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How Canadian doctors are using an incisionless surgery to remove tumours

WATCH: A Canadian teenager has become the first person in North America to have a benign tumour near his hip removed without radiation or surgery. Shirlee Engel explains how it was done.

He was promised no needles, no pain, and a non-invasive surgery to get the tumour out of his leg. It sounds too good to be true, but Canadian doctors removed a benign tumour from 16-year-old Jack Campanile’s bone in a treatment completely free from incisions.

Doctors at the Hospital for Sick Children are the first in North America to use this innovative procedure called high-intensity focused ultrasound – or HIFU – to destroy a tumour.

The specialized procedure relies on magnetic resonance imaging (MRI) and ultrasound waves to zap away at a tumour without piercing the skin.

“MRI-guided focused ultrasound is a relatively new technology. The focused ultrasound component has been around for years but the key ingredient is the MRI imaging,” Dr. James Drake told Global News. He’s the lead for the hospital’s Centre of Image-guided Innovation and Therapeutical Intervention.

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WATCH: In this SickKids Hospital video, Campanile and his doctors explain how the HIFU procedure works.

http://youtu.be/mzPtRpQ5mRc?list=UURXuIrY0w8NPvBptXtfDKvA

(Video courtesy the Hospital for Sick Children)

The patient lies in a standard MRI scanner and has regular images taken, but beneath them is an ultrasound transducer that focuses ultrasound beams on a small point as minute as a grain of rice. It acts like a magnifying glass so the ultrasound wave is then able to zero in on its target spot to destroy abnormal tissue.

The MRI, in the meantime, can measure precision and temperature to make sure the doctors are targeting the right spot and are at the correct heat to burn away the tumour.

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“So while we’re delivering the treatment, we can see exactly where the target is because it’s heated up by the ultrasound,” Drake explained.

It’s radiation-free and non-invasive so the doctors believe they’re significantly decreasing the risks involved with other surgeries.

“The potential for high-intensity focused ultrasound for both medical and surgical procedures is huge,” Dr. Michael Temple, a SickKids interventional radiologist who led the surgery, said in a hospital video. Right now, he’s in India.

READ MORE: Toronto hospital uses incisionless surgery on teen with tumour

The procedure is only in its experimental stages – the doctors say they hope to conduct the therapy on 10 more patients and evaluate their results. If they’re as positive as Campanile’s, their hope is to network with other pediatric centres.

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“Innovation is the future. We want medical care to advance. We all think it’s going to go to minimally invasive or non-invasive and we think we’re on the forefront,” Drake said.

WATCH: Jack Campanile and Dr. James Drake discuss the new procedure used to remove the tumour from Jack’s leg.

The incision-free treatment also makes for a faster recovery and fewer complications. In Campanile’s case, after the surgery was conducted on July 17, he was pain-free by the time he went to bed.

Campanile, an athletic teen who loves hockey, wakeboarding and snowboarding, had been living with bone pain for a year because of a benign bone tumour called osteoid osteoma.

(The condition is common in young men, about 10 to 35 years old. Even with small tumours – the size of one centimetre – SickKids says patients report “extreme pain.”)

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In a single year, Campanile would take roughly 700 painkillers. His dosage schedule tampered with his sleep, school and daily activities.

Weeks after the procedure, he reports that he hasn’t taken a painkiller since his operation. And within days, Campanile returned to his day-to-day routine.

If it weren’t for the HIFU therapy, doctors would have drilled a small hole in the bone and inserted an electrical wire or a laser to obliterate the bad cells.

The HIFU treatment, in Campanile’s case, only took 20 minutes. There were seven sessions with each individual treatment lasting about 12 seconds. It’s the zeroing in on the targeted region that takes time.

Drake and Temple received the green light to move ahead with other bone tumours.

The procedure isn’t covered by OHIP. Because it’s part of a research project, the costs are paid through research funding.

HIFU has been employed for some time in Europe to treat osteoid osteoma, but in North America it is mostly used to remove uterine fibroids and malignant tumours that have spread to the bone.

– With files from the Canadian Press

carmen.chai@globalnews.ca

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