Laser interstitial thermal therapy gives relief to stage IV melanoma survivor

By the time Jennifer Weihe decided to try laser interstitial thermal therapy, or LITT,
with neurosurgeon Ganesh Rao, M.D., she’d already been through chemotherapy, two different forms of radiation, two skin cancer surgeries and immunotherapy. Despite all of the aggressive,
cutting-edge treatments she received before LITT, the melanoma kept returning to her brain.

Jennifer was one of the first patients to try the new, minimally
invasive treatment with Dr. Rao, and remains cancer-free more than a
year later.

After a melanoma diagnosis, cancer metastasizes

Jennifer was diagnosed with stage I melanoma in 2003. It was quickly
and easily removed in her home state of Kentucky. When a second
suspicious mole appeared 10 years later, skin cancer surgery didn’t
control the melanoma for long.

“I went from stage I to stage IV in six months,” Jennifer says. “The
melanoma skipped over the rest of my body and went right to the brain.”

Unfortunately, melanoma is one of the most common cancers to spread,
or metastasize, to the brain. And metastatic brain tumors are notoriously difficult to
successfully treat. Jennifer’s sister, a physician, knew it was
important to get the best care possible, and recommended that Jennifer
travel to MD Anderson in Houston for treatment.

Choosing MD Anderson for cancer treatment

Here, Jennifer’s multidisciplinary care team, including Dr. Rao,
tried several different treatment approaches over the next 15 months.
Jennifer did well on Keytruda®, an immunotherapy drug for melanoma,
and the disease didn’t spread anywhere else in her body. But it
continued to return to her brain. Jennifer was back in Kentucky when
she first experienced an alarming new symptom. 

“I was speaking gibberish,” Jennifer says. “My brain and my mouth
weren’t working together, so we went to the ER.” Even after targeted
radiation to the brain tumors, new lesions appeared.

“The doctors started discussing some options I wasn’t ready to do,”
Jennifer says. “So I called Dr. Rao’s office. They said, ‘Get down
here; we’re doing new things.’ We quickly went to Houston!”

Laser interstitial thermal therapy: something new

The “new thing” was laser interstitial thermal therapy. Laser
therapy wasn’t new, but the ability to combine it with real-time MRI
monitoring, making it safe to use in the brain, was. When Jennifer
called in November 2014, Dr. Rao and his colleagues had just recently
started using laser interstitial thermal therapy to treat brain tumors.

“When you’re getting work done on your brain, it’s a nerve-wracking
experience,” Jennifer says. “But Dr. Rao calmed me and carefully
explained the procedure to us so we could understand exactly what was happening.”

Laser interstitial thermal therapy works by inserting a probe
directly into the tumor. The very tip of the probe is heated enough to
destroy the lesion from the inside out, while the real-time MRI
monitoring ensures the high temperatures never reach the surrounding
healthy brain tissue.

“They put you to sleep and it’s not painful,” says Jennifer, who
stayed in the hospital just one night. “Afterwards, the areas in my
brain that were treated with laser interstitial thermal therapy —
including those that control communication, mobility and vision —
healed well over the next few months. I was able to communicate and
walk the day after the procedure. It was pretty amazing.”

A few months after Jennifer’s initial laser interstitial thermal
therapy, four new brain lesions showed up on an MRI. So they tried it
again, treating all four in one session. One more lesion appeared in
July 2015, and she underwent laser interstitial thermal therapy for a
third time.

Third time’s a charm

In all, Jennifer had six different brain lesions treated with laser
interstitial thermal therapy on three separate occasions. The cancer
has not returned since the third procedure.

“The doctors aren’t ready to say I’m in remission, but I’ve been
stable for over a year and I feel good,” Jennifer says. Quarterly
scans of her brain and body remain clear, and Jennifer looks forward
to fully returning to her family-owned real estate business soon. 

“When you face death, everything changes,” Jennifer says. “Question
your doctors, and ask for second or third opinions until you find the
most up-to-date information. Have faith in God, and be thankful for
every day.”


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