A new treatment destroys ovarian cancer using a beam of energy. Executive PA Terry Middlecott, 62, a grandmother from Surbiton, Surrey, was one of the first to undergo it, as she tells PAT HAGAN.
The patient
Last year, I started getting a dull ache in my abdomen and felt tired even after a good night’s sleep.
When the pains became more frequent, I saw my GP. She initially diagnosed irritable bowel syndrome because I was severely constipated and told me to eat more fibre and drink plenty of water.
But this didn’t help and after a few weeks my stomach was so swollen I could no longer do up my trousers. I went back to my GP who examined me again and said she could feel something hard on the right side of my abdomen.
I was referred to a urologist, who I saw privately two weeks later.
A new treatment destroys ovarian cancer using a beam of energy (stock image)
They took blood samples to measure levels of a substance called CA125, higher levels of which are linked to ovarian cancer.
When the results came back a few days later, they showed my levels were high.I burst into tears when the consultant broke the news. It never occurred to me or my husband Keith, 62, that I might have cancer. We went home in a daze.
I was told I needed surgery followed by chemotherapy and referred to The Royal Marsden Hospital.
It really hit me that things were serious when my operation was booked for less than three weeks after my GP first felt the lump.
At an appointment held before the procedure the surgeon explained that sometimes part of the bowel has to be removed if the cancer has spread.
This meant I would need a stoma, where a hole is cut in the surface of the abdomen to allow waste to drain into a colostomy bag.
In some cases this is temporary while the bowel heals, but depending on the amount of tissue removed, it could be permanent.
The idea of a colostomy bag horrified me, so when my surgeon said he could use a new treatment called PlasmaJet, which could significantly reduce this risk, I felt hopeful. It involves firing a plasma beam directly at cancerous tissue without harming healthy cells beneath.
During the six-hour operation my ovaries, uterus and fallopian tubes were removed, and I spent three days in intensive care before going home.
Afterwards I took painkillers but still struggled to sit up or stand for weeks as it involved using the muscles in my stomach.
However, the tumour was completely removed and the PlasmaJet meant I avoided a colostomy bag.
I needed six sessions of chemotherapy and I’ve had scans every three months since it ended last December. The cancer has not returned. Now I make the most of every day. Not having to worry about a colostomy bag makes that much easier.
The surgeon
John Butler is a consultant surgeon in gynaecological cancer at The Royal Marsden NHS Trust in London.
More than 7,000 women a year in the UK are diagnosed with ovarian cancer. In around 70 per cent, the disease has already spread to other organs and tissues.
Treatment typically means removing the ovaries, uterus and fallopian tubes. For one in 20 patients it also means we have to take out a section of the bowel as this is one of the first areas malignant cells migrate to.
More than 7,000 women a year in the UK are diagnosed with ovarian cancer (picture posed by model)
Following this surgery the colon needs longer to heal. To allow for this we sometimes attach the top end of it to an opening in the abdomen — called a stoma — to drain waste into a bag.
This is usually temporary, but some patients can end up with a permanent stoma if their bowel has been too badly damaged.
When I inform patients this might happen, they are terrified. Many see a colostomy bag as a constant reminder of their cancer.
There are various surgical techniques for ovarian cancer. The most commonly used is diathermy, where a probe that generates temperatures of up to 45c destroys cancerous cells.
However, this also damages healthy cells deep inside the tissue as the heat passes from the probe and through the layers of cells underneath. In the bowel this increases the risk of doing so much damage that a stoma is required.
But over the last couple of years we have been trialling PlasmaJet. At the press of a button, the machine generates a bright beam of energy, similar to a Star Wars lightsaber, through the tip of a wand. Plasma is a form of energy generated using a gas called argon.
It’s different from most surgical lasers, which are generated by light or by carbon dioxide gas, which penetrate much deeper into the tissue — up to 14mm, compared with less than 2mm for PlasmaJet.
The probe does not make contact with the tissue. It is held about 1cm above the area that needs treating and produces a beam of hot plasma gas that is fully absorbed by the cancerous cells on the surface, not the healthy cells underneath.
Once the patient is under general anaesthetic, a long incision is made down the centre of the abdomen to allow us to remove any organs where the cancer has advanced too far for them to be saved. We then use PlasmaJet to treat other diseased areas.
It takes just a few seconds to destroy the cancerous cells, but as the very fine PlasmaJet beam only treats an area of 5mm in diameter at a time, the whole process can take a couple of hours.
It’s a major breakthrough which could allow up to 50 per cent of women in Terry’s position to avoid a bowel resection.
- The PlasmaJet machine costs around £30,000.