A new laser surgery for breast cancer has just been approved for use in the UK. It leaves virtually no scars and only needs local anesthesia.
Frances Barr, 69, a mother of two and a retired PA from Bristol, was one of the first women in Britain to have it as part of a process, as she tells PAT HAGAN.
Frances Barr, 69, from Bristol was one of the first women in Britain with a new laser cancer surgery that has just been approved for use in the UK
Like all women over the age of 50 in the UK, I am invited to breast cancer screening every three years.
It was during one of these mammograms in 2013 that a suspicious growth was found in my right breast. It was not clear whether it was cancer and I was not alarmed unnecessarily.
But I was referred to the Bristol Breast Care Center and underwent a second mammogram a few weeks later, followed by a biopsy. When I received the results a few days later, I received a terrible shock.
The size of a pea was cancerous and I needed urgent treatment. It was devastating news. Fortunately my husband, Geoff, 79, was with me and was an enormous comfort.
My consultant said I needed a lumpectomy to remove the tumor. This would involve an incision of a few centimeters in length and the removal of a small amount of surrounding "healthy" tissue, in the event that cancer cells began to spread.
This would be followed by radiotherapy to destroy dragging cells. My lymph nodes (glands in the armpits where cancer cells often migrate) would be removed in case.
However, when I left my appointment, one of the nurses said the center was about to start a trial for a treatment that could replace a lumpectomy in women with relatively small tumors with a diameter of less than 20 mm.
The retired PA, pictured, met cancer specialist Dr. Mike Shere who explained that the Novilase laser treatment would involve surgery with local anesthesia instead of general anesthesia
She arranged for me to meet cancer specialist Dr. Mike Shere, who oversaw the process.
He explained that instead of surgery with general anesthesia, the new procedure used local anesthesia. It involved the insertion of a fine, hollow needle through the breast tissue into the tumor. A probe would be passed through the needle and a hot laser beam would destroy the tumor.
The whole thing would take less than an hour and then I would leave a small, barely visible prick mark.
Because I was one of the first people in the world to receive the treatment and doctors were still not sure if it would work, it would have been unethical for me to have it instead of a lumpectomy – because there was a danger that it would not do & # 39; Don't kill all cancers.
WHAT ARE THE RISKS & # 39; S?
There are no major risks compared to a lumpectomy, but the Novilase laser treatment is currently not suitable for breast tumors with a diameter larger than 20 mm.
Professor Philip Drew, a breast surgeon consultant at Duchy Hospital in Truro, Cornwall, says the procedure can be particularly useful for older women with small breast tumors who may be less resistant to current surgery.
But, he adds, "we need to make sure that all cancers come to an end: that's the first question patients ask when they come by."
I was told that a few weeks later I would have the laser treatment followed by a lumpectomy, so that doctors could see if the treatment had worked, as well as removal of the lymph nodes.
In November 2013 I had the Novilase procedure. Dr. Shere first injected local anesthetic into the front of my right breast and then used a portable ultrasound monitor to navigate the tumor with a long needle.
Once the point reached it, he introduced the laser probe to destroy the cancerous tissue. I was awake and talked to one of the nurses everywhere – I felt pretty calm.
The needle that penetrated was uncomfortable, but not painful, and then I had a cup of tea before I went home.
The next day there was some pain, but acetaminophen caused it. For a day I wore a tight bandage around my chest to reduce swelling and my chest returned to normal within a day or two.
Two months later I had removed the lumpectomy and my lymph nodes. This was much more invasive and kept me unemployed for a few weeks. I was left with a scar of 1.5 in length and an ugly dent in my breast from the tissue removal.
Surgeons also removed the dead tissue that had been lasered and found no trace of the cancer: the laser treatment had worked.
Now I enjoy life as much as possible, training and walking my dogs.
The laser surgery involved introducing a fine, hollow needle through the breast tissue into the tumor. A probe was then passed through the needle and a hot laser beam destroyed the tumor (file photo)
Dr. Mike Shere is a cancer specialist at the Bristol Breast Care Center.
Approximately 25,000 women a year in the UK undergo a lumpectomy for breast cancer, usually when the tumor has not spread.
These are very effective in eradicating small tumors, but leave a scar. Between 1.5 and 10 percent of the lumpectomy wounds also get infected.
The new laser treatment could achieve the same results, but without the additional damage, because the access point where bacteria can enter is much smaller.
Our center was one of the first in Europe to try Novilase and it was recently approved in the UK so that many more women could benefit quickly.
An MRI scan maps the location of the tumor, after which local anesthesia is injected into the breast and a needle – about 4 in length – is slowly inserted until the tip is in the center of the tumor.
The needle is attached to a handset operated by the physician and runs in parallel with another needle, only 15 mm apart, which is inserted into the breast at the same time. This has five small temperature sensors.
When both needles are in position, a fiber optic cable is fed through the needle. At the push of a button on the console, a laser beam from the fiber optic cable penetrates the cancerous tissue.
Frances, in the photo, said the needle that penetrated was uncomfortable, but not painful, and within a few days her breast returned to normal
The laser needs about ten minutes to reach the desired temperature from 60 ° C to 100 ° C. The needle's heat sensors show whether it is hot enough to be effective or so hot that there is a risk of damage to healthy tissue.
The only thing left is two small puncture wounds and the patient can go home immediately.
The great thing about laser therapy is that it can be safely repeated if scans show that it did not destroy all tumors the first time.
Although it is currently only being tested on small tumors, we can theoretically use different needles to treat larger tumors.
The results of the study, involving 61 patients in centers around the world, were published in Annals Of Surgical Oncology in 2018. This showed that 84 percent of patients with tumors up to 20 mm completely destroyed them with one treatment.
In women whose tumor was 15 mm or less, the success rate was 98 percent – comparable to lumpectomy.
Laser treatment can eventually put an end to lumpectomies. Currently, patients still need surgery for lymph node removal as this is standard practice, but studies are beginning to show that this is of no benefit unless you know the cancer has spread to them.
I predict that routine lymph node removal might be a thing of the past within the next five years, by which time Novilase could be used extensively in the NHS.
Novilase costs £ 300.
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