Breakthroughs in Brain Cancer
January 30, 2017

When Angela Thomas needed brain surgery to destroy a reoccurring tumor, she came to St. Luke’s Cancer Center. Even though it meant driving nearly three hours each way.

Live-saving technology, called Visualase®, allowed Angela’s cancer to be targeted and treated minimally-invasively, allowing her to heal faster and get back to normal sooner.

“This is an exciting breakthrough in the treatment of brain cancer,” says Hugh Moulding, MD, PhD, Chief of St. Luke’s Department of Neurosurgery and Clinical Director of the St. Luke’s Brain and Spine Tumor Center. “We are now able to treat tumors previously considered inoperable because the accuracy of laser technology allows us to reach lesions deep into the brain and even near sensitive areas.”

St. Luke’s is the first in the region to offer this technology and Dr. Moulding is the only physician in the Lehigh Valley and surrounding areas performing the procedure.

Visualase, an MRI-guided laser ablation system by Medtronic, enables neurosurgeons to deliver laser energy though a hole with a diameter approximately the size of a coffee stirrer. The precision of the technology, also known as laser interstitial thermal therapy (LITT), allows the laser to destroy the tumor while minimizing harm to surrounding tissue.

“MRI-guided laser ablation is often the best hope for patients due to the lesion’s location or because the patient has already exhausted other treatment options,” he says. “For example, radiosurgery, a type of radiation therapy, is an effective treatment of brain lesions, however, using radiosurgery to treat a recurring tumor greatly increases the risk of complications from radiation.”

Angela was an ideal candidate for Visualase. She had been diagnosed with melanoma, and then brain cancer, about two years ago. Consequently, she has received various types of cancer treatments. When a tumor previously treated with radiosurgery began to regrow, Dr. Moulding scheduled the laser ablation procedure. She received the treatment on May 26 at St. Luke’s University Hospital in Bethlehem.

“I didn’t know exactly what to expect, but the treatment went very well,” says Angela. “It was much simpler than I expected.”

To prepare a patient for the treatment, Dr. Moulding drills a small hole in the skull. Then, the laser applicator and cooling catheter are precisely placed into the tumor. The patient is then taken to the MRI suite to confirm placement of the laser. As a safeguard, Dr. Moulding delivers a low power test pulse. During the treatment, the laser power is increased and while the laser is activated, special MRI images are converted to thermal maps and damage zone estimates. These provide Dr. Moulding with precise feedback in real time. He uses these to manage the laser’s delivery of light energy to the target area as the tumor is heated and destroyed.

Immediately after therapy, Dr. Moulding reviews additional MRI images to verify that the treated area matched the patient’s surgical goal.

“Due to the minimally invasive nature of the procedure, patients are discharged within a day of their procedure – much sooner than patients who have had traditional, open surgery,” Dr. Moulding says. “Also, laser ablation patients report experiencing fewer side effects than those receiving open surgery.”

For Angela, a busy wife and mother of two teenagers, getting “back to normal” faster was important. In fact, Angela had no side effects. “I didn’t even have a headache,” she says. “My entire family was very anxious before the procedure so the first thing I did after surgery was to call my kids. I face-timed them so they could see that I was fine.”

Also, because the entry level is so small, the procedure leaves little or no noticeable scarring or loss of hair. “The spot healed within two weeks,” Angela says. “I took it easy for three weeks and then I was back to normal.”

Angela, who loves camping, recently enjoyed a family trip to upstate New York this past fall. “For two years now, I have had health issues,” she says “This was the first time in three years that our family got to enjoy camping together. It was a blast!”