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EDITIONS
 Wednesday, 18 December, 2002, 19:00 GMT
Cancer treated outside body
Surgery
The whole liver was removed from the body
Scientists have treated cancer by removing an entire organ, administering radiotherapy and re-implanting it back into the body.

It is believed to be the first time that such a procedure has been used to treat cancer.

The likelihood is that a patient with 14 liver tumours would not ordinarily last a year, so if this technique can extend life expectancy and improve quality of life that is tremendous

Nigel Hughes
The technique enables doctors to treat the cancerous organ with radiotherapy without any risk to other organs.

The procedure was used by doctors in Italy to treat a 48-year-old man with multiple tumours in his liver.

New Scientist magazine reports that one year after surgery, the liver is functionally normally and latest scans show no sign of tumours.

Exciting potential

The team, surgeons from San Matteo Hospital in Pavia and physicists from the local division of the National Institute of Nuclear Physics, plans to treat six further patients using the same technique.

It is hoped that eventually it will be used to treat hard-to-treat cancers in other organs that can be transplanted, such as the lungs or pancreas.

The patient they have treated had had a colon tumour removed, but the cancer spread to his liver.

Scans revealed no fewer than 14 tumours there, and many smaller ones were discovered during the operation.

Such diffuse cancers are very difficult to treat by conventional means.

The tumours proved resistant to chemotherapy. And there was little hope of killing such widespread growth with conventional radiotherapy.

This usually involves focusing X-ray beams onto the target - without destroying the liver.

Boron atoms

So doctors decided to try a method called boron neutron capture therapy.

This involves injecting boron atoms into the cancerous organ, and using a neutron beam to split them into destructive high-energy particles.

Cancer cells grow faster than normal cells, and so take up more boron atoms. This means that they are more likely to be destroyed when the neutron beam is switched on.

But to ensure that all cancerous cells are destroyed, an even dose of neutrons has to be given to the entire organ.

This is not easy to do in the body, where obstructions such as bones block the neutron beam.

And the tissues surrounding the organ inevitably receive a large dose of radiation.

To overcome the problem, surgeons removed the entire liver.

The organ was placed in a Teflon bag that neutrons can pass through and taken to a research reactor nearby, where it was irradiated with neutrons.

It was then re-implanted, just as in a normal liver transplant operation.

Dr Tazio Pinelli, the physicist who co-ordinated the work, said: "By explanting the organ, we could give a high and uniform dose to all the liver, which is impossible to obtain inside the body without serious risk to the patient."

The doctors stress that the technique is still in its infancy. Even if proven to be effective, it is unlikely to be used on all but the most serious cases, and would only work where one organ was affected.

Nigel Hughes, chief executive of the British Liver Trust, told BBC News Online that the technique sounded very promising.

"The likelihood is that a patient with 14 liver tumours would not ordinarily last a year, so if this technique can extend life expectancy and improve quality of life that is tremendous."

However, Mr Hughes warned that there were not enough specialists in the UK to offer all liver cancer patients access to current surgical procedures, which involve cutting out cancerous sections of the organ.

"Even if this technique is proven to work, it is very dubious whether the NHS could actually provide it in any meaningful way."

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  The BBC's Gill Higgins
"Cancer specialists in the UK are cautious"
See also:

29 Oct 02 | Health
08 Jul 02 | England
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