The worldwide hunt for a cancer cure continues, and the Fox Cities offer new technologies in addition to some intriguing contributions to cancer research.
Though some surgical techniques used to remove cancerous tumors have remained unchanged over the years, the tools used to perform them have evolved. Charles Cheng is a surgical oncologist at Fox Valley Surgical Associates in Appleton and within the past decade, he has had access to the Harmonic ultrasonic shearer. The tool, powered by an ultrasonic energy source, resembles a pair of scissors. The rapid vibration of the blade created by the ultrasonic energy source allows surgeons to incise, coagulate and seal vessels at a low temperature, which prevents further tissue damage. In extracting thyroid tumors, “what used to be a 10 centimeter incision is now a three or four centimeter incision,” Cheng states.
Specific to thyroid cancer, use of this instrument halves the cost of treatment, and it is more efficient than its alternatives. The smaller incision prevents excessive blood loss, and as a result, patients can conceivably go home the same day as their surgery. Cheng adds that precision technology companies such as Olympus are working to create even more up-to-date energy sources. Cheng postulates that the energy source of the future will utilize microwave technology, or a new hybrid of existing energy sources.
Developments in radiation have also made cancer treatment more precise. Dr. Rick Davis, a radiation oncologist at St. Elizabeth’s hospital in Appleton and Mercy Medical Center in Oshkosh, is eager to install a varien trubeam linear accelerator at the Oshkosh location in May. The machine generates therapeutic, high-energy x-rays in a beam to treat tumors. This new machine, which is one of the “most advanced, latest technologies in the world” according to Davis, allows the operator to shape the beam so that it is the exact size and shape of the tumor. This allows for more efficient and accurate treatment with minimal toxic exposure to the patient.
In addition to Mercy, St. Elizabeth, Aurora BayCare and local Affinity Cancer Centers have these machines. “There is a general sense in small towns like Oshkosh that you need to travel [to big cities] to get top rate treatment. But that is clearly not the case,” explains Davis.
Dr. Randall Johnson of the Neuroscience Group in Neenah acknowledges the benefits of research not directly related to treatment. Advanced techniques in molecular biology have been able to identify differences in the molecular makeup of certain brain tumors. “This is helpful information,” Johnson explains, “because we can take larger classes of tumors and reclassify them more accurately.”
Take a Pill
While developments in cancer research have made radiation and surgery practices more precise, new research in other fields may eventually make those practices obsolete. Dr. Dhimant Patel of Aurora BayCare Medical Center is a medical oncologist who is excited to offer his patients alternatives to chemotherapy. Certain advancements have been made in immune therapy over the last few years. “Immune modular drugs tackle the genetic makeup of the cancer, and shut off blood supply to the cancer cells,” explains Patel.
In looking at new diseases to which the immune modular drugs can be applied, a vaccine for pancreatic cancer has been developed. In this treatment, the immune system is exposed to the cancer so that it can recognize and destroy the disease while producing natural antibodies. The vaccine is now the subject of a phase 3 study in the clinical trial stage. This means that 50 percent of the pancreatic cancer patients at Aurora are receiving treatment via this vaccine, as opposed to chemotherapy. The Aurora clinic in Green Bay and a clinic in Madison are the only two places in the state that have access to this vaccine.
Dr. Morris Johnson and Dr. Michael Smits are developing a treatment that – though separate from the immune therapy to which Dr. Patel refers – also takes the form of a pill, administering two drugs that work sequentially and rapidly to kill the patient’s cancer cells.
They were granted a U.S. Patent for their unique cancer treatment in April of 2012. They have been collaborating on their analytical testing right here in the Fox Cities for years. The first drug, Buthionine Sulfoxinine (BSO), inhibits an enzyme that synthesizes glutathione. Depleting glutathione levels sensitizes cancerous cells. The second drug, the compound Methylglyoxal (MG), naturally occurs in the body in extremely low levels.
Increased levels of MG in cancer cells induces a natural body function called apoptosis, in which cells kill themselves when they are damaged. Cancer cells are generally immune to apoptosis, but this treatment makes the cells susceptible.
Johnson and Smits saw success with their in vitro trials at the end of last year. Beginning last November, they began two weeks of treatment on a dog with stage 4 lymphoma. As of January, the blood chemistry in the dog’s lymph nodes look good, and he has gone into remission.
“If we are successful in companion animals, then we have a really good chance of [the drug] being successful in humans,” Smits says.
Madison is the current reference for cancer treatment in companion animals, but with time, money and more progress, this treatment – which they estimate to be approximately half the cost of chemotherapy – may be available locally. The two doctors are currently working on obtaining a grant to expand their clinical trials on companion animals in the Fox Cities. “Testing locally will give us more control [over the trials], and it will be beneficial to the public,” Johnson says.
Dr. Michelle Koellermeier, an OB-GYN at Women’s Care of Wisconsin in Neenah, was diagnosed with breast cancer several months ago. Now placed in the unusual situation of being a patient, Koellermeier has some new insight as to what current cancer treatment is like in the Fox Cities, as well as a unique perspective on the role of the doctor in patient care.
As part of Koellermeier’s treatment, she has been administered a new IV drug called Herceptin. The drug targets and inhibits the receptors of the HER2 (human epidermal growth factor receptor 2) proteins contained in the cancer cells. Koellermeier gets an IV of the drug every three weeks, and the treatment lasts for one year. The development of this drug arose from similar molecular biological research focusing on the genetic makeup of the cell that Dr. Johnson was referring to previously.
Though her practice’s involvement with cancer does not go beyond diagnosis, Koellermeier’s experience as a patient has given her a comprehensive perspective on cancer treatment, both from the doctor’s and patient’s perspective. She has discovered how different the patient’s and doctor’s experiences are in offices or hospitals, and when she returns to her practice she seeks to “mesh the two different worlds together, in order to better guide the patient.”
Koellermeier is proof of how understanding cancer can involve one in the “collaborative type of care” that patients need and deserve.