2013年4月17日 星期三

冷療治癌 ( cryoablation for cancer treatment )

什麼叫做冷療治癌
把細胞冰死的方法叫冷療.以一個探針插入腫瘤的中心,讓針頭形或一個冰球溫度達到攝氏負一百七十度左右來冰凍癌細胞.一般用氬氣.十分鐘後用氦氣來解凍.然後再用氬氣來冰凍一次,總共約三十分鐘.只要局部麻醉,當天或隔天就可出院.導管是中空的絕熱管.利用超音波或MRI定位.

應用
攝護腺癌 (在美國已非常普遍.但操作方法與上述略有不同,一次約美金一萬三千元左右,可重複做.)
擴散的肝肺卵巢大腸或腎的腫瘤.(Peter Littrup and Hyun bang of Wayne State Univerity of Michigan, 他們有超過一千次的經驗,便宜而且效果又好又不痛,一次約一萬五千元.)
乳癌 ( 數個美國大型教學醫院已做完27個病人的臨床研究第一期.這些實驗的病人是在幾個禮拜之後再做部份切除術時量測癌胞.結果是腫瘤小於1公分或者腫瘤如果是浸潤性導管癌,小於1.5公分其去除率百分百.目前正做第二期.冷療在乳癌上的治癌最讓人興奮.不止無痛,乳部保留,低價,而且不必化療或放療.而且可重復做,因為凍死的癌細胞被人体的清道夫細胞吃掉後讓身体的免役力變強,不易復發.同時在冰凍時癌細跑沒機會逃走,所以也不會轉移.以後只要身心靈保持健康体內排毒乾淨應可保安康.根據資料美國已有診所在做乳癌的泠療.例如Dr. Simmons:
Dr. Rache Simmons
NewYork-Presbyterian / Weill Cornell
425 E 61st St
Fl 10
New York, NY 10065

在英國奧地利及中國也都有醫院在做冷療.台灣呢?

我的意見
因為探針小,冰球成形就不會太大.這是為什麼美國臨床只用在小於1.5公分的浸潤性導管癌的原因.但我們可一次用兩個或兩個以上的探針呀?或者用單一探針但移位使用像在做採樣本的做法.這樣較大的腫瘤也可治療了.中國福大(Fuda)醫院用在無法再開刀的病人上也取得相當的成績.原位癌若怕無法殺死全部,似乎也可重複做呀,而且若免役力增強說不定清不乾淨的癌細胞最終也會被殺死.所以我覺得冷療的應用在乳癌的治療上實值得台灣急起直追.希望全台的乳癌患者團結起來去總統府前抗議示威要求台灣應在冷療及低電流療上好好研究及應用,去除不人道的程咬金的三斧頭:動刀,放療及化療.




Read more: http://www.vitals.com/doctors/Dr_Rache_Simmons.html#ixzz2Qo3s9bb7)


Dr. Peter Littrup, a professor of Radiology, Urology and Radiation Oncology Clinical Operations at the Barbara Ann Karmanos Cancer Institute in Detroit
http://www.knowcancer.com/blog/ice-age-cryotherapy-may-be-the-future-of-cancer-treatment/

Cryosurgery of breast cancer by Lizhi Niu1,2, Liang Zhou1,2, Kecheng Xu1,2
Aug 10, 2012, Gland Surgery
http://www.glandsurgery.org/article/view/992/1195

1Department of Oncology, Affiliated Fuda Hospital, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Science, No. 91-93 Judezhong Road, Haizhu District, Guangzhou 510305, China; 2Guangzhou Fuda Cancer Hospital, Jinan University School of Medicine, No. 2 Tangdexi Road, Tianhe District, Guangzhou 510305, China

Corresponding to:
Lizhi Niu, MD, PhD. Guangzhou Fuda Cancer Hospital, Jinan University School of Medicine, No. 2 Tangdexi Road, Tianhe District, Guangzhou 510305, China.
Email: niuboshi1966@yahoo.com.cn.

Patient selection of cryoablation

Patient selection is key to successful cryoablation. DCIS represents a special problem, the presence of DCIS at the margin of the cryoablation zone results in incomplete tumor necrosis, in other words, DCIS may be a relative contraindication to cryotherapy. However, even using MR imaging, DCIS lesions are only detected in 60-70% of patients with breast cancer (15). This fact makes it impossible to include DCIS components of invasive carcinomas in the therapy planning for such cases.

Generally, DCIS is often seen in tumors >15 mm. Cryoablation is adaptable for tumors <10 mm, for primary tumors 10 to 15 mm, only those without an extensive intraductal component are destroyed, while tumors over 15 mm are not reliably eradicated with cryoablation.

Core biopsy is helpful to detect the presence of DCIS. Specifically, the noncalcified type of DCIS causes the most treatment failures in the patients with larger tumors. It is suggested that cryosurgery should be limited to invasive ductal cancers <1.5 cm and with <25% DCIS on the core biopsy. Some breast cancers, such as invasive lobular carcinoma and significant intraductal carcinoma, tend to be multifocal and may include foci too small to be detected through imaging, making them unsuitable for in situ ablation. Tumors that present with more than the most minimal degree of microcalcification should also be excluded, since the extent of these lesions on mammography often can not be detected (5).

It is suggested that the immune system of the host becomes sensitized to the tumor being destroyed by the cryosurgery. As the body resorbs the necrotic tissue, an active immunity is developed for the tumor tissue. Any primary tumor tissue undamaged by the cryosurgery and the metastases can be destroyed by the immune system after cryosurgery (32,33). The “cryoimmunological response”, obviously, results in therapeutic benefits for advanced breast cancer.

http://www.fudahospital.com/alb_asp_new/show_crosurgery_book.asp?page=crosurgery_2_5_1

Dr. Michael Sabel, surgical oncologist from the Comprehensive Cancer Center and lead author of the study, University of Michigan
http://www.ur.umich.edu/0304/May24_04/19.shtml
Funding for the study came from Sanarus Medical Inc., which developed the cryoablation probe used in the study.



Oxford University Press
http://jnci.oxfordjournals.org/content/92/18/1464.long

Nikolai N. KORPAN, MD, PhD, FISS, FICS, FISC
University Professor of Surgery
General Practitioner Surgeon
The Rudolfinerhaus
Billrothstrasse 78
A-1190 Vienna, Austria


the modern cryosurgical unit ,,FreezeForce1" is a highly sophisticated Universal Cryosurgical System developed to meet the most demanding needs of today's "White Surgery

At present only a handful of companies are in the cryosurgical market. These include Irvine, Calif.-based Endocare Inc., Galil Medical Ltd. of Israel, and Cryomedical Sciences Inc. of Rockville, Md