What Should Be the Alternative When Cancer Is Unresectable?

Introduction to the conference

With the purpose of further standardization and promotion of minimally-invasive ablation treatment for cancer, China Forum on Ablation Therapy in conjunction with the 3rd China Forum on Embolization Therapy was convened from August 4th to 7th, 2016, in Tianjin, together with the establishment of Ablation Expert Committee at the same time. Apart from well-known experts and scholars abroad, the conference also brought together specialists from varying medical fields including epidemiology, surgery, medicine, radiotherapy, medical imaging, pathology to address on new technologies and concepts. Prof. Niu Lizhi, president of Fuda Cancer Hospital affiliated to Jinan University School of Medicine, upon the invitation, delivered a keynote speech titled New Minimally-invasive Treatment of Pancreatic Cancer- Argon-Helium Cryosurgery and NanoKnife Therapy (irreversible electroporation).

Ablation therapy brings a new hope for cancer patient

It is statistically shown that nearly one-third of families in China might be threatened by cancer in the next decade. More seriously, 80% of cancer patients are already at advanced stage upon the first diagnosis, leaving them no opportunity of having surgical resection, for lacking in awareness of tumor prevention. In such a case, how to improve the survival rate and life quality of cancer patients has become an important issue in today's medical field.

Surgical resection, chemotherapy, radiotherapy are the three conventional treatments for cancer, which, however, are only effective in 20%-30% cancer patients. With the development of imaging technology, interventional oncology has already become one of four “pillars” in cancer treatment.

Prof. Niu Lizhi pointed out that interventional treatment, the fastest developing ablation treatment today, includes thermal ablation (Radiofrequency, microwave) and cold ablation (cryoablation and liquid nitrogen); irreversible electroporation (NanoKnife) is neither cold nor hot special technique; there are some technologies in development, such as laser, focused ultrasound etc.

Ablation therapy can not only bring hope for those middle-advanced cancer patients with urecsectable tumor, but can also achieve the same curative effect as surgery in treating some early-staged cancers, like liver cancer, kidney cancer and prostate cancer.

Different types of ablation technology are applicable to different tumors, for example, thermal ablation including RF, microwave are mainly used for treating liver cancer, while cryosurgical ablation are more suitable for prostate and kidney cancer; NanoKnife with the advantage of being neither hot or cold stands out as a preferential treatment for pancreatic cancer which is particularly intolerable to thermal ablation.

Local ablation has advantages in treating pancreatic cancer 

The modern cryosurgical ablation represented by argon-helium technology emerging in the last 20th century together with IRE (irreversible electroporation, namely, NanoKnife) that rapidly developed in recent years both brings a new hope of life to cancer patients with inoperable tumor.

Prof. Niu Lizhi highlighted the advantage of cryoablation and NanoKnife in treating pancreatic cancer in his speech. 

In recent years, pancreatic cancer morbidity dramatically rises in China and many other Asian countries and regions, along with the change in dietary structure (meat takes up increasingly higher proportion in resident's dietary) and living environment, etc.

Surgical resection, as the primary option in treating pancreatic cancer (regarded as the king of cancer), is however rarely applied in real terms for the late detection. And chemotherapy, as another optional treatment, is insensitive to pancreatic cancer in practical terms. In recent years, Fuda Cancer Hospital conducted a series of treatments including argon-helium cryotherapy, NanoKnife effectively treating numerous middle-advanced stage cancer patients, and basically achieved its aim at controlling tumor progression, improving life quality and prolonging survive time.

Prof. Niu Lizhi introduced that Fuda Cancer Hospital took the lead in developing Nanoknife therapy in Mainland China in July 2015, and it was also the first hospital to report preclinical study of Nano-knife ablation on pancreatic cancer, which proves that NanoKnife makes no destruction on bile duct, portal vein and other important intracorporal organs (see Journal of Interventional Radiology, 2015).

In addition, Fuda Cancer Hospital has already published seven papers on NanoKnife therapy for pancreatic cancer in US Pancreas-the world’s most authoritative journal in the field of pancreas.

Up to now, Fuda Cancer Hospital has performed NanoKnife ablation on over 140 cancer patients, and half of those patients are pancreatic cancer patient.

During the 5th International (Guangzhou) Forum for Cancer Treatment held on Jul. 2nd, 2016, two IRE procedures were live broadcast. The surgeon was Prof. Niu Lizhi. One of these two patients, a 55-year old Hong Kong SAR resident, had repeated fever and abdominal pain since early 2016. After inspected, he was found a tumor measuring about 3.8cm in pancreatic tail and diagnosed with pancreatic cancer. On the live broadcast, Prof. Niu performed IRE on the pancreatic tumor under the guidance of ultrasound and CT scan. The procedure went successfully and intraoperative bleeding was only 2ml, which greatly wowed all the guests present.

Prof. Niu Lizhi pointed out that Nanoknife has more advantages compared with other ablation technologies. For example, it is selective for tissue ablation, which damages cells rather than vascular walls, nerves, bile ducts, intestinal canal and so on. The ablation procedure can be displayed by ultrasound, CT or MR, ensuring that ablation effect was to the best therefore. Therefore, Nanoknife ablation, especially applicable to the tumor around great vessels, hepatic hilus, gallbladder, bile duct and ureter, shows unique advantages in treating pancreatic and liver cancer.