Juana Pérez Ruiz already had to endure the calamity of breast cancer 17 years ago. Then the treatment was complicated: radiotherapy, chemotherapy and surgery were the most common, and the process and recovery were complicated. Today, at age 83, a routine check-up gave her a nightmare, this time in the other breast. But medicine is progressing unstoppably and this time Juana had a very different experience: she underwent thermoablation of the tumor at the Clinical Hospital, an outpatient and painless procedure which, in a few minutes and under local anesthesia, freed from the new threat. .
Dr. Myriam Montes, breast radiologist at this public health center, has been applying this procedure for three years: “We were pioneers in Europe,” she recalls. Today it has spread to other hospitals in Madrid, given its effectiveness: 25 patients during this period at the Clinic, “and no recurrence”, says Montes.
The method is simple: it is applied percutaneously, under local anesthesia, by introducing a needle guided by ultrasound. When it reaches the location of the tumor, very intense heat is generated in the needle using microwaves – it can reach 100 degrees Celsius, he points out – and it has the effect the necrosis of cancer cells, without damaging healthy tissues: “In vivo, we can see how the tumor disappears, until it becomes blurry,” explains the doctor.
The minimally invasive system is currently applied only in certain cases: to tumors less than three centimeters and to women who, for various reasons, have excluded surgery – due to age, contraindications to the general anesthesia, etc. -.
The extreme heat used for this breast tumor thermoablation can reach up to 100 degrees Celsius; Yes, “it’s for a very localized area, and we have tables that indicate how much power should be applied, depending on the size of the tumor,” says Dr. Montes.
Image of the breast with the tumor (left), and after treatment, without trace of cancer (right)
For further monitoring of the patient and to be able to assess any early recurrence, the San Carlos Clinical Hospital has a new device that performs mammograms with contrast. Dr. Montes defends the procedure because “it is less aggressive and is also not incompatible with other treatments” that can be administered simultaneously. He predicts that once its use is sufficiently proven, heat ablation of breast tumors “will be applied to more people, and to younger people; “This will be one of the treatments of the future.”
At 83 years old, Juana retains enormous vitality and boundless curiosity: she never stops asking for details about the treatment. “I actually always really liked medicine; In fact, I wanted to study it but I couldn’t due to lack of funds.
Married for 64 years and widowed for two years, her professional life was linked to the Made Laboratory in Madrid. From what happened 17 years ago, with his first tumor, to what he experienced on this second occasion, there is a whole world. “They did it to me on March 4 of this year, and they kept making me talk, they made me laugh…”
Sensations
The entire procedure takes place without setting foot in an operating room, in a much more relaxed environment and under local anesthesia, and is similar to carrying out a puncture. “I thought they were putting liquid into me with the needle, and it turned out to be hot, but I didn’t notice it, neither cold nor hot. Of course, we notice the little needle that goes through,” says the patient.
The procedure itself lasted about three minutes, although the entire process, from entry to exit, could have lasted about 15 minutes, the doctor estimates. The “before” and “after” mammograms show how the tumor that existed at the start of the procedure had completely disappeared in the image taken later.
The experience, he affirms, was much lighter than his previous intervention and, moreover, “I was not afraid of it; “You are treated by people who make you forget the word cancer,” he says.
Thermoablation of breast tumors has been applied at the San Carlos Clinical Hospital, over the last three years, on 25 patients, “and there has been no recurrence”, insists Montes. The technique is compatible with subsequent radiotherapy treatment, as well as with the more common hormonal treatment for 5 years. In addition, the treatment can be reapplied later, as many times as necessary.
But it also has limits: it cannot be applied to everyone, at least for the moment, but only to selected patients. And on tumors whose size does not exceed 3 centimeters. It is more economical than other treatments, “especially if we take into account what surgery involves: an admission, an intervention, wound care… It also requires much less staff”, emphasizes Montes .
Thermoablation has become the answer for women who cannot undergo breast surgery and who, until this technique began to be applied, “were undergoing medical treatment for their tumor until the disease could no longer be controlled,” explains the doctor.
This solution also leaves no physical or cosmetic consequences, and offers better results than pharmacological treatment alone; This is effective temporarily without completely stopping the disease, with the risk that the disease will progress and affect the skin or chest wall, eventually requiring surgery.
The experience of this treatment at the Clinic gives results that the hospital describes as “very encouraging, because in well-selected cases we have so far not detected any recurrence.” They also do not leave scars and complications are rare. “It is a procedure very well tolerated by patients”, which has the great advantage that, being carried out under imaging guidance, it allows radiologists to have control of the procedure at all times and to note that the ablation of the tumor occurs satisfactorily.
