C02 Laser for Mastectomies and Wounds
Comments
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OMG Mari, how is this not fun? Were gonna catch there ass in a sling for suppressing a better treatment for about 30 years.
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There's actually an ablation clinical trial going on here in Philly, at Lakenau! It's freezing of tumors. THis is Phase 2 of the trial..they had very good results for phase 1.
I looked into participating, but I couldn't, because I have a 2nd tumor
I was pretty bummed about that. -
swg, It's in the pervious posting about ablation. There were five sites listed as participating in the trial. This trial has value. I also state it was in phase 2.
What I object to is that there seems to have been a disruption/ suppression/stopping of the development of laser assisted surgery for mastectomy. It occurred 30 years ago. Maker's and Morris's presentation at ACS identified many things that were relevant then and are relevant ever since their presentation.
Somehow the research into laser assisted mastectomies was stopped. A screeching stop. Three men in the country were doing it. Ansanelli will not forgive me for this, but he had to fight in court to continue doing the procedure.
Dear Dr. Ansanelli, please, forgive me, but what they did has to be undone.
I don't know yet what happened to Maker & Morris. But I do know nothing by them was published. I have contacted both of them without a response. Maker is still practicing and I have contacted him with no response as of today. Morris is retired and I've located him and sent a message.
What you are missing here is that three surgeons independently were using C02 lasers to do mastectomies, in the 1980's. All were having the same results i.e better than conventional modified radical mastectomy. Again repeating, why didn't the surgical community gravitate to this as a better way and support research
I'm not going to waste words. Money. Breasts are big money.
For the lack of due diligence in the search for a better treatment, they(ACS and AMA) are going to have to prove that they did not suppress Laser mastectomy as an option or the best choice.
Best choice option is moot, because the search wasn't just buried, it was squelched. It was crushed,
We are talking an approach to mastectomies that people COMFORTABLY leave after an hour in recovery. Their pain medicine is Extra Strength Tylenol. People that describe that they went out to dinner and did errands.
That wasn't my experience. That wasn't the experience of anyone that I've talked to on these boards except for Chef and Snowday, both patients of Dr Ansanelli.
I'm pissed and so you should be too. Read from the beginning everyone. Start to develop an outrage that laser treatment has been developed for almost all body parts since 1960. Three surgeons did it in the 80's. If you don't understand the significance of what happened, I'm not sure how to get it better across to you
Laser is used on head to ankle soft tissue. As I stated in the topic box "What is softer than a breast?"
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Photomed Laser Surg. 2008 Jun;26(3):257-62. doi: 10.1089/pho.2007.2146.
Comparison of carbon dioxide laser and scalpel for breast lumpectomy: a
randomized controlled trial.
Kaviani A(1), Fateh M, Ataie-Fashtami L, Yunesian M, Najafi M, Berry M, Rabbani
A.
Author information:
(1)Department of Surgery, Tehran University of Medical Sciences, Paris, France.
akaviani@sina.tums.ac.ir
OBJECTIVE: To investigate whether the CO2 laser is superior to conventional
surgical techniques for minor breast surgery in a randomized clinical trial.
BACKGROUND DATA: It has been suggested in the literature that application of CO2
laser in breast surgery might be superior to conventional surgery in some
aspects.
PATIENTS AND METHODS: Sixty women whose breast masses were suitable for
excisional biopsy were randomly allocated to laser and control (conventional
surgical technique with scalpel) groups. Perioperative and postoperative
variables were recorded and analyzed.
RESULTS: The patients' ages ranged from 16-63 y. There were no significant
differences between the two groups in total operative time (17.4 min with laser
and 17.5 min with scalpel). There was a significant decrease in the required dose
of lidocaine in the laser group (9.3 mL) compared to the scalpel group (12.4 mL;
p = 0.01). In addition, hemorrhage was significantly lower in the laser group
(6.6 mL) compared to the control group (11.9 mL; p = 0.006). There was no
difference in the grade of the scar or postoperative pain between the two groups.
CONCLUSION: Use of the CO2 laser in breast mass biopsy has some advantages,
including a lower requirement for local anesthetic and a lower rate of
intraoperative bleeding. Furthermore, using the laser does not prolong the
operative time.
DOI: 10.1089/pho.2007.2146
PMID: 18588441 [Indexed for MEDLINE]
Ahonghaua Yi Xue Za Zhi (Taipei). 1994 may; 53(5):288-92
Evaluation of the CO2 laser in performance of breast surgery
Kuo SJ(1)
Author information:
(1) Department of Surgery, Changhau Christian Hospital. Taiwan, R.O O
BACKGROUND: In several studies the C)@ laser has proved to have properties which make it particularly useful to the general surgeon in management of breast tumor.
METHODS: Four hundred and seventy-twopatients, including two males, which age range from15 to 84 years. The operative procedures include excisional biopsy, segmentectomy and modified radical mastectomy. In this study, one group was operated on by the scalpel: for the other group C02 laser(Sharplan Model 773) was used. This is a comparison of the healing process, the operative course and follow-up of patients who underwent breast surgery. Eighteen of the series were fresh, locally advanced mammary carcinoma cases and were managed with induction chemotherapy using cyclophosphamide, Adriamycin, 5-flurouracil, followed by definitive extirpative laser surgery.
Results: The patient(s) have been followed from 12-60 months. Good cosmetic results without local recurrence of tumor were observed following the laser treatment. An effective massive tumor necrosis of 80% occurred after induction chemotherapy. Swelling and distortion of cancer cells with vesicles filling in the cytoplasm and nucleus were demonstrated.
CONCLUSIONS: Laser technology for breast surgery was concluded to assist the operating surgeon with more precision, smaller wounds, more hemostasis, less tissue damage, and reduced morbidity except prolonged wound healing.
PMID: 8039042[Indexed for MEDLINE]
1. Khirurgia (Mosk). 1993 May;(5): 18-23
[Article in Russian]
Demidov VP, Chissov VI, Rykov, Putyrskii LA, Kuzmin VA.
The work describes the peculiarities of radical resections of the breast with high-energy C02 laser in the treatment of patients with early stages of breast carcinoma. The advantages of the laser scalpel are pointed out. Twenty radical operations were conducted for breast cancer carcinoma with the use of a C02 laser. The operation did not last longer than practically, blood loss diminished by half(from350ml to 150 ml), and the wounds healed in the usual period. Reduced pain sensitivity in the region of the wound was noted in the postoperative period. This study is continued.
PMID: 8089980[Indexed for MEDLINE]
Int Surg. 1987 Oct-Dec:72(4):208-10.
Laser operation for breast cancer
Wang YH(1).
Author information:
(1) Surgical Department, Changhau Christian Hospital, Taiwan, Republic of China
From April of 1985 to March of 1986 there were 48 cases of laser breast operations. Twelve cases of breast cancer were treated by modified radical mastectomy using a C02 laser. Another twelve cases of breast cancer were treated conventionally using a scalped and electrocautery for the purpose of comparison. Laser surgery offers some advantages. The conventional surgery involved more blood loss(300 ml to 750 ml) and needed blood transfusion, whereas laser surgery produced a 20 ml to 400 ml blood loss with no need of blood transfusion. Since in laser surgery, cutting and ligation is by sealing, the laser operations tool from1.5 hours to 3 hours, whereas conventional surgery took 2 hours to 3.5 hours. All the 24 cases of breast cancer, treated either by conventional or by laser surgery, had stitches removed on the tenth day. No wound disruption was observed in either group. In conclusion , laser surgery can provided a very safe and effective method in the treatment of breast cancer.
PMID 3448030[Indexed for Medline]
Lasers Surg Med 1986;6(5):470-2
CO2Laser in cancer surgery of the Breast:a Comparative clinical Study.
Ansanelli VW.
Review of the literature reveals little to no data regarding the use of the CO2 laser as a surgical modality in the local treatment of breast cancer. This study was undertaken to determine if the CO2 laser is a surgical improvement over the scalpel, influencing patient care during the surgical and postsurgical period. In the author's series, a total of 209 procedures were preformed. Within this group, 105 cases were performed with the CO2 laser and 104 cases were performed with the scalpel. Biopsies were always performed as a separate prior to definitive surgery. This study was not designed to compare cure rate, the medical follow-up period being 1 year. The results of this study demonstrate a significant improvement in patients' postoperative care, surgical technique, and hospital cost effectiveness.
PMID:3100894 [Indexed for MEDLINE]
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These citations are in time sequence, with the most recent being first. More work needs to be done in analyzing the data that is common to the group in the form of bar charts etc to simplify the information.
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The below is C&P from http://www.globalspec.com/learnmore/optical_components_optics/lasers/carbon_dioxide_lasers
It is safety data info. Not sure how it will be useful, but storing it anyway. Global spec credited it to Erchonia.
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To address the concerns above, the Center for Devices and Radiological Health (CDRH) — a division of the US Food and Drug Administration (FDA) — provides a laser safety classification scheme based on six product classes. Lasers are also specified by different classes described in the international IEC 60825 standard. The table below describes both US domestic and international classes for laser safety; most CO2 lasers qualify as Class 4 devices.
Laser safety classes. Image credit: Erchonia
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reserved
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Yohoo Mari, back from vacation, are you out there?
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Mari I'll pretend you are here. Worked oodles today. Many phone calls. All dead ends so far. Still following breadcrumbs.
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Talked with Dr Maker, essentially a dead end. He did use a YAG laser and did teaching throughout the country on it's use, and published on it. But that was long ago. He doesn't believe that the laser has any advantages over standard conventional surgery. He is unfamiliar with the few more recent studies since the 80' & 90's.
Talked with the President of the Board of Directors (national) Veterinary association. Essentially dead end. The question to him was " Where in the US in veterinary research being done with lasers?" Dead end. He also has experience of laser mastectomy use in animals for 20 years, not convinced of advantages.
Talk with a few manufactures dead end so far.
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https://www.youtube.com/watch?v=9Oi3AETd0Dk
Aesculight laser used in the vet sphere.
What's nice about the video is that it encompasses all the reasons that lasers are useful in the human community. The few limited studies done on women, have found the same outcomes i.e reduced surgical time, reduced bleeding, reduced infection, reduced recovery time.
To date there has been no study that looks at affect/effect on recurrence. What is known that there is a problem with tumor seeding and or release of circulating tumor cells (CTC's) with standard conventional surgery.
The research being done with a laser probe mentioned in an earlier approach has it's limitations in that it concentrates only on the identified tumor site which is vaporized. That treatment then is followed in a few days by a standard conventional mastectomy. Since the known factors of reduced bleeding, infection, surgical time, and pain have already been shown consistently to be true in the limited studies, research to compare recurrence differences is an open question that shouldn't be diminished as a serious question
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General overview of C02 and Yag lasers. Not very useful, but is a breadcrumb
Another general information page from American Cancer Society, same thing breadcrumb
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In the two day ago searching . I found a screen shot post of one of my posts on TREATO. I wasn't happy of course. If I had a cell phone the lesson would have been screen shot. I went tonight to there site. Couldn't find it.
The problem with this even though anyone can lurk. The material within BCO by Terms of Service belongs to BCO.. The post taken was about me stating that there might have been suppression of a surgical modality.
Anyone reading that can surmise much without context of the other information written here. Regretfully, it puts a pause a how I write. Others should be aware also. Not nice
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https://www.drugs.com/news/fda-clears-stereotactic-radiotherapy-treating-breast-cancer-68227.html
FDA Clears Stereotactic Radiotherapy System for Use in Treating Breast Cancer
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Dr. Susan Love has said that she will read this thread. Hoping she will see the problems that I see. But perspectives are/ can be different. We will see what her opinion is
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Maker's and Morris's presentation at ACS identified many things that were relevant then and are relevant ever since their presentation.The material within BCO by Terms of Service belongs to BCO.. The post taken was about me stating that there might have been suppression of a surgical modality. We can take a example of Printer, There are many people who use Laser printer for the printing. Brother is one of the best Laser printer which used in many organization. and Brother printer also provide best Brother Printer Support to their user.
[URL= brotherprintersupportnumber.co.uk] Brother Printer Support [/URL]
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Berry, would like to explore your comment. Was your contact with Maker and Morris back in the 80's? What post re: surgical modality are you referring too that was taken from you? What does BCO TOS have to do with your post?
I see that this is your first post on BCO, sorry you are here, but you will find many wonderful folks here that are helpful.
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Hello,
Would someone here be willing to contact me regarding laser breast surgery? I've been trying to find people who have used Dr Victor Ansanelli in Plainview, NY. My email is vcorbin11@hotmail.com. I will contact anyone by phone if you can email me your number. I've recently been diagnosed with early breast cancer. I'm not sure yet what method of removal will be done. My understanding is the laser method is FDA approved, at least that is what I see on Dr Ansanelli's site.
Thanks,
vcorb
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Vcorb, Sent PM
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hi, can you kindly also share this with me please? my mom has been diagnosed with stage 4 breast cancer and i am hoping Dr Victor Ansanelli is able to help her..
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Holding call Ansanelli's office direct. They will tell you if he will deal with a stage4 patient. It's way outside my wheelhouse.
Sorry, your mom is going through this. I feel your fear, been there with many.
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I have lost the thrust of dealing with most things on BCO. Not just this thread. But the whole of BCO. . Perhaps in a future time, this will be active again. I know this is a serious issue. I know that it is a hidden issue. I know women have been cheated b/c laser surgery was denied us. Hopefully, I won't be sucicided b/c of my statement.
The breast industry IS huge. Surgery IS huge. BREAST surgery is a money maker. If you think me a joker, a bearer of tales not true. Look at the numbers.
WHY has laser surgery progressed from 1960 with the eye, to every part of the body , down to the toenails. Head to toe on soft tissue. Why not the breast? Why not the breast? The breast is a money maker...………
Only women can change this. They can change this by demanding change. Why demand change. Look at the studies I have listed. Reduced Infection, reduced loss of work, reduced recovery time, reduced blood loss, reduced drainage, reduced use of opioids, able to be done under twilight anesthesia, able to walk away the same day with NSAIDS control.PLUS, the known factor that cells can migrate during the act of surgery. Known fact. If laser can mitigate this. WHY are we not receiving this as an option for surgery? WHY?
Is it b/c of someone's golf dues?
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OH BTW, I believe the AMA and the ACS-----------American Medical Association and the American College of Surgeons have colluded to block the development of Laser surgery for the breast. If that was not clear in my previous writings. It is now absolutely clear.
ABSOLUTELY CLEAR -
A few years ago, I knew someone who was refusing all tx, and in seeking low impact tx for her, I came across laser lumpectomy, was stunned it was only offered in a few centers.
I wonder whether laser lx/mx currently does, or may in future, allow harvesting of sufficient sized tissue in good condition for pathology studies.
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OxYgen, Hi been off awhile. No knowledge of "a few that offer laser lumpectomies" Would love to have you post the sites.
Frankly, my focus has been "why not the whole mastectomy". I think this whole thing is wrong. I think Dr A's approach should be evaluated for outcome. But appears to being blocked. I think money is behind it.Again, why? Beating the poor dead opossum (just a word choice, no comparison). If laser has been used since 1960, starting with the eye, advancing each decade for other uses on soft tissue, for "stuff from the top of the head to the toenails of the feet, and everything between. WHY isn't laser routinely used for excision on the softest tissue of all (metaphorically) the BREAST.
Breast may be big or small, that's not the issue. The issue is what is the best mode of excision. Again the AMA and ACS have blocked this from the 1980's
When we look at the possibility of "seeding" by excision through the lymph or blood vessels by standard excision, IF excison by laser could have prevented that "seeding" , how many women have we lost b/c the ACS and AMA blocked a better way for women so they could make money. Was Pharma involved? Was Radiation folks involved. I have been behind closed doors for EMS things. What may seem reasonable to the public can come down to simply who pissed who off. or where was the best money. No consideration of value. Value in the scenario that I'm espousing is LIFE unencumbered by Mets, caused by the act of surgery.
Guessing I will keep on the tangent, until some person in power wanders on and decides to carry the standard(flag , historic old usage). I tried. I couldn't find anyone in the system, that wanted to fight the system. To me, that says the tight control of AMA and ACS is as tight as the Mafia.
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Oxygen, I was off on my crusade and espousing.
If you go back there is and organization and doc mentioned in this thread that was in trials about using a specific laser. The laser is used in the similar fashion of an ablating unit. The problem I had with the studies and trials was: they would insert the probe, use the Laser, then two (?) days post laser usage would do a standard mastectomy. In the trials they were looking for a reduction of cancer cells within so many millimeters--clean margins of the laser probe.
Well, isn't that nice. (said sarcastically) Each trial showed progress. Each trial was fully funded by the owner of the laser probe. Oh, conflict of interest? No, (again sarcasm) it was a woman's issue, and they were trying to find a better way.
Why not then do a full mastectomy by Laser after the waiting period. Well, that would demand that the doc have a laser skill. Is it hard to learn. All surgical skills have a learning curve. Extra cost to a department. Yes. BUT we have lasers in OR's that are used head to toe. Why? They have been shown to provide "Best" results. How did these best results come about. The AMA and ACS supported there use, but the "Best" use concept did not include the BREAST.
Damn off on that tangent again.
The only "Best "use for a laser that is not being done is for the BREAST. The ONLY way this will change is women asking for it.
Advocacy i.e. asking BCO to advocate would be very good. BCO advocacy for us in the past since I have been here has been GREAT. They watch what we write and talk about. Then for items missing from the main page, they write topics. i.e constipation. No topic on constipooation (love that misspelling, leaving it) I wrote a topic. Took awhile BCO had a main page topic.
But asking them to become an advocate for research and residency training for laser assisted mastectomy is within our need. We need this.
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