nanoknife IRE for pancreatic cancer

980 Posts | Page(s): Prev 12...44 45 46 47 48 ...9798 Next 

RE: nanoknife IRE for pancreatic cancer

by PhilipJax on Wed Dec 30, 2015 03:30 PM

Quote | Reply

Martoi

IRE is performed during the open resection surgery.  And, the IRE progress is monitored and reapplied if necessary in real time

Perhaps you posed the question to Dr Martin in the wrong way.  No physician is likely to criticize another in the brotherhood of physicians.

As directly whether the patient is a candidate for Irreversible Electroporation.  If yes, do it.  You will get IRE and resection, both.

PhilipJax

RE: nanoknife IRE for pancreatic cancer

by margol on Wed Dec 30, 2015 03:43 PM

Quote | Reply

Thanks for your response.

But just to be clear - no physicians were criticizing each other...sorry if I implied that.  Just have gotten two different opinions regarding whether fiducials will affect IRE.

Also, When discussing with Dr. Martin's nurse, it was pretty clear that it is not always IRE+resection, only where he thinks that is possible.  Maybe I am misunderstanding you.

At this point, for reasons unknown to me, based on an examination of my mother's last CT scan, Dr Martin said to go for radiation, not straight to IRE.  Perhaps I will resend her MRI(which we hope to have in the next few days) to him before we start the radiation to see if it changes his mind. 

Regarding the real-time results...that is very interesting.  Traci told me was that the first CT scan 3 months post IRE had to be done in Louiville as their radiologists know what to look for to confirm that the IRE was effective.

Thank you all very much for your comments and advice and concern.

RE: nanoknife IRE for pancreatic cancer

by PhilipJax on Fri Jan 01, 2016 01:14 PM

Quote | Reply

Margol,

Send JHopkins’ Christopher L Wolfgang, MD, PhD,cwolfga2@jhmi.edu, a complete package of records in pdf format: Latest CT/PET/MRI reports, overall status report (including disease stage), surgery, biopsy, blood work, etc in one clean easy-to-read file. Say the CT/PET/MRI disks are enroute.

In a concise coverletter, ask whether the patient would be a candidate for Irreversible Electroporation and resection under Dr Wolfgang’s care. Do not say what every other physician recommends, which is not relevant. If you say what another physician recommends, Dr Wolfgang will be forced to contradict that physician.

And, give a brief overview of the patient’s condition, cancer stage, and treatment thus far – nothing else.

Good care managers maintain copies of the latest reports at all times (which always contain surprises not told the patient). So, you should be able to get this email out in a matter of hours.

You could have a reply within a week.

PhilipJax

RE: nanoknife IRE for pancreatic cancer

by KC2020 on Sun Jan 03, 2016 08:31 AM

Quote | Reply
Hi Everyone, Thank you so much for the wonderful information on this thread. It's been a godsend to find this level and quality of info (thank you PhilipJax) to enable me to obtain a much better understanding of IRE NanoKnife procedure. I am set down for the NanoKnife procedure at Prince of Wales hospital in Sydney Australia on the 3 Feb. As far as I can ascertain I will only be the 3rd person in Australia to have this procedure surgically administered for adenocarcinoma of the pancreas. The first was via the Alfred Hospital in Melbourne (back in Feb this year) and the 2nd will be via my surgeon at POW on the 27 Jan. So it is all rather new in this country albeit we are seeing excellent results in other soft tissue tumours such as prostate. I had a failed Whipple procedure about 10 weeks ago. They were unable to carry out the whipple as my tumour is far too adhered to the artery. It is hoped that the NanoKnife will enable the whipple to be undertaken at a later date. As yet there is no evidence that my cancer has spread and I have seen quite good results from the chemo (first two cycles of chemo pre surgery resulted in the tumour reducing from 4.2cm x 2cm down to 2cm x 2cm). So currently I have just finished 2 more cycles of chemo and then will undertake fresh CT tomorrow and a PET scan next week with a view to hopefully have the NanoKnife on the 3rd Feb. Cheers

RE: nanoknife IRE for pancreatic cancer

by tallysis on Sun Jan 03, 2016 11:25 AM

Quote | Reply
The nano knife (IRE) procedure has been a huge advancement for those patients who cannot have a traditional Whipple. If it's successfully used, like in my sister's case, it replaces the Whipple surgery. Which is good! It's big surgery by itself and good not to do it twice! We are all thankful for this cancer compass thread and PhillipJAx in particular. There is also a Facebook page, Nanoknife surgery Warriors, where thee is good sharing on the procedure.

RE: nanoknife IRE for pancreatic cancer

by PhilipJax on Sun Jan 03, 2016 03:51 PM

Quote | Reply

KC2020:

I assume that the IRE therapy will take place intraoperatively, during open surgery or laparoscopically, which are much preferred to percutaneously.

Since your facility, Prince of Wales, is rather inexperienced, you may wish to study several of RCG Martin’s training articles, found at

http://anesthpain.com/41974.pdf

http://www.thejgo.org/article/download/3987/4359

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3815199/pdf/pone

Once you become expert on them, you might question your surgeon and anesthesiologist on the strong points of the articles.

PhilipJax

RE: nanoknife IRE for pancreatic cancer

by KC2020 on Tue Jan 05, 2016 10:06 PM

Quote | Reply
PhiipJax Thanks for the excellent articles. Very Informative. Obviously, ideally, I would look to find a surgeon and hospital who have performed at least 5 IRE Nanoknife procedures, but given where we are at in Australia around this proceduree this is not possible. The articles however at least help position me to ask the appropriate questions. Yes, the IRE Therapy will take place intraoperatively during open surgery. There is another hospital in Melbourne who perfom them (predominately) percutaneously but I am unsure just how many they have performed and the outcomes. Given the shortcoming of a CT disclosing the extent of invasion in my artery, intraoperatively is the only way to go in my case (and I understand this approach is achieving the best outcomes V percutaneously) Thanks again tallysis Unsure at this stage if the whipple will definately be undertaken. My surgeons plan is to monitor post the IRE and then make a call. Having said that, being one of the main Pancreatic cancer surgeons in this country and given the newness (despite the outcomes being achieved) of the Nanoknife, I think his tendency would naturally be to operate if/when possible. But I agree, and hopefully the IRE will over time replace the need for the the whipple outright. Yes I am aware of the Facebook page and joined up pre Christmas. It also is a great place to share information and hear others stories. Thanks KC2020

RE: nanoknife IRE for pancreatic cancer

by KC2020 on Tue Jan 05, 2016 10:13 PM

Quote | Reply
Apologies for the formating of my posts. They look fine on the ipad but when they finally post just come up as just one peice of text. Cheers

RE: nanoknife IRE for pancreatic cancer

by tallysis on Tue Jan 05, 2016 10:21 PM

Quote | Reply
Keep us up on your progress here or on FB. Our prayers are with you!

RE: nanoknife IRE for pancreatic cancer

by bambi99d on Thu Jan 07, 2016 08:30 PM

Quote | Reply

Are they performing the NanoKnife at Johns Hopkins now? 

980 Posts | Page(s): Prev 12...44 45 46 47 48 ...9798 Next 
Subscribe to this message board discussion

Latest Messages

View More

We care about your feedback. Let us know how we can improve your CancerCompass experience.