Microwaves help treat patient's liver tumors

Norbert von der Groeben

Gwen McCane says she was initially told the cancer that reached her liver was incurable, but doctors at Stanford offered a solution: using microwave ablation to heat and destroy the tumors.

When Gwen McCane says she's been to hell and back, it's hard to believe.

Her vibrant personality shines brightly when she enters a room, and she's happy to share a long list of daily activities. But three years ago, the pain she thought was probably acid reflux was diagnosed as pancreatic cancer. She had chemotherapy and radiation, which beat back the disease. Then it showed up in her liver. At first, she couldn't find a physician who would treat her. "It's inoperable, it's incurable, nothing anybody can do," she was told. She kept inquiring.

"My brother said, 'I want you to go to Stanford,'" McCane said. "'If anyone tells you that something is inoperable and incurable, let Stanford have the last word on that.'"

At Stanford Hospital & Clinics, she found Gloria Hwang, MD, clinical assistant professor of radiology. "She came in and said, 'No problem. I know what it is,' and she told me about microwave ablation." Hwang is an interventional radiologist, a specialist in a field that's not as well-known or understood as it might be, considering its usefulness in cases like McCane's. "We use X-rays, ultrasound, CT and occasionally MRI to look into patients so we can get devices into them to kill cancers," Hwang said. "The great thing is that we don't need to make large incisions in our patients. We can go in with just the poke of a needle."

McCane's new tumors were small, but deep inside her liver, the body's largest organ, which is so rich with blood vessels that any surgery is tricky. When Hwang does microwave ablation, she makes a small incision and, guided by imaging, finds the tumors and applies microwave heat to them to destroy them. The body then absorbs the dead tissue. Many patients go home the same day.

Norbert von der Groeben

Now finished with her treatment, McCane is once again playing golf, conducting self-esteem workshops at a county juvenile hall, meeting friends to play cards and working in her garden.

The microwave technology is not new, Hwang said, but its use to treat tumors is recent. It doesn't require a lengthy hospital stay, it quickly treats tumors that are otherwise difficult to eradicate, and it does so with minimal damage to healthy tissues. McCane's tumors were perfect for the approach, Hwang said. "They weren't too large, and they were in a location that was easy and safe to target."

McCane also wanted the tumors treated because she needed cataract surgery and couldn't have that until she was off chemotherapy — and she didn't want to stop her chemotherapy with those liver tumors still active inside her. "I was able to treat her," Hwang said, "so she could get her cataract surgery so she could drive again. I really wanted that for her. I wanted her to get her life back."

Hwang chose to use a new microwave device to treat McCane — one designed by a radiologist familiar with ablations. "Before this technology, most people would say if a patient is healthy enough for surgery, then that's the way to go because then you know you've taken the tumor out of the body," Hwang said. "It's hard to argue with that." But many patients, like McCane, can't tolerate surgery or have tumors that can't be reached by surgery, Hwang said. "Microwave ablation offers an option for a significant number of people who may feel like they've run out of options. That's a lot of what we do in interventional radiology — treating the sickest patients who can't tolerate toxic medications or major surgery. We offer them a chance of beating their cancer."

Now 73, McCane is back to playing golf, conducting self-esteem workshops at a county juvenile hall, meeting friends to play cards, working in her garden and spending time with her husband of 50 years. And when she has a question, she knows she can call Hwang and get a quick response. "When you find a doctor that tells you, 'It's no problem,' that helps you not give up. It makes all the difference in the world. I look good today because of my doctors at Stanford."

"Every day we see people who have a real need, and they're scared and they want to know they have options," Hwang said. "My mission as a doctor is to offer them these options — and to offer them newer, better ways of treating their cancers."

Sara Wykes is a writer for the Stanford Hospital & Clinics communications office.