A portable machine allows surgeons to release intense cancer-killing radiation while patients lie on the operating table to have their tumors removed
Groundbreaking one-blast radiotherapy offers new hope to pancreatic cancer patients who only have a few months to live.
A portable machine allows surgeons to release intense cancer-killing radiation while patients lie on the operating table to have their tumors removed.
The approach means that treatment is given exactly where it is needed, and destroys all remaining cancer cells in hard-to-reach areas – reducing the chance of the disease returning.
Since 2017, 11 patients with pancreatic cancer who were previously deemed unsuitable for surgery have been treated at the University Hospital Southampton NHS Trust, the only place in the UK with high-tech equipment.
So far, none of this group has seen their tumors grow back in the target area.
Arjun Takhar, a consultant surgeon at the hospital, says: "Pancreatic cancer often spreads to nearby organs and can penetrate large blood vessels. Previously it had been difficult to remove the tumor without leaving small cancer cells, increasing the risk of the disease returning. With the help of intraoperative radiotherapy we can clear up remaining cancer cells. & # 39;
Pancreatic cancer, diagnosed at 10,000 Britons per year, is notoriously difficult to treat. It rarely causes early symptoms, which means that cases are often not picked up until the disease has spread.
In more than 80 percent of the cases, it is too late to operate by the time the tumor is discovered and only five percent of the survivors diagnosed for more than five years.
The pancreas is a gland that is part of the digestive system and produces enzymes that break down food and hormones that regulate blood sugar. It is located high in the abdomen, close to the stomach, liver and vital blood vessels. If cancer spreads to these areas, it is usually considered too difficult to remove. Instead, patients are offered chemotherapy that can stop tumor growth and buy them some time. But they will normally die within 18 months.
However, by using a combination of chemotherapy, complex surgery and intraoperative radiotherapy, surgeons believe that it is possible to remove pancreatic tumors that have spread close to blood vessels and prevent them from growing back in this area.
Radiotherapy is given to some cancer patients after surgery to try and get it back. But due to the positioning of the pancreas, radiotherapy with external rays can damage the surrounding tissue. Intraoperative radiotherapy safely delivers a precise dose of radiation to the pancreas. Research suggests that this reduces the risk of the cancer returning to the previous site of the tumor.
"We have demonstrated that this approach is safe, we can take these patients home and it could have a much longer lasting effect on their survival," says Takhar. Patients who choose to undergo the procedure receive a combination of three chemotherapy drugs for up to nine months to reduce their tumor. If it reduces the patient, surgery is performed under general anesthesia, with a cut in the abdomen, usually lasting up to eight hours.
Since 2017, 11 patients with pancreatic cancer who were previously deemed unsuitable for surgery have been treated at the University Hospital Southampton NHS Trust, the only place in the UK with high-tech equipment (photo: Southampton General Hospital, part of the University of Southampton NHS Foundation Trust)
The surgeons must first remove the end of the stomach, part of the small intestine, part of the pancreas and part of the bile duct – the tube that connects the liver to the intestine – to get rid of the tumor. The patient is then driven under the Mobetron electron beam radiotherapy machine. An explosion of radiation is delivered to the target area. This & # 39; removes & # 39; all remaining cancer cells near the blood vessels. Then the remaining pancreas, bile ducts and stomach are again attached to each other and reunited in the small intestine. Patients are usually at home within nine days.
The surgery is suitable for patients with locally advanced pancreatic cancer that touches the blood vessels but is not intertwined. For patients with pancreatic cancer that does not yet affect nearby blood vessels – the treatment is usually surgery to remove the tumor, followed by chemotherapy, sometimes in combination with external radiotherapy.
Dan Brown, 42, from Southampton, was diagnosed with pancreatic cancer in February 2018. "When I tried to eat and drink, I felt a little sick," he says. "The doctor gave me medication for heartburn, but I noticed that my skin was turning yellow."
The father of two had jaundice – a sign of pancreatic cancer – and tests showed that he had the disease. After six months of chemotherapy, he underwent radiotherapy surgery at the University Hospital Southampton NHS Trust in October.
"The operation lasted 12 hours and I was home after seven days," he says. In April, scans revealed that Mr Brown's pancreas was still free of cancer and that he was back at work in traffic management. Southampton University Hospital NHS Trust uses the same technology to treat colon, bladder, cervical, and head and neck cancers.
The treatment is not funded by the NHS due to a lack of long-term evidence, and the equipment for Mr Brown's procedure was funded by PLANETS Cancer Charity, which has to raise £ 10,000 a month to continue to deliver the treatment.
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