When the radiologist goes to blast a metastasis in the liver or the lung (after I've diagnosed it on core, of course) they use either hot (radiofrequency ablation) or cold (cryotherapy). Problem with both of these, is that if the lesion is too near the inferior vena cava or the portal vein, it is off limits - don't want to fry or freeze either one of those structures.
In comes the Nano Knife. When the geneticists were trying to pull DNA out of or put it into a cell to study the alterations, they learned that the right amount of electrical impulses could create pores in the cell to allow this to happen easier. But too much -- OOPS! Apoptosis. Cell death. Now there's an idea. Billions of dollars later, we have the Nano Knife. Take two probes about the size of an 18 gauge core needle (one positive and one negative), place them on either side of the lesion (a 1.5 cm lesion requires three pairs), and approximately 1.5 hours later (you really want to get those positive and negative ends lined up parallel to prevent disastrous consequences), you turn around to the juice box and hit the juice. 44 amps, for this lesion. The patient needs to be deeply anesthetized to prevent them from flying off the table.
We are one of only about a dozen or so institutions around the world using this technology. And as of this month, we probably have the highest 'n' - subject population.
So I got to be the path part of the path/rad/onc team that presented to over 100 people at the first Tumor Board. It was electrically engaging, and I learned a lot about the implications of my diagnostic decisions. Can't wait until next month. Hopefully I will have my camera in place by then - waiting on some software glitches to be resolved.
My summer nanny started this week full time - so the kids are having fun making rounds to the racquet club, the Purple Cow, and Chuck E Cheese. Glad they are happy. Was a little worried the last week of school when John's favorite song was this one:
I never saw that movie, - the song came in a mix from a friend. At first I thought it was horribly cheesy, but I've found myself enjoying singing along. And we like to make up our own weird pie fillings at the end, to supplement the banana cream and butterscotch. We do not limit to food groups. Fecal matter and insects are allowed.
So we've been going back and forth between this one and Sicily's favorite this month: