Breast Cancer? Put It On Ice

The bad news? It was cancer. The good news? It was in the early stages. Just a baby at 1.5 cm. It’s hard to believe something so small can wield such an impact. When my new friend went to a routine mammogram, she was surprised to hear back from her doctor a few days later. “They only call when something’s wrong,” she told me. That’s when she learned she had cancerous cells in her left breast and pre-cancerous cells in her right. Although we’d just met, I had a strong sense that self advocacy comes naturally to Lauren. Dressed in white with stylish cropped hair, she looks like the picture of self confidence – like someone smart enough to figure out what she wants and brave enough to go after it. The first thing she did was to consult her naturopath, the medical provider she considers her primary physician. Together, they decided to change Lauren’s diet: no caffeine, no alcohol, no animal protein, no grains, no sugar. No fun, I thought, wondering if the miserly splash of apple juice in my organic sparkling ginger spritzer would have been a deal breaker on that plan. But here’s the deal: the tumor that measured 1.5 cm at Lauren’s initial appointment measured only 1 cm at a follow-up appointment. Maybe it was the diet. Lauren plunged into research, tapping into every resource she could think of and investigating every option with passion. The standard of care called for a lumpectomy on the left breast followed by radiation. Then, for five years, she’d have hormone therapy and regular imaging every six months. The other alternative was a double mastectomy. “I was leaning toward the double mastectomy,” Lauren said, “because I hated the idea of ‘worried waiting.’” I knew what she was talking about because I’ve been having mammograms twice a year for a long time. And I always wonder if they’re going to tell me my cancer’s back. “Worried waiting” is a perfect description. “The problem with the mastectomy is that they can’t save your nipples,” Lauren said. “That was the part that bothered me.” Although it sounds like a minor issue, it isn’t. You can get a 3-D tattoo that looks a lot like a nipple, but losing any body part is an irreparable loss. I remember how relieved I was when I learned my own nipple would be saved when I had my nipple-sparing lumpectomy. “I was mulling over these decisions when I bumped into a friend,” Lauren said, “and she told me about cryoablation. It’s a procedure where they freeze tumors using nitrogen.” I visualized one of those trendy new ice cream shops where you can order any flavor you want and the guy behind the counter disappears into a cloud just before he hands you your cone. But it’s not like that. The way it works is ingenious. In cryoablation, a needle-sized guided-probe delivers nitrogen to the tumor, freezing it and killing the cancerous cells. Ten minutes later, they inject it with nitrogen again — giving that nasty tumor the double whammy. The whole procedure takes less than an hour and recovery time is short, only a couple of days, with no serious side effects. Even the risk of scarring is minimal. And studies suggest that cryotherapy might help the body’s natural immune system in future risks for cancer. I asked Lauren if it was painful, or if it felt weird to watch the procedure being performed on her body while she was wide awake. “Part of it was uncomfortable,” she told me, “but I wouldn’t say it was painful.” She went on to explain that the first step in the process is to deliver a local anesthetic. Then, they pump the area with saline to protect the skin from being frozen. “I watched my breast blow up like a balloon,” she said, “and I could feel my skin stretching from the inside out. It was surreal.” Although many cryotherapy patients follow up the procedure with radiation, Lauren opted not to. Instead, she manages her diet with a vengance, takes immune-boosting supplements, and plans to see her doctor regularly.

Fortunately, cryoablation is in clinical trial, and it's showing impressive results. To find out if you're a candidate, check the criteria:

• Age 50 or older

• Invasive ductal carcinoma diagnosed by a core needle biopsy;

• Maximum tumor size 2 cm or smaller based on mammogram, ultrasound and MRI;

• Clinically node negative, hormone receptor positive, and HER2 negative;

• Less than 25 percent intraductal component in the aggregate;

• Lesion must be visible by ultrasound;

• Adequate breast size with .5 cm margins between the ablated lesion and the skin. In the battle against cancer, there’s been tremendous progress. But the standard of care – chemo, surgery, and radiation – remains the cornerstone of treatment. Cryotherapy hints that a far less painful, less invasive, and less expensive alternative might be out there, and pioneers like Lauren are helping to make that change.

This piece was published first on BreastCancer-News, a great resource for breast cancer patients and the people who love us.