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16 October 2023 – After London and Hong Kong, it is the turn of the Erasmus Hospital to carry out the first endoscopic microwave ablation of a lung cancer in Belgium. Four lesions in three patients have already benefitted from this innovative and non-invasive treatment for lung cancer. New progress combining diagnosis and treatment that is of potential benefit to patients being treated for lung cancer.  Innovative treatment Professors Benjamin Bondue, pneumologist and clinic director, and Dimitri Leduc, Head of the Medico-Surgical Department of Thoracic Pathology, recently used this innovative technique to treat four cancerous lesions in three patients. This non-invasive method is proposed for patients who are unable to benefit from surgery due to their age, a poor respiratory function or comorbidities.  As such, it is an innovative alternative to radiotherapy and interventional radiology. “Compared to radiotherapy, this new method has the advantage that it can be carried out during the same operating time required to take biopsy samples, it can be repeated if necessary, and it is more precisely targeted at the treatment zone.  Unlike interventional radiology methods, it makes it possible to pass through natural orifices and to avoid a high risk of pneumothorax,” stresses Professor Bondue. Endoscopic ablation by the microwave method is therefore an additional treatment option when treating inoperable patents. “This effectively completes our arsenal for diagnosing the pulmonary nodule following screening campaigns. The technique of endoscopic navigation is already used routinely at the Erasmus Hospital that has developed major expertise in this field,” concludes Professor Leduc. Cauterization by endoscopic navigation The nodule is burned using a catheter introduced through natural orifices by endoscopy. The greater part of the intervention consists of appropriately placing the catheter through the nodule thanks to a precise navigation and use of a kind of scanner (CBCT) during the procedure.  Several return visits to check the scanner images are needed to find the right position for the ablation catheter. When the catheter is in place, the ablation begins and takes no more than 10 minutes. The aim is to burn the entire tumour while sparing a maximum of healthy tissue. After the procedure the patient wakes up without a surgical drain or painkillers. He or she remains hospitalised under surveillance for a few days and a verification scan is carried out the day after the intervention.  This new treatment represents real progress permitting a combined  lung cancer diagnosis and treatment. It is a new tool in our arsenal in combating ling cancer for inoperable patients at the Jules Bordet Institute and the Erasmus Hospital within the Brussels University Hospital. For information on endoscopic lung nodule removal, please contact our medical secretariat on 02/555.39.43, or by email at secmed [dot] pneumo [dot] erasme [at] hubruxelles [dot] be (secmed[dot]pneumo[dot]erasme[at]hubruxelles[dot]be)   LE REPORTAGE

Prostate cancer is the most common cancer in men, currently affecting 1 in 10 men in Belgium. Thanks to the expertise of multidisciplinary teams and the effectiveness of innovative methods, the Jules Bordet Institute, as the Brussels University Hospital (U.U.B) Cancer Centre, proposes ultra-personalised patient care and is adopting a pioneering role, nationally and internationally, in cancer care and research in the field of prostate cancer screening, diagnosis and treatment.       More targeted diagnosis with the PANDORA study  A number of tests are required to diagnose prostate cancer, starting with measuring PSA levels in the blood and a digital rectal examination. If these examinations indicate a suspected cancer, an MRI can be carried out, in some cases followed by a prostate biopsy (removal of tiny samples of prostate tissue) to confirm and refine the result. The prostate biopsy is the key examination in the prostate diagnosis as it alone can confirm the presence of a cancer and is an essential factor when deciding on the treatment options. However, this biopsy can cause discomfort to patients, present a risk of complications (infection, bleeding) and sometimes reveal indolent tumours that do not require treatment. Experts at the Brussels University Hospital are therefore exploring alternatives to the biopsy. The PANDORA study, supported by the Jules Bordet Association, the Erasmus Fund and the Belgian Association of Urology, is posing the hypothesis that by including a PSMA PET/MRI in the  diagnosis tests it will be easier to effectively select patients who genuinely need a prostate biopsy  and therefore avoid unnecessary biopsies.  “This method combines the detection of an overexpressed protein in prostate cancer cells (PSMA) by means of positron emission tomography (PET) and the carrying out of a prostate MRI,” explains Romain Diamand, the PANDORA study investigator. Although at present it is used primarily to identify a recurrence of prostate cancer, it seems that this examination is also very promising for assisting in the initial diagnosis of this type of cancer.    More effective radiotherapy treatment thanks to an MRI-Linac   Thanks to its expertise and multidisciplinarity, the Jules Bordet Institute is able to offer ultra- personalised prostate cancer care. Since acquiring the MRI-Linac 1.5 T, with the support of the Jules Bordet Association, the progress in radiotherapy treatment has been nothing less than remarkable. This machine, the only one of its kind in Belgium, combines the power of a linear accelerator with the image quality of an MRI to provide tumour images in real time and thus a more precise targeting of  radiotherapy. “For the patient, this kind of ultra-personalised treatment that can be adapted daily makes it possible to spare a maximum of healthy tissue, reduce the risks of toxicity compared to conventional machines and, for some prostate cancers, reduce the number of radiotherapy sessions to 5, “ explains François Xavier Otte, radiotherapist at the Jules Bordet Institute.   Hopes for minimally invasive treatment: focal therapy  Focal therapy is a minimally invasive treatment that can be prescribed as an alternative to surgery or radiotherapy for small tumours caught at an early stage. The principle is to treat  the cancer zone and leave the rest of the prostate intact and thereby avoid risks of impotence and incontinence. There are several types of focal therapy: ultrasound, cryotherapy and laser. The Jules Bordet Institute is the only centre in Belgium to propose focal therapy using HIFU (High Intensity Focal Ultrasounds) technology that employs high energy ultrasound to destroy the disease. Research into focal therapies is very promising and a number of trials are in progress to validate new protocols. Microwave ablation has already shown its effectiveness in treating a number of organs. “The VIOLETTE study is seeking to prove its effectiveness in treating prostate cancer thanks to ultra-focal therapy with a microwave ablation protocol with image fusion so as to achieve a very precise  elimination of the tumour core, thereby neutralising it without harming the prostate functions,” explains Alexandre Peltier, urologist and principal investigator with the VIOLETTE study. 

Prostate cancer is the most common cancer in men, currently affecting 1 in 10 men in Belgium. Thanks to the expertise of multidisciplinary teams and the effectiveness of innovative methods, the Jules Bordet Institute, as the Brussels University Hospital (U.U.B) Cancer Centre, proposes ultra-personalised patient care and is adopting a pioneering role, nationally and internationally, in cancer care and research in the field of prostate cancer screening, diagnosis and treatment. More targeted diagnosis with the PANDORA study  A number of tests are required to diagnose prostate cancer, starting with measuring PSA levels in the blood and a digital rectal examination. If these examinations indicate a suspected cancer, an MRI can be carried out, in some cases followed by a prostate biopsy (removal of tiny samples of prostate tissue) to confirm and refine the result. The prostate biopsy is the key examination in the prostate diagnosis as it alone can confirm the presence of a cancer and is an essential factor when deciding on the treatment options. However, this biopsy can cause discomfort to patients, present a risk of complications (infection, bleeding) and sometimes reveal indolent tumours that do not require treatment. Experts at the Brussels University Hospital are therefore exploring alternatives to the biopsy. The PANDORA study, supported by the Jules Bordet Association, the Erasmus Fund and the Belgian Association of Urology, is posing the hypothesis that by including a PSMA PET/MRI in the  diagnosis tests it will be easier to effectively select patients who genuinely need a prostate biopsy  and therefore avoid unnecessary biopsies.  “This method combines the detection of an overexpressed protein in prostate cancer cells (PSMA) by means of positron emission tomography (PET) and the carrying out of a prostate MRI,” explains Romain Diamand, the PANDORA study investigator. Although at present it is used primarily to identify a recurrence of prostate cancer, it seems that this examination is also very promising for assisting in the initial diagnosis of this type of cancer.    More effective radiotherapy treatment thanks to an MRI-Linac   Thanks to its expertise and multidisciplinarity, the Jules Bordet Institute is able to offer ultra- personalised prostate cancer care. Since acquiring the MRI-Linac 1.5 T, with the support of the Jules Bordet Association, the progress in radiotherapy treatment has been nothing less than remarkable. This machine, the only one of its kind in Belgium, combines the power of a linear accelerator with the image quality of an MRI to provide tumour images in real time and thus a more precise targeting of  radiotherapy. “For the patient, this kind of ultra-personalised treatment that can be adapted daily makes it possible to spare a maximum of healthy tissue, reduce the risks of toxicity compared to conventional machines and, for some prostate cancers, reduce the number of radiotherapy sessions to 5, “ explains François Xavier Otte, radiotherapist at the Jules Bordet Institute.   Hopes for minimally invasive treatment: focal therapy  Focal therapy is a minimally invasive treatment that can be prescribed as an alternative to surgery or radiotherapy for small tumours caught at an early stage. The principle is to treat  the cancer zone and leave the rest of the prostate intact and thereby avoid risks of impotence and incontinence. There are several types of focal therapy: ultrasound, cryotherapy and laser. The Jules Bordet Institute is the only centre in Belgium to propose focal therapy using HIFU (High Intensity Focal Ultrasounds) technology that employs high energy ultrasound to destroy the disease. Research into focal therapies is very promising and a number of trials are in progress to validate new protocols. Microwave ablation has already shown its effectiveness in treating a number of organs. “The VIOLETTE study is seeking to prove its effectiveness in treating prostate cancer thanks to ultra-focal therapy with a microwave ablation protocol with image fusion so as to achieve a very precise  elimination of the tumour core, thereby neutralising it without harming the prostate functions,” explains Alexandre Peltier, urologist and principal investigator with the VIOLETTE study.