by
Brendon Nafziger, DOTmed News Associate Editor | January 22, 2010
And because the tumors' heat sensitivity makes them selectively affected by the treatment, the technique makes it easier to determine tumor margins. Scar tissue from the microwave heat naturally forms the borders of the areas that need to be removed during breast conservation surgeries.
"It biologically determines its own margins," says Dr. Dooley. "You don't have to artificially determine it with imaging."
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Although we colloquially say that microwaves "nuke" food, microwaves are not ionizing radiation and do not appear to pose any radiation-associated health risks. In microwave thermotherapy, the main side effects are pain near the surface of the skin from the heat or even small burns around the temperature probe used in the study to measure how much energy the tumor received. In clinical practice, these probes might not be needed, and the pain near the surface can be lessened by blowing cool air against the skin.
Dr. Dooley thinks microwave thermotherapy could be useful in shrinking tumors in other organs, such as the liver, which is solid and doesn't shift around a lot. But the real use for it could be to heat-activate drugs over cancer sites, so they deploy their toxic payload only over the tumor and not expose the rest of the body to harsh, cell-destroying medication.
For now, Dr. Dooley hopes to launch another round of studies, recruiting several thousand patients from multiple centers around the world, to see if the technique can work against larger tumors.
"First, [we need to] demonstrate in the redesign that equipment for larger tumors [can] down-stage those tumors with fewer doses of chemotherapy and get the same or greater effects," he says.
He would also hope by biopsying the cancers to at last truly figure out exactly how the microwaves are heat-killing them.
"That would be one of the components of a clinical trial, taking tumor samples," he says. "Although it's been observed for 30 years, no one has come up with the plausible, testable hypothesis that's convincing. It's something we need to understand better."
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