather than later,” Hall says. “But it’s no longer in the forefront of your mind. I’ve even been able to return to work part-time.”

However, not every patient with metastatic disease is a suitable candidate for ablation. Interventional radiologists typically only use the technique on patients with 10 tumours or fewer. Any more, and the only viable options are treatments such as chemotherapy or immunotherapy. “You wouldn’t dream of ablating 50 tumours, because if someone has 50 visible tumours, it’s likely that they have another 100 developing that are not yet visible, and so they need drug treatment to treat the disseminated disease,” Adam says.

But in the coming years, ablation is likely to become available to more and more patients, allowing interventional radiologists to tackle cancers in ever more complex locations.

Among the most promising methods is a technology called irreversible electroporation, which involves electrodes being inserted through the skin into a tumour, allowing a high voltage to be generated across the cancer cell membranes, causing them to self-destruct. This is only offered by a small handful of specialised centres in the world, but is expected to become more widespread over the next decade. “It’s a non-thermal approach, so you can go into more sensitive areas such as the pancreas, or ablate tumours which are in the centre of the liver,” Callstrom says.

One day, interventional radiologists may even be able to ablate the most difficult cancers of all – deep brain tumours. The Israeli company Insightec is developing a device that can use focused ultrasound to destroy brain lesions. Because these tiny pulses of energy can be detected on MRI scanners, surgeons can calibrate them to the exact millimetre. “Each pulse generates a single ablation the size of a grain of rice,” Callstrom says. “Because it’s so tiny this allows you to basically tattoo the tumour and so avoid the boundary to any blood vessels or neurons.”

So for the many patients who have cancer that doesn’t respond to any form of drug treatment, there is now often a way of managing and prolonging their lives, which wasn’t possible before.

“The results of these studies have completely changed the thinking regarding some cancers,” Callstrom says. “With patients with metastatic sarcomas, for instance, people used to think that if the drugs failed, that was that. But now we can monitor them. And every time new tumours pop up, we ablate them.”

• This article was amended on 7 August 2018 to make clear that microwave ablation treatment is conducted by interventional radiologists, rather than surgeons.

https://www.theguardian.com/science/2018/aug/06/ablation-destroys-cancer-prolongs-lives-tumours

These 6 Warning Signs Show That Your Liver is Full of Toxins

Published on Jan 31, 2017
These 6 Warning Signs Show That Your Liver is Full of Toxins

Every time I talk about the liver, I tell you that it’s a vital organ that regulates the toxins and waste in your organism.

If it’s not for the liver, the toxins will take over your body, and you will start feeling sick.

Call it the terminator as it transforms toxins into waste and makes your body safely expel through poop or urine.

It looks like a harsh and dirty job, but some organ has to do it. That’s why it’s important for you to do anything in your power to make the job easier.

It’s how you are going to keep it healthy and little less employed.

Remember that it’s never too late. Opening your eyes and making yourself start right now will do the trick.

If you don’t want to start right now, that’s okay. You can start whenever you want, but need to watch out for the warning signs you are going to see bellow.

If you feel at least one of them, it’s time for you to take the health in your hands and start caring.

Ready or not, here they come:

Sign #1: Unexplained Weight Gain

When your liver is damaged, and it struggles to fight off the millions of toxins attacking it every day, the calorie reduction and overtime in the gym won’t do the trick.

The body has gotten used to storing unfiltered toxins in the fat cells, which is just another reason for what you feel at this moment.

Your liver is responsible for going through grease. When you keep it busy with something else, it will start running sluggishly leaving the fat cells to fight on their own.

The only fighting move they have is to absorb fat and make you bigger.

Sign #2: Allergies

The liver creates antibodies every time it feels something is not right. These antibodies are doing a great job attacking the allergens and making them go away.

Unfortunately, the liver won’t be able to do its work if it’s running sluggishly.

It’s too busy doing something else leaving these allergens to develop in your body.

On top of this, your brain runs regularly sending signals to your liver that the body is getting harmed of these allergens. It marks those allergens for removal, but the liver can’t finish the job.

The build up of too much histamine becomes a problem, as well. That’s where you start feeling dizzy and feeling the allergy symptoms like itchiness, headaches, and fogginess.

Sign #3: Chronic Fatigue

According to Dr. Edward Group, the chronic fatigue represents the most common symptom when it comes to liver toxicity.

The toxins play a huge role disrupting the metabolism of your muscles causing aches, fatigue, and different pain.

Dr. David Buscher reports that the whole fatigue process gets much worse when a backlog of toxins come back and take down the entire immune system.

Sign #4: Excessive Sweating and Body Odor

The liver could be compared with a car. When you drive the car for too long without leaving it to rest for a moment, you can notice the temperature meter getting higher.

It’s the same thing. The liver gets hot when overworked. I don’t know if you know, but the liver is a pretty big organ.

When it gets hot, the whole body gets hot. It can cool itself by excessive sweating. And we all know that sweating could lead to body odor.

Sign #5: Acne

The toxins in your body can cause hormonal imbalances which are vivid through the stubborn acne on your body.

Sign #6: Bad Breath

Dr. Frank Lipman says that if the bad breath keeps coming back, it could be a sign of a liver malfunction.

Do you feel some of these symptoms? – It’s crucial for you to visit your doctor and speak about the cause.

Check the liver and see whether it functions normally or it got a little bit rusty.

Proceed to watch this video that will teach you how to build and maintain a strong liver.

https://youtu.be/jS9XvVoRJQI
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