Northeast Times

Life after the NanoKnife

New treat­ments: Since Ju­ly 2012, Dr. Wag­n­er has used the Nan­oKnife to per­form pro­ced­ures sev­en times. GREG BEZ­ANIS / FOR THE TIMES

Back in Au­gust 2011, Peggy Reed­er saw a doc­tor for a per­sist­ent cough.

Pneu­mo­nia was sus­pec­ted. She had chest X-rays and blood work was taken.

Reed­er, though, did not have pneu­mo­nia. She was dia­gnosed with pan­cre­at­ic can­cer.

Twenty-four chemo­ther­apy treat­ments over a five-month peri­od from Oc­to­ber 2011 to March 2012 did not fully kill the tu­mor, and she didn’t want the can­cer to spread.

Next, Dr. Steven C. Wag­n­er of Can­cer Treat­ment Cen­ters of Amer­ica told Reed­er of the Nan­oKnife, a sys­tem that util­izes a min­im­ally in­vas­ive meth­od called ir­re­vers­ible elec­tro­por­a­tion to kill tu­mors in loc­a­tions that are con­sidered chal­len­ging or high risk. Phil­adelphia’s CTCA is the first hos­pit­al in Pennsylvania to use the Nan­oKnife.

Reed­er, a 54-year-old from My­ers­ville, Md., listened care­fully, thought it over and even­tu­ally agreed to “get ’er done.” The pro­ced­ure took place on Dec. 12 at CTCA’s East­ern Re­gion­al Med­ic­al Cen­ter at 1331 E. Wyom­ing Ave.

A scan taken after the pro­ced­ure showed that the tu­mor was re­moved, and Reed­er felt fine af­ter­ward.

“I wasn’t sore. I nev­er got sick. I had no prob­lems at all. I went on to a nor­mal life,” she said. “Dr. Wag­n­er did me right. I had faith in him. He’s the man.”

Reed­er had the pro­ced­ure on a Wed­nes­day and was re­leased two days later. Her friends, Doug and Shari Knott, who had been dat­ing for 12 years, de­cided to get mar­ried on 12/12/2012. Their wed­ding re­cep­tion was held two days later at a Mex­ic­an res­taur­ant in Fre­d­er­ick, Md.

“I came home on Fri­day and went right to the wed­ding re­cep­tion,” Reed­er said.

Reed­er has since joined Plan­et Fit­ness, spend­ing her time there lift­ing weights and walk­ing on the tread­mill. She also swims for aer­obic ex­er­cise.

The pa­tient re­turned to CTCA for a fol­low-up scan on Jan. 18 and is sched­uled to re­turn for an­oth­er one on March 15.

The three-month mark will be cru­cial, but the early res­ults are prom­ising.

“Peggy did great. Her treat­ment is done,” said Wag­n­er, an in­ter­ven­tion­al ra­di­olo­gist. “She was very nervous, but she’s done well. She’s a very sweet lady.”

CTCA is one of just a few dozen hos­pit­als in the United States to of­fer the op­tion.

“We’re so in­nov­at­ive and pro­gress­ive in can­cer care, and it’s yet an­oth­er tool we have,” Wag­n­er said.

Wag­n­er spent a lot of time ex­plain­ing the Nan­oKnife to Reed­er and gave her time to de­cide wheth­er the pro­ced­ure was the right way to go.

In gen­er­al, the treat­ment lasts two to five hours, and pa­tients are giv­en gen­er­al an­es­thesia. They lie on their back or stom­ach.

Wag­n­er care­fully guides up to six thin needles/probes in­to the pa­tient’s body and stra­tegic­ally places them around the tu­mor.

The Nan­oKnife in­cludes a key­board and screen that in­clude the tu­mor size and the num­ber of probes and en­ergy level to be used. The probes, which are con­nec­ted to cables hooked onto the ma­chine, go through the skin and or­gan, then send elec­tric­al pulses to per­man­ently punc­ture holes in the tu­mor, des­troy­ing it.

The doc­tor, who is pas­sion­ate about his work, de­scribes the Nan­oKnife treat­ment op­tion as “ex­cit­ing.” It is not only ef­fect­ive, but min­im­ally in­vas­ive.

 “She’s a great ex­ample,” he said of Reed­er. “She had very little pain, if any. The probes are very, very thin. It’s a test­a­ment to how quickly a pa­tient can re­cov­er.”

Ac­cord­ing to the Na­tion­al Can­cer In­sti­tute, more than 45,000 Amer­ic­ans will be dia­gnosed with pan­cre­at­ic can­cer in 2013. Most will be age 65 and older.

A pan­cre­at­ic can­cer dia­gnos­is of­ten leaves few treat­ment op­tions and little hope, since there are no early de­tec­tion meth­ods.

As for those who are dia­gnosed, Wag­n­er be­lieves the highly pre­cise tu­mor-tar­geted ther­apy offered by the Nan­oKnife can be a lifesaver, killing the tu­mors without the need for sur­gery.

The device also may be used to treat tu­mors in or near the pan­creas, liv­er, kid­ney, pel­vis, gall blad­der, bowel, ma­jor blood ves­sels and oth­er areas. It spares sur­round­ing healthy cell tis­sue and can be re­peated, if ne­ces­sary.

Typ­ic­ally, the tu­mors must be about 1¼ inches or smal­ler to pro­ceed.

Wag­n­er first saw the Nan­oKnife in 2010 at a con­fer­ence of the So­ci­ety of In­ter­ven­tion­al Ra­di­ology.

“My first im­pres­sion was that it was too good to be true,” he said.

The cost was $400,000 — CTCA’s Illinois hos­pit­al also has one — and Wag­n­er thinks the pur­chase has been worth it.

Since Ju­ly 2012, Wag­n­er has used the Nan­oKnife sev­en times. Three pa­tients had pan­cre­at­ic can­cer, three had liv­er can­cer and one had a lymph node on the ab­do­men.

Wag­n­er ac­know­ledges that there is no data to pre­dict long-term out­comes, but be­lieves the pro­ced­ure to be a “safe and ef­fect­ive treat­ment.”

“We fol­low them closely after the pro­ced­ure, and every­one so far has done well,” he said. “There are no wounds to re­cov­er from or in­cisions to heal. They can re­cov­er very quickly. Most pa­tients are out the next day. It’s ex­cit­ing for us. Pa­tients have more op­tions for treat­ment. It’s more in­di­vidu­al­ized can­cer care.”

The closest hos­pit­als to CTCA that of­fer the Nan­oKnife, ac­cord­ing to Wag­n­er, are the Uni­versity of Mary­land Med­ic­al Cen­ter and the Me­mori­al Sloan-Ket­ter­ing Can­cer Cen­ter in New York.

Wag­n­er ex­pects the device to be­come more pop­u­lar in med­ic­al set­tings, not­ing that Phil­adelphia-area doc­tors of­ten ask him a ques­tion.

“How’s that Nan­oKnife go­ing?”••

Re­port­er Tom War­ing can be reached at 215-354-3034 or twar­ing@bsmphilly.com

You can reach at twaring@bsmphilly.com.

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