Montefiore in the News
Montefiore Physicians are First on East Coast to use Innovative Interventional Oncology Procedure
- April 3, 2012
Ablation System Provides Palliative Pain Relief for Cancer Patients with Metastatic Tumors in the Spine
New York City, NY (April 4, 2012) - Physicians at Montefiore Medical Center are first on the East Coast to use a new radiofrequency ablation system that delivers energy directly into a metastatic spinal tumor to heat and destroy tumor cells and provide palliative pain relief.
The procedure was successfully performed by Allan Brook, MD, Director of Interventional Neuroradiology at Montefiore Medical Center, using a new FDA-approved radiofrequency ablation system designed specifically for spine tumors. The patient is a 74-year-old Bronx man with metastatic prostate cancer.
"Prior to our treatment, the patient was admitted for pain management. Even as an inpatient he was unable to walk without severe pain, and after the best medical therapy he remained in bed. The day after the procedure, the patient was discharged home, fully able to walk," Dr. Brook explained. "Our multidisciplinary team of experts in neurosurgery, orthopedic surgery, radiation oncology and medical oncology agreed to introduce this high quality image-guided therapy to relieve this patient's pain. This is the level of care that patients in the 21st century should expect."
Radiofrequency ablation is a cancer therapy in which a needle electrode is used to deliver energy directly into a tumor to heat and destroy cancer cells and to provide palliative pain relief. The STAR System uses a navigational electrode to target metastatic tumors in the spine, the most common site for bone metastases in patients with primary cancers of the breast, prostate or lung.
The procedure is performed in the interventional suite with the patient under anesthesia. With the patient lying prone, the physician inserts a needle into the vertebrae, then inserts the radiofrequency probe through the needle into the tumor. The radiofrequency energy burns away tumors cells so the physician can inject cement to prevent structural collapse of the spine. The entire procedure takes approximately 30 minutes and because it is performed in a single visit, patients can restore their quality of life without delaying any systemic therapy they are undergoing for their primary cancer.
A nationally recognized pain management expert, Dr. Brook was the first physician in New York State to conduct a vertebroplasty, an outpatient procedure in which bone cement is injected into the vertebrae to stabilize compression fractures and reduce pain. He is co-director of the annual Degenerative Spine Disease seminar, which is attended by several hundred physicians and allied health professionals from all specialties, and director of a national interdisciplinary acute stroke intervention meeting held annually in New York City (AIM/VEITH Symposium). Dr. Brook also teaches courses on minimally invasive spine pain management and acute stroke management.
Domingo Gonzalez is the first patient to undergo the ablation treatment at Montefiore. The retired factory worker was diagnosed with metastatic prostate cancer in 2006 and has received chemotherapy and radiation therapy to manage his disease. When the cancer spread to his spine, the result was chronic debilitating pain.
Beyond treatment with pain medication, the primary therapy for treating painful spinal metastases like Mr. Gonzalez's has been external beam radiation, which when effective, may require weeks or months to address the associated pain and disability. This new ablative therapy is followed with cement augmentation to stabilize the pathologic fracture, then the team of radiation and medical oncologists determine if stereotactic radiation and/or chemotherapy is warranted for future control of the disease.
"The use of the STAR ablation system for this indication fits our paradigm of targeting therapy to maximize benefit and minimize toxicity. This is an excellent example of the power of regional cancer therapy," said Steven K. Libutti, MD, Vice Chairman of Surgery and Director of the Montefiore Einstein Center for Cancer Care. "Dr. Brook and his team are pushing the envelope and bringing new and exciting options to our patients at the Montefiore Einstein Center for Cancer Care."
The new technology, developed by DFINE, Inc., is called the Spinal Tumor Ablation with Radiofrequency (STARTM) System.