New Breast Cancer Treatment "Cooks" Tumors

      HOUSTON, Oct. 12 (UPI) -- A new treatment for breast cancer now in preliminary trials in Texas might eliminate the need for many breast cancer patients to have their tumors surgically removed.

      The treatment involves using ultrasound technology to heat the tumor up to a point -- usually around 140 degrees Fahrenheit -- where the cancer cells are "cooked" and die. The technique''s investigators add a special diagnostic procedure known as magnetic resonance imaging (MRI) to show them the tumor''s precise location and best area for targeting the treatment.

      "If this works, it could have big advantages for women with breast cancer -- no recovery time, no scars," said Dr. Marc Fenstermacher, diagnostic radiologist at the M.D. Anderson Cancer Center, in Houston. He is leading the phase II clinical trial with John Hazle, a physicist at the cancer center who developed the technique.

      Under Food and Drug Administration regulations, phase II clinical trials are designed first to test the safety of treatment candidates -- not primarily their effectiveness, as the later phase III trials emphasize. However, the Houston team is "absolutely excited" about the technique''s prospects, Fenstermacher told United Press International.

      The researchers have performed the procedure on two patients so far, with good results, he said. They are looking to recruit 13 more.

      "As soon as we do 15, we''ll publish it and move onto the pivotal study where we treat the patients (with this technique) and compare them to patients who had surgery," Fenstermacher said.

      Nevertheless, Fenstermacher cautions the procedure does not replace other parts of breast cancer treatment.

      "Almost all women who have breast cancer and have surgery also get something else -- radiation and often chemotherapy," he said. "This technique is only a replacement for the surgery part, not for the radiation and chemotherapy."

      And breast cancer patients who have this technique will still have to have some surgery, as they will still need to get one of their lymph nodes removed -- either just before or just after the ultrasound procedure -- to determine whether the cancer has spread.

      "That would be important both from the standpoint of deciding what the best treatment is and determining what the prognosis is," said Fenstermacher.

      Dr. Stephen Edge, chief of breast surgery at the Roswell Park Cancer Institute in Buffalo, N.Y., said that techniques like this one -- often called "thermal ablation" -- clearly have potential.

      "Ablation of the tumor within the breast without actually removing the tissue will find a place in breast cancer therapy in the future," he said. "But where will it fall in our armamentarium? No one really knows." A few years ago, Edge''s institution considered doing a similar trial, but officials there eventually decided that it would be too expensive.

      One reason that ablation''s place in breast cancer therapy is unclear is that the current therapy -- lumpectomy plus radiation and chemotherapy -- is quite effective, Edge said.

      "For the majority of people, lumpectomy is not disfiguring; it''s not a difficult operation for them to have. It''s usually done under local anesthetic as an outpatient," he explained. "To replace lumpectomy with this kind of radiation, you''d have to demonstrate that the recurrence rates are no worse (with the new therapy). If you implement something that doesn''t work, you hurt people in the long run."

      Ablation has been tried in other forms of cancer, including prostate cancer, and is currently used to treat inoperable liver tumors. But it has not gained widespread use up to now because there hasn''t been a good way to make sure the correct area is being heated up enough, Fenstermacher said. That''s why the use of MRI is so important, he added.

      But Edge said that other ablation techniques have employed other methods, such as ultrasound imaging, to monitor the procedure. "So what if they''re using MRI? The question is, what is this technique''s effect in terms of treating cancer?"

      That question awaits phase III, should the Houston team''s approach pass the phase II trials.

      (Reported by Joyce Frieden in Washington.)

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