"What a difference a year makes!" exclaimed Doris McArdle and her daughter, Sharon Duffy, in a recent New Year’s greeting.
The recipients of that message – David Heller, Neal Kassell, M.D. and Wladyslaw Gedroyc, M.D. – made a difference that McArdle will never forget. In November 2010, the indomitable, 89-year-old McArdle boarded a trans-Atlantic flight from Chicago to London. There, she successfully underwent a noninvasive MR-guided focused ultrasound procedure to relieve acute pain and discomfort caused by a large benign tumor in her pancreas.
"The pancreatic tumor had grown to the point that it obstructed the liver bile duct, and Mom had to be hospitalized for almost a week," recalls Duffy. "At that time, they put a temporary stent in her bile duct, and it looked like Mom had only two options going forward: do nothing and let the tumor mass continue to grow or undergo Whipple surgery, which we heard was horrific and offered doubtful prospects for recovery."
Fortunately, McArdle’s internist, Robert Havey, M.D., had heard about focused ultrasound from FUS Foundation board member David Heller and had read some of the scientific literature about it. "Dr. Havey asked if focused ultrasound would work for his patient, so I brought Dr. Kassell at the FUS Foundation into the loop," Heller notes.
After reviewing CT scans and other information, Kassell turned to Gedroyc, a pioneering clinician in MR-guided focused ultrasound ablation who is based at St. Mary’s Hospital in London.
"We carried out this procedure on a one-off basis under compassionate grounds since Mrs. McArdle had no other reasonable alternatives," explains Gedroyc. "It’s important to note that this was a benign pancreatic tumor and not a pancreatic cancer, which currently has a dismal prognosis. We would not have treated a tumor as large as hers if it had been malignant."
According to Gedroyc, the size of McArdle’s tumor – which was 12 centimeters in diameter – provided an acceptable acoustic window but was narrower than anticipated. That constraint limited the amount of tumor mass he could ablate to about 25 percent. "Clips from gallbladder surgery dating back 25 years reduced the area we could sonicate. Abdominal gas also limited our options," he notes.
In addition to treating McArdle, who was his first pancreatic patient, Gedroyc has used MR-guided focused ultrasound twice before on a compassionate basis. The first patient had soft tissue metastases and the second suffered from a retroperitoneal paraganglioma, a rare type of tumor.
Gedroyc sent McArdle home with a CD containing her MRI images so Havey could manage her recovery and follow-up care.
(Left to right) Doris McArdle, George McArdle, John Duffy, Rita Havey
and Dr. Robert Havey
Recovery and beyond
"Dr. Gedroyc was very frank about the uncharted waters we were entering but we all felt we were in the boat with a very capable captain!," Duffy says. "Mom was very anxious in the days leading up to the procedure but kept a good sense of humor, which certainly helped. All of the medical people at St. Mary’s were so nice, friendly, knowledgeable and caring that it helped ease our anxiety tremendously."
After her treatment, McArdle stayed overnight in the hospital with Duffy at her side. "Mom was not a very good roommate because by 3 a.m. she was fully recovered from the anesthetics, was hungry and looking for breakfast! By morning, she was up and about, dressed and looking great with no side effects whatsoever. Focused ultrasound is wonderful technology!" Duffy exclaims.
Now, two months post-treatment, McArdle reports, "My pain is reduced overall by maybe 75 percent. Sometimes, I’m pain free – which is really wonderful! Sometimes, the area that the doctor couldn't treat acts up, and I feel a fair amount of pain. I wish the whole tumor could have been treated and hope this technology continues to evolve so the rest of it can be treated. That would be great!"
Duffy adds, "Our entire family is thrilled. If it hadn't been for those clips from gallbladder surgery, we believe Dr. Gedroyc could have treated the entire mass so Mom’s pain would be completely gone."
"In hindsight," she continues, "the hardest part of the whole undertaking was the travel to and from London and dealing with jet lag. The procedure itself was very successful! We would heartily recommend others to consider focused ultrasound. I think the grea imonial is that my mother would go to all the way to London and do the procedure again!"
Regarding his role as the connecting link between McArdle’s family and focused ultrasound experts, Heller says, "This is a wonderful, fabulous story. It reinforces my belief in what focused ultrasound can do in the right hands. If I or my wife were suffering from something similar, I would not hesitate to have the procedure."
Originally Posted January 2011
Happy 95th Birthday, Doris!
The Foundation extends warm birthday wishes to longtime supporter Doris McArdle, who recently reached the age of 95 years young. Mrs. McArdle underwent focused ultrasound treatment for a benign pancreatic tumor at St. Mary’s Hospital in London by Wadyslaw Gedroyc, MD when she was 89 years old. The treatment ablated about a fourth of her 12-centimeter tumor and relieved her persistent pain.
“I am absolutely delighted that we have been able to contribute to her health and well-being--the success of this procedure is a great encouragement in our efforts to take the utilization of focused ultrasound further for many patients,” wrote Dr. Gedroyc.
The Janice McArdle Cancer Foundation supports the Foundation and donates to clinical trials for metastatic brain tumors and lung cancer. We wish you many more, Doris!
UPDATED March 2016