Mar. 10, 2000 JACKSON, Mississippi, U.S.A. -- All of the PET scans were crystal clear. Every cancer cell was killed in the targeted zones where lung tumors once had grown.
The news was everything that was hoped for by Dr. Patrick Sewell, an assistant professor of radiology and surgery at the University of Mississippi Medical Center (UMC) in Jackson, Miss. The results of his China study confirmed the medical viability of his new pioneering surgical procedure.
All nine follow-up PET scans indicate this new procedure is killing 100 percent of targeted tumors, Sewell said in a March 7 press conference at the medical center. His final surgery was completed the night of March 3 in Guangzhou (pronounced "gwan-zO"), China, just before his return to Jackson from the 16-day-trip.
These findings could give lung cancer patients a favorable alternative to traditional treatments and change the way lung cancer surgery is performed worldwide.
Sewell developed the interventional radiology procedure -- called radiofrequency of the lung tumor ablation -- and is considered the world's authority on it. He performed it for the first time in the world at UMC about a year ago. The Guangzhou, China, Study marked the first time the procedure's effectiveness on primary tumors was tested and the first time follow-up PET scans were performed.
"It's so good for the patients," Sewell explained, "that they can be treated so completely, so quickly, so safely and so cheaply with this procedure.
"It makes perfect scientific sense," he added. "But, emotionally, it's beyond belief to see patients come in and go so quickly and their tumors are treated. Even as much as I believe in this procedure, it's still hard to believe."
Dr. Ralph Vance, an oncologist and UMC professor of medicine, said, "In the 20 years I've been treating cancer, this procedure has the potential for being the greatest thing that's ever come about."
Vance accompanied Sewell on the first trip to China, in October, and designed the protocols for the surgeries in the latest trip, which officially is named the Guangzhou, China, Study.
The procedure kills cancer with a radiofrequency (hot) probe, which is inserted into tumors and guided by interventional CAT scan images. Within a day or two after their surgeries, all of the China patients had follow-up PET (positron-emission tomography) scans, which detect metabolic activity in live cells, such as cancer cells.
The successful results also came earlier than expected in the process.
"Initially, we were going to do some of the PET scans early and some in about four months because we didn't know if the immediate scans would provide clear evidence of killed (cancer) cells," said Dr. Thomas Lawson, a pathologist and director of clinical affairs for Radio Therapeutics Corp., the U.S. company that manufacturers the probe. "After all, nobody had ever seen a PET scan on thermally treated lung tissue, until now.
"But the results were conclusive," Lawson added, so all of the PET scans were conducted immediately. "There's no reason to wait." Radio Therapeutics paid for the PET scans, which cost $2,000 each.
The Guangzhou, China, Study ideally was to have 10 patients. Sewell saved the 10th patient position for Jackson. He will perform the study's 10th surgery at UMC in the next several weeks.
The study's aim was to prove this procedure kills both metastasized (cancer that has spread) and primary (non-metastasized) tumors of the lung. Only tumors that were isolated and surrounded by healthy tissue qualified for the study, so follow-up PET scans could clearly evaluate the treated area.
The first PET scan result came in Feb. 26. It showed no metabolic activity in the tumor area treated, nor in the area immediately surrounding the tumor, which also was treated. That indicated all cancer was killed in the targeted zone, Sewell explained then. "There is increased metabolic activity, however, around the dead tumor's location, which is a natural result of the thermal injury" to healthy (non-cancerous) tissue. "This is exactly what we would expect to see," he said Feb. 26. That ring of metabolic activity around the treated zone was caused by healing of the area heated by the probe.
In the year Sewell has performed this procedure at UMC, all but one of his American patients had metastasized lung cancer. One, who underwent surgery shortly before the China trip began, had primary lung cancer. In the United States, primary lung cancer traditionally is treated with conventional surgery, chemotherapy and/or radiation.
Among the nine Chinese patients: five had primary tumors with no indications of metastasis, two had primary lung tumors with metastasis and two had metastasized cancer that had spread to the lung from other locations.
The nine patients, who ranged and age from 38 to 78, had surgeries that lasted from 40 minutes to 4 3/4 hours. Four were women. All were Chinese. Their tumors ranged in size from a dime to a grapefruit.
No China patient required general anesthesia. Eight were treated with local anesthesia and one was treated with local anesthesia and heavy sedation.
In Sewell's procedure, there is less trauma to the body and a much shorter recovery period than for conventional surgery or chemotherapy. His procedure is much less expensive than conventional surgery and/or chemotherapy. After his procedure, patients usually go home within a day or two.
Five of the Chinese patients underwent surgery at the Tumor Hospital of Guangzhou. The other four had their surgeries at one of three Shanghai hospitals. He also lectured physicians in Beijing, Xi'an, Guangzhou and Shanghai. As few as a dozen and as many as five bus loads of Chinese physicians observed each of Sewell's procedures.
"We're naming the study for Guangzhou because they were the most enthusiastic and they found the most and the best patients for the study," Sewell said. "The also are a hospital devoted to the treatment of tumors."
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