Judy Ann Ellison’s story Renal Cancer-America

In 2012, two sisters from Phoenix of United States presented to Guangzhou Fuda Cancer Hospital. The younger sister suffered from renal cancer. Two years ago, before she came to Fuda, she underwent surgical resection. Unfortunately, her tumor recurred after one year. A head-size tumor appeared on the right abdomen. She received radiotherapy, chemotherapy and molecular targeted therapy, but failed to have good treatment effects. Her doctors regretted to tell her that they cannot do any treatments for her. The sisters cannot be resigned to the bad fact, so they came to Fuda Cancer Hospital, where the younger sister underwent cryosurgery- assisted surgery. 

When the abdominal cavity was open, a large tumor was exposed on the right side. Firstly 80% of the tumor was removed through surgery, and the residual tumor was cryo-ablated. Professor Xu Kecheng also stayed in the operation room to guide surgery from the beginning to the end. When walking out of the operating room, he met the elder sister who was waiting for her younger sister at the door. After the elder sister looked at photos taken by camera of the phone, she immediately burst into tears, jumping and shouting, "China, Thank you". She held Professor Xu tight with her arms, repeating "Thank you". President Xu was also moved to tears. What a great family affection!

Before discharging from hospital, the two sisters took photo with Professor Xu.

Treatment Experience

This is a patient with recurrent renal cancer, huge abdominal tumor, which cannot be cleared through traditional therapy. However, this huge tumor was almost removed by cryoablation-assisted surgery.

Similar to prostate, kidney is an appropriate target organ for cryotherapy for the following reasons: ① generally kidney cancerdistributes in unilateral kidney, which can easily be found under the laparoscopy; ② Utrasound, CT or MRI can clearly show renal cancer, thus it is suitable for percutaneous cryoablation; ③ the pathogenesis of kidney canceris closely related to body immunity, and cryoablation can stimulate anti-tumor immunity.

The indications of cryotherapy for kidney cancermainly include peripheral or intracortical renal tumors, isolated renal tumor that is less than 4cm; relative indications include central kidney canceror intrarenal cancer (close to central blood vessels and / or collecting duct), kidney cancerthat is near renal pelvis and kidney cancerthat is larger than 4cm.

Compared with surgery or laparoscopic partial nephrectomy, cryoablation for small renal tumors enjoys the advantage of short treatment time and fewer complications; compared with radiofrequency ablation, cryoablation have the advantage of less analgetics and anesthetics and complete tissue necrosis. Therefore, cryosurgery may be preferred minimally invasive therapy for small renal tumors.

For progressive kidney cancer, the main purpose of cryosurgery is to reduce the tumor load to create conditions for other treatments. Judy suffered from progressive kidney cancer, it was cryoablation-assisted surgery that successfully removed her recurrent tumor.

In 2007, it was reported that 12 patients with locally progressive kidney cancer were treated through cryoablation-assisted surgery or percutaneous cryosurgery in Fuda Cancer Hospital.  Among these 12 cases, there were 8 male patients and 4 female patients, age from 21 to 87 years old, with a median age of 57 years old. Only one case that was received initial treatment, the other cases have received surgery, chemotherapy, and radiotherapy and immunotherapy but tumor recurred. There were three cases of cryoablation-assisted surgery and nine cases of percutaneous cryosurgery. Results: The tumor shrank more than 60% to 90%, 7 patients had survived 5 to 29 months. 

There was one case that has survived for 49 months whose cancer type was T3N0M0. After percutaneous cryosurgery, his tumor shrank more than 90%. After 4-year medical checkups, there is not more evidence for tumor. 3 cases who received cryoablation-assisted surgery were all dead, the survival time were respectively 18, 28 and 7 months, and the causes of death were pulmonary metastasis associated with infection, systemic failure and renal failure. 2 patients who underwent percutaneous cryosurgery died of lung metastasis and systemic metastasis after 12 and 7 months.