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Stopping Breast Cancer Cold

Cryosurgery may stop breast cancer by teaching the body how to prevent recurrence.

Breast cancer is the second most common cancer affecting American women, with nearly 200,000 expected to be diagnosed this year. Although this is a large number, the good news is the majority will be successfully treated, thanks to the advances cancer research has made over the years. Mammography in the realm of early detection and improvements in surgical procedures, chemotherapy and radiation treatments that are more effective and have fewer side effects all have aided in extending the long-term survival rate for breast cancer. In spite of these advances, the threat of recurrence remains. Michael Sabel, M.D., assistant professor of surgery at the U-M Cancer Center, thinks cryo-surgery can stop breast cancer by teaching the body how to prevent recurrence.

What is cryosurgery?
Cryosurgery is a procedure in which a thin probe, that gets extremely cold at the tip, is placed at the center of a tumor. This freezes the tumor, killing the cancer cells. It is an innovative, exciting and elegant approach to the treatment of breast cancer. Through the freezing process, cryosurgery destroys the breast cancer tumor. Unlike with surgery, the tumor is not removed. Instead, the body re-absorbs the dead cancer cells, as it would do with any dead tissue.

It is Dr. Sabel's hope that this absorption will stimulate the immune response in the same way the body reacts to any injury or illness. "The white blood cells will recognize the cancer in the same way as when you get an infection. The immune system then recognizes the bacteria and kills it elsewhere in the body." He adds, "I am hoping that cryosurgery will stimulate a similar sort of immune response, or at least a minor response that I can then increase with other immune therapies, such as cytokines."

According to Dr. Sabel, the great problem with breast surgery is recurrence. Recurrence happens because there are microscopic cancer cells elsewhere in the body that escape detection at the time of surgery. Currently, once breast cancer is detected, the next step in the majority of cases is to surgically remove the tumor. Chemotherapy and/or radiation treatment is often used along with surgery, both to treat the known tumor, but also to prevent recurrence by destroying any residual cancer cells-cells which are impossible to detect.

"Even with the addition of chemotherapy and Tamoxifen, in the next five or 10 years that cancer will come back in a percentage of patients. That is what we are trying to improve upon. If I can use the immune system to eliminate those microscopic cells at the time of the surgery, that should reduce the number of women who recur in five years," says Dr. Sabel.

Clinical trial to test cryosurgery
Over the summer, Dr. Sabel began gathering subjects for a clinical trial on the use of cryosurgery. Women with breast cancer were selected, and their tumors are being treated with both cryosurgery and traditional surgical techniques. During the next several years, the women will be followed to see if their immune systems did learn to target any residual cancer cells in their bodies.

Dr. Sabel is optimistic about the future of cryosurgery, as well as breast cancer research in general. "I think there are some tremendous therapies and diagnostic approaches that are in the pipeline. The future promise of these is very bright, but we need women to participate in the clinical trails to demonstrate whether these therapies will be the savior that we hope they will be. I want to emphasize how important it is for women to be a part of this. The reason that we don't have to treat every woman with cancer with a mastectomy today is because thousands of women in the past agreed to be randomized between lumpectomy and mastectomy. If they hadn't participated in that trial we would still be doing mastectomies on all women."

For more information on how you may participate in this, or any other clinical trial, please call the Cancer AnswerLine™ at (800) 865-1125.

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