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2016年12月21日星期三

Focus on Cancer Academic Research and Benefits Cancer Patients

Opening ceremony of research project approved by Guangzhou Health and Family Planning Commission was held in St. Stamford Modern Cancer Hospital Guangzhou.

On Feb. 26, 2016, applied by St. Stamford Modern Cancer HospitalGuangzhou, the research project comparing efficacy and safety between treatments of combining nanoknife with gemcitabine and radiotherapy with gemcitabine for local pancreatic cancer, was approved by Guangzhou Health and Family Planning Commission. In the afternoon of Dec. 5 St. Stamford Modern Cancer Hospital Guangzhou gave the opening report of the research project with the participation and guidance of Prof. Xu Meng, chief physician and doctoral supervisor of the first clinical medicine college of Jinan University and organizer of biological treatment committee of Guangdong anticancer association, and presence of Tu Xiaoming, vice president of Singapore St.Stamford International Medical Group, and Wang Huaizhong, dean of St. Stamford Modern Cancer Hospital Guangzhou, together with other leaders and research groups.
Members of the research project initiation consultation committee

In the ceremony, Huang Deliang, oncology inpatient department director of St. Stamford Modern Cancer Hospital Guangzhou, gave the theme report to the project comparing efficacy and safety between treatments of combining nanoknife with gemcitabine and radiotherapy with gemcitabine. The subject of the research is to compare the local ablation efficacy of nanoknife, when combined with current well-acknowledged effective treatment of gemcitabine, with combination of gemcitabine with other therapies, and assess their safety to serve better clinical application. This project is, verified by Guangzhou intelligence institute, an initiative research project at home and abroad and also a breakthrough in pancreatic cancer treatment.
Huang Deliang, executor of the research project

Then the research group held a heated discussion over main content and feasibility of the research, focusing on the expected effect of combining gemcitabine with nanoknife technology at its 100% efficacy in treating pancreatic cancer. Associated director of oncology department and doctoral supervisor, Prof. Wang Xin, pointed out, as long as pancreatic cancer patients treated by the joint treatment of nanoknife and gemcitabine survive longer than the control group, the research is testified successful, so just keep calm during the process. Meanwhile, the research group also conducted analysis and discussion on every detail of the research process to guarantee the final success.

On the scene of the opening ceremony of the research project
     
In the end, Prof. Xu Meng gave his comments and instruction on the research project, which according to him is research on precision medicine and ranks in advanced research fields. He stressed study index detailing and safety during the research, expecting a formation of the hospital’s own clinical treatment guidelines based on 30 cases of joint treatment of nanoknife and gemcitabine. He hoped the research group can steadily conducts this project, with high-end technology of nanoknife as a platform and pancreatic cancer treatment as a start, to establish a characteristic treatment of high-end nanoknife technology combined with other therapies. He believed, with pancreatic cancer as the first target, it will cover more cancers and benefit more cancer patients.

Tu Xiaoming, Vice president of Singapore St.Stamford International Medical Group,

During the opening report, Tu Xiaoming, Vice president of Singapore St.Stamford International Medical Group, said it’s not easy to get the government's approval for a research project, but St.Stamford Modern Cancer Hospital Guangzhou has successfully passed two research project initiations. Besides the mentioned project, the other one was research on the feasibility of cryotherapy in triple-negative breast cancer recurrence and metastasis, applied by director Dai Wenyan. These indicated the hospital’s new level in technical innovation and overall improvement on academic and research ability. The opening report aroused extensive social attention.

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2016年12月13日星期二

Nanoknife Benefits Colorectal Cancer Stage IV Patient with Confidence and Optimism

PRAKOTHARN MR. DENCHAI, comes from Thailand, was diagnosed with colorectal cancer stage III after recurrence of bloody stool in 2013. On the advice of doctor, MR. DENCHAI underwent resection of colorectal tumor. In mid-2015, metastasis and recurrence occurred. The Ct scans turned out that there was a tumor in his liver and the size was about 3.5cm*3cm. After nanoknife in Modern CancerHospital Guangzhou, his condition is well under control and the tumor marker has almost backed to normal. The symptoms including fatigue have also disappeared.



MR. DENCHAI(the third on the left) with medical staff in MCHG

Bloody Stool: Typical Symptom of Colorectal Cancer

MR. DENCHAI is 43 years old this year (2016). Symptom of bloody stool occurred to him since 2008. Bloody stool is a typical symptom that occurs when colorectalcancer developed to a certain stage. However most people neglect the symptom as bleeding caused by internal piles and even doctors would make misdiagnosis. In fact, colorectal cancer, featuring high incidence rate and death rate, frequently occurs among people over 45. Therefore it is necessary to take promptly colorectal cancer screening as soon as the symptom of bloody stool occurs.

After the occurrence of bloody stool, MR. DENCHAI didn’t take it serious. Until being diagnosed with sigmoid colorectal cancer in a regular check-up, he was in depressed mood and then undertook tumor removal on the doctor’s suggestion.  


Minimally invasive specialist in MCGH, Director Bai Haishan was performing puncture and placing electrode probes for the patient

One month after the surgery, MR. DENCHAI began to undergo chemotherapy which uses chemo drugs to kill cancer cells all over the body and may cause serious side effects.  Indeed, MR. DENCHAI terribly suffered from severe hiccup after chemotherapy. “Every day I belched around the clock, which affected eating and sleeping.” Being unbearable to the side effects of chemotherapy, MR. DENCHAI gave up after two sessions of treatment. Finally, he got to know MCHG through a Thailand advertisement. Minimally invasive treatment taking advantages of few side effects caught his eyes and gave him hope. Therefore he went to Guangzhou for treatment.

Nanoknife Got Tumor Promptly Under Control.

In MCHG, MR. DENCHAI confirmed the diagnosis, recurrence and metastasis of colorectal cancer stage IV after radical resection. For his hepatic metastatic tumor, Multi-Disciplinary Team (MDT) from MCHG immediately held a discussion. Since it was a single lesion, some doctors wondered whether surgery was feasible. The lesion was located between the right branch of portal vein and right hepatic artery. Applying removal surgery might cause damage to these tissues and also might have high risk. Ultimately after two-hour discussion, Multi-Disciplinary Team (MDT) decided to apply the most advanced technique nanoknife to Mr. DENCHAI.

During the nanoknife treatment

Nanoknife is a brand new, advanced tumor ablation therapy, which breaks the membrane of tumor cells with high voltage pulses from electrode probes, resulting in multiple permanent nano-meters Irreversible Electroporation (IRE), damaging cells balance and accelerating the death of cancer cells. The advantages of nanoknife far outweigh traditional surgery such as, no damage to important tissues around the tumor, reservation of vessels, bile duct, nerve, ureter, etc ,  distinct border of ablation area, reducing the recurrence risk and achieving same therapeutic effect as usual operation. 


Electric probes releasing high-voltage pulses to break the membrane of tumor cells

After the treatment, MR. DENCHAI’s tumor got promptly under control. In addition, he was free from side effects as before such as, nausea and vomiting. He got soon rid of weak condition and regained optimism and confidence. According to the chief physician Ma Xiaoying, currently MR. DENCHAI’s tumor marker has almost backed to normal and he is in good condition. 

MR. DENCHAI in good condition after treatment

Nanoknife-New Hope for Middle and Advanced Stage Cancer Patients

It is known that nanoknife has been approved by US FDA into clinical use Ministry of Public Health of China approved the technology for cancer treatment in 2015. It is a brand new ablation therapy for solid tumor occurred in liver and pancreas.

Director Bai Haishan in Modern Cancer Hospital Guangzhou pointed out that nanoknife  applied in clinic these years has brought hope to pancreatic cancer and hepatic cancer patients. It enables patients with inoperable condition to achieve a chance of radical therapeutic effect. “Especially for those tumors adjacent to main blood vessels, doctors can’t do anything in the past. Patients always can just passively wait for the fate. But now, these small probes can effectively avoid surgical risk.”


The successful completion of nonaknife for recurrence of colorectal cancer with liver metastasis means Modern Cancer Hospital Guangzhou has made great progress in the field of nanoknife, which will bring more new hope for the middle and advanced stage cancer patients.

2016年12月11日星期日

Nanoknife, Good Option for Inoperable Hepatic Tumor

Nanoknife for Primary Liver Cancer was Performed Successfully in St. Stamford ModernCancer Hospital Guangzhou.



In the morning of Nov 30th, nanoknife for liver cancer was performed successfully again with general anesthesia in Modern Cancer Hospital Guangzhou. Guided by Director Bai Haishan who has over 30 years of operation experience, the treatment witnessed another milestone of Nanoknife at our hospital. The patient didn’t suffer from any side effects such as pain and fever. After one-night observation in ICU, he was in good mental state and sent back to general ward. 


Director Bai Haishan was performing nanoknife for the patient 


The patient Mr. Pan is 51 years old  from Vietnam. In July, he detected a 4 cm*4.3 cm tumor in his left lobe of liver by CT scan. The blood test showed that his AFP reached to 665ng/ml. Local doctor suggested him take surgery but he refused. Instead he just took traditional Chinse medicine at home. On 11th Nov, 2016, Mr. Pan went back to hospital for recheck. By CT scans and blood test, he knew his condition got worsen with enlargement of the tumor  and increase of AFP to 1225ng/ml.


Electrode probes were performed precisely into the tumor as planned


High Risks to Perform Traditional Surgery for Tumor near Critical Structures

On 19th Nov, 2016, Mr. Pan came to St. Stamford MCHG. After thorough examination, he was diagnosed with primary hepatocellular carcinoma stage II. Back then,  the liver tumor enlarged to 5cm and the AFT reached to 900ng/ml. Surgery expert in MCHG, Bai Haishan, introduced that primary liver cancer could be  treated by surgery or regular ablation, while there’s a technical difficulty, “the tumor was adjacent to main visceral organs, stomach on the left and hepatic major vessel on the right. It would be possible to damage stomach wall or cause gastric perforation whiling performing removal surgery. In addition, radical therapeutic effect couldn’t be achieved by regular ablation”, Director Bai added.

Preparation and plan before treatment


Nanoknife, Safe and Suitable for Mr. Pan 

Multidisciplinary Team (MDT) from MCHG immediately held a meeting based on Mr. Pan’ s case and decided to apply the advanced nanoknife to Mr. Pan. Nanoknife breaks the membrane of tumor cells with high voltage pulses from electrode probes, resulting in multiple permanent nano-meters Irreversible Electroporation (IRE), damaging cells balance and accelerating the death of cancer cells.



Nanoknife electrode probes


Director Bai Haishan pointed out that compared to other kinds of ablation therapy, nanoknife, a non-thermal ablation technique, will not cause incomplete ablation due to tumor’s adjacent location to main blood vessels. Meanwhile, vessels, nerves and other healthy tissues within ablation zone can be preserved without damage. “For those patients who are reluctant to undergo surgery, or patients with inoperable or difficult-to-reach tumors, including tumors located near critical structures and major blood vessels, nanoknife is a quite good option. It is not only safe, but also can achieve therapeutic effect as normal surgery does.”  Director Bai said.


The next day after treatment, Director Bai Haishan visited Mr. Pan



Mr. Pan could walk in the next day after treatment and he also was in good condition with good appetite and sound sleep. At 11 am, Director Bai Haishan personally visited him.  Director Bai pointed out, “As long as he continues the follow-up treatment, his condition will be greatly improved and even achieve radical therapeutic effect.”

2016年12月6日星期二

Introduction of Nanoknife Technology

        Nanoknife is a brand-new cutting-edge ablation technology for tumor treatment. It breaks the membrane of tumor cells with high voltage pulses from electrode probes, resulting in multiple irreversible nano-meter electroporated holes, which is applicable to pancreatic cancer, liver cancer and other solid tumor treatments.


What’s Nanoknife
Nanoknife is a brand-new cutting-edge ablation technology for tumor treatment. Derived from Irreversible Electroporation (IRE), it breaks the membrane of tumor cells with high voltage pulses from electrode probes, resulting in multiple irreversible nano-meter electroporated holes. Thus, it destroys the balance in and between tumor cells and accelerates their death.


Clinical Application of Nanoknife


Nanoknife was approved by US FDA into clinical use in October, 2011 and has passed EU CE accreditation. In recently years, it has been successively put into clinical use in over 100 core cancer hospitals around the world, including China, whose Ministry of Health approved in June, 2015 the use of this technology in cancer treatment.

 


Advantages of Nanoknife


Short course of ablation
  
To ablate a solid tumor of 3cm in diameter, 5 minutes is more than enough. Every pair of probes releases 90 microsecond ultra-short pulses, which takes less than one minute. Even if there are 3-4 overlapped ablation areas, some patients can still be discharged the same day or next day after the whole process. 


Vessels, nerves and other vital tissues in the ablated area are well protected.
Another advantage of nanoknife ablation is that it causes in the ablated area no irreversible damage to important tissue structures like vessels, bile duct, nerves and ureter, etc.. All important tissue structures within liver, such as artery, vein, portal vein, bile duct, etc. will be well reserved after nanoknife operation.

Non-thermal ablation
  
The ablation of nanoknife breaks cell membrane using mainly electrical pulses, without creating thermal energy during the process, while traditional ablation uses temperature alternation to cause protein denaturation, damaging all kinds of protein and DNA, and consequently makes above mentioned tissue structures irreparable. Moreover, if there are major vessels in the ablated area, the thermal energy of traditional ablation will be taken away by the bloodstream and the ablation effect will be weaken, thus, recurrence is more likely to happen.

Thorough treatment, clear boundary
Another advantage of nanoknife is that its ablation can completely cover the tumor no matter where it is located and in what sizes and shape. Meanwhile, after ablation, there is clear boundary between the ablated and unablated area, which means no residual lesion and therefore lower risk of recurrence.  

Normal cells occupy the ablated area shortly to restore its normal function
 
Traditional ablation use temperature alternation to trigger protein denaturation, resulting in coagulative necrosis, after which no tissue structure in the area survives. On the contrary, nanoknife is to induce death of tumor cells and use phagocytosis of immune cells of human body to eliminate the dead tissues, thus to repair and regenerate normal tissues. 

Real-time monitoring on the process
 
Nanoknife treatment can be guided and monitored under ultrasound, CT and MRI. With assistance of these equipments, the nanoknife probes are located, process and actual range of ablation area are monitored in real time. Thus, doctors can observe the changes of the ablated area and around tissues to ensure the treatment effect, safety and quick recovery afterwards.

Adaptable to more complicated situations
  

Traditional ablation is impracticable to situations when the tumor involves major vessels, bile duct, pancreiatic duct, portal vein and other vital areas. Moreover, there is high risk of damaging nerves and causing paralysis, loss of sexual ability and other consequences in using traditional ablation to treat prostate tumor or tumor near the spine. On the contrary, nanoknife does no harm to the ducts and nerves, therefore it is practicable to above mentioned situations and plays an irreplaceable role in treating patients of this kind.


Adaptable to illnesses


Illnesses can be treated with nanoknife include tumors in pancreas, liver, lung, kidney, prostate, etc.. It is of particular advantages in dealing with tumors involving porta hepatis, gallbladder, bile duct, pancreas and ureter.

Cautions
1)     
During the process, general anesthesia and tracheal intubation are needed. Because the released millisecond high-voltage electrical pulses may cause muscle vibration, muscle relaxants are also required.
2)        
For patients who have near the tumor implanted metal objects, including stents, radioactive particles, heart pacemaker etc. and those who have arrhythmia or have recently experienced myocardial infarction, nanoknife is impracticable.


Nana knife is the advanced tumor treatment technology at Modern Cancer Hopsital Guangzhou. It is applicable to treat the tumor near hepatic portal, gallbladder, bile duct, pancreas or ureter, which brings more treatment options to cancer patients.

2016年12月5日星期一

“Thank God, You’re Here”

----Documentary of Dr. Ke’s Clinical Reception
Author: Dr. Ke Liqun from Modern Cancer Hospital Guangzhou
The person who sat opposite to me was an elderly mother of a cancer patient. From her look of great concern and anxiety, I knew she was a good mother. As we met, she frankly told me, “This is my sixth time to consult Chinese expert.” I handed a cup of tea to her and replied to her with smile, “After you consult with me, I am sure that you will not find the seventh Chinese specialist anymore.”

According to this mother, I knew that her daughter, a breast cancer patient, was 36 years old. Two years ago, she took surgery first, and then six sessions of chemotherapy, later oral tamoxifen (an anticancer hormone drug). After one year, she discovered cancer came back with metastasis to liver and lung during her regular check-up. Subsequently, she took treatment in Singapore where the doctor made her a plan of 8 sessions of chemotherapy. So far, she had finished 7 sessions. Although the lesions in her lung shrank, the tumor in her liver did not.  

I verified her statement after I compared two CT photos before and after treatment. I asked, “What may you want me to help?” She answered, “Singapore doctors said they only have chemotherapy, while a Chinese professor recommends me 125I seed implantation, and some advise me interventional therapy and cryotherapy. I want to ask for your suggestion.”




“It’s sad that cancer metastasized to liver and lung so quickly after breast cancer surgery”, rather than answered her questions directly, I said, “If the patient took several sessions of preoperative chemotherapy, then surgery, and lastly chemotherapy and radiotherapy, she would not be in this current condition.” The old woman blurted out, “Yes, Singapore doctor also holds the same opinion.”   
Then, I explained the applicable time, efficacy, limitation and side effects to use surgery, radiotherapy and chemotherapy for advanced breast cancer, as well as their mechanism of immunity damage and promotion of cancer recurrence and metastasis in detail. Furthermore, I pointed out that her daughter was a victim of conventional cancer treatment, taking treatment meanwhile getting cancer metastasis. “I also know that chemotherapy cannot work anymore”, she sighed, “On the one hand, we haven’t found out a reliable treatment to replace chemotherapy yet. On the other hand, my daughter firmly trusts Singapore medical technology. ” When she asked whether there were any reliable alternative treatments in China, I made a detailed introduction of principles, advantages, applications and operating processes of cryotherapy, interventional therapy and particle nanoknife to her, which substituted for surgery, chemotherapy and radiotherapy respectively. Besides, I suggested her daughter come for consultation personally. However, the old women said, “Since she was diagnosed with cancer, she hasn’t wanted to see anyone, even her friends. I have persuaded her to see Chinese doctors for many times, but was rejected. ”

Two days later, this old woman visited our office again, leading her husband and her son in this time. Her husband said he and his son were doctors, and his wife was a retired pharmacist. They aimed to explore hormone therapy with me.    

He asked, “My daughter’s breast cancer is ER-positive (estrogen receptor-positive). Why can’t tamoxifen prevent her cancer metastasis?”

“Your question is very professional”, I said, “Indeed, estrogen is highly correlated with breast cancer development. Since the early 1990s, people take estrogen as the high-risk factor of breast cancer. But it is not the only factor that causes cancer. Because tamoxifen plays a role in resisting estrogen, applying tamoxifen as adjuvant therapy to ER-positive breast cancer patients can lower metastasis rate by 65%. In other words, about one third of ER-positive breast cancer patients cannot benefit from tamoxifen. ”
“Now that tamoxifen doesn’t take effect on antiestrogen, is there any help to eliminate the source of estrogen by removing my daughter’s ovary and womb?” The patient’s father questioned me closely.

I said, “Your thought is very fashionable, which has theory basis and supporting cases.” And then I took a foreign star who removed her ovary and womb to prevent breast cancer as an example. I continued to say, “However, as I say, estrogen is not the only factor to cause breast cancer. There are other factors causing breast cancer. Under the situation that tamoxifen doesn’t work, it may be backfired that to lie hopes on removing ovary and womb to control advanced breast cancer. Moreover, your daughter’s breast cancer has spread extensively. Is there any gynecologist who takes adventure to cut out a normal ovary and a normal womb for unreliable effect? Even given a lot of guts, he or she dare not!” At last, I showed my greetings and wishes to the patients, conveyed by them. I encouraged the patient to have confidence and patience to fight against cancer, and to have positive and optimistic attitude as the return for family love. Besides, I gave her some guidance in daily life.  




A week later, the patient’s mother excitedly called and told me her daughter wanted to see me.


The patient was a cool and young lady, unlike an advanced cancer patient. I stood up, hold her hands and said, “Thank God, you’re here.” On seeing her surprised look, I promptly explained, “There is a humorous Chinese host from CCTV (China Central Television), similar to the figure of English Mr. Bean. He hosts a program called ‘Thank God, you’re here’ which is popular in China. ” As she smiled, I said, “To welcome you, I specially prepare an egg for you. But it is not for you to eat, but a prop to answer your questions.”


She asked me the first question, “At the very start, my doctor told me that my disease is not so serious, which can be treated well. Why does the cancer metastasize so quickly? ”

I replied, “It is related to the substandard of the first treatment. But it is not the main reason. And here is the origin to cause breast cancer development and worsening. On the one side, cancer stem cells are crazy to copy and produce cancer cells without limitations; on the other side, the body immunity cannot recognize and kill so much cancer cells. Those two reasons combine together to become a tumor which grows and spreads constantly. Let’s look at this egg, the most primordial stem cell of chicken. Compared with a normal cell of chicken, except for its bigger size, the egg has a layer of thick shell. Human cancer stem cell has the similar structure of egg shell, so it is not afraid of chemotherapy and radiotherapy. Before taking tumor removal surgery, if cancer stem cells move to other organs or tissues and grow there, it is difficult to prevent cancer recurrence and metastasis no matter how much chemotherapy and radiotherapy we do later. It is well known that the treatment effect of surgery for the early cancer is remarkable. And people hold that it is unnecessary to take chemotherapy and radiotherapy for most of early cancer patients after operation. Why? Because the cancer stem cell at the early stage of cancer is still in the central of the tumor to grow stronger without moving outside. At this time, via surgery, cancer stem cell can be eliminated with the whole tumor. As for your present condition, the ideal treatment plan cannot be lack of intervention for cancer stem cell. Apart from surgery, there are minimally invasive treatments to intervene cancer stem cells and cancer cells in your body, including cryotherapy, microwave ablation, radio frequency, energetic particle etc. They can kill cancer towards its source. Moreover, if they are combined with immunotherapy, it will make your condition even better.”




She asked an aggressive question, “What you say above is very nice. But I have a friend who is a breast cancer patient too. At first she went to Guangzhou to get treatment, but her condition was worse and worse. Until she was transferred to Singapore hospital, her condition got control. Could you please tell me why?”

I answered, “First of all, Guangzhou is one of three biggest cities in China. There are many cancer hospitals with various cancer treatments in Guangzhou. So, could you please tell me which hospital your friend was admitted to? What treatments did she take? Secondly, minimally invasive therapy, as I say, is a new and high-end cancer treatment project. It highly demands for good equipments, and especially suitable treatment programme and high level of doctor’s medical techniques. That is to say, treatment effect of minimally invasive therapy is bound up with merit of doctor’s techniques and advancement of medical equipments. Different doctor operates different equipment, and the efficacy is different. Besides, the treatment effect also depends on the individual condition. Thirdly, your mom told me that you haven’t smiled since you got sick. But today, when I said the first sentence to you, I saw you smiling. So, I believe if you can receive better treatment, smile will be always on your face, increasing more joys to your families and friends.”

Two weeks later, Indonesian patient Chandra, accompanied by her family, flied to Guangzhou to begin her special treatment trip in Modern Cancer Hospital Guangzhou.