byUniversity of Texas at San Antonio

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UT Health San Antonio Multispecialty and Research Hospital became the first in South Texas to use an emerging and less-invasive treatment called radiofrequency ablation on a comorbid patient with a pancreatic cancer tumor that couldn't be removed by surgery.

The method, RFA for short, delivers controlled heat in high-energyradiofrequency wavesto a tumor using a small probe from an endoscope, a flexible tube passed through the mouth, destroying cancer cells in a focused area. It may offer benefits for some patients, such as shrinking the tumor, easing symptoms and possibly helping them live longer, especially when other options are not safe or possible.Early researchsuggests it also may "wake up" the body's immune system and help it recognize and fight the cancer.

The achievement is seen as an important milestone for UT Health San Antonio, the academic health center of The University of Texas at San Antonio, and the patients it serves across the region, as well as for its growing role as a statewide leader in advanced care and innovation in treatment of diseases affecting the pancreas, gallbladder and bile ducts.

"This accomplishment exemplifies our collective commitment to pushing the boundaries of what is achievable for our patients, our community and the field of gastroenterology," said Prabhleen Chahal, MD, MASGE, FACG, chief of the Division of Gastroenterology and Nutrition at UT Health San Antonio, and professor of medicine at UT San Antonio's Long School of Medicine.

"Most importantly, this represents new hope for patients with complex comorbidities who would previously have been considered untreatable."

The recent procedure was performed successfully by Rajat Garg, MD, assistant professor of medicine also in the gastroenterology and nutrition division of the Long School, and a member of its advanced endoscopy team, in coordination with surgical oncology, anesthesiology, medical oncology and perioperative teams at UT Health San Antonio.

The patient had other serious health problems, including liver scarring or cirrhosis, and high blood pressure in his lungs. At the hospital, his case was discussed in detail at weeklymultidisciplinary pancreatic tumor boardmeetings, where specialists from gastroenterology (stomach and intestinal diseases) and other medical fields review complex cases and agree on a unified treatment plan.

After reviewing the patient's scans, medical history and the available evidence, the tumor board determined that surgery and standard chemotherapy would be too risky and decided that endoscopic RFA was the safest and most reasonable treatment option.

Not that RFA is without limitations. Researchers are still studying exactly how helpful it is for pancreatic cancer, so it is not yet a standard treatment like chemotherapy, radiation or surgery. And it requires special equipment and doctors with specific training, so it is usually offered only at certain centers and only for carefully selected patients as part of a broader treatment plan.

Still, Garg credits the hospital with being such a place, from its administrators and staff to the multidisciplinary team at UT Health San Antonio, where this breakthrough could happen.

"Coordination among the entire procedural team—endoscopy doctors, nurses, technicians, the anesthesia team and hospital leadership—made it possible to obtain the device, schedule the procedure and prepare the patient, enabling successful delivery of RFA in the treatment of this aggressive and otherwise difficult-to-manage disease," Garg said.

Key medical concepts Pancreatic Cancer Radiofrequency Ablation Pulmonary Hypertension Cirrhosis

Provided by University of Texas at San Antonio