SPDT together with Surgery

SPDT together with Surgery

Hopper (6) makes the point that in a large number of solid tumors, surgery leaves behind residual microscopic disease that may lead to local recurrence or metastatic disease. SPDT is an ideal adjuvant therapy especially when the risk of local failure is high, as in gastrointestinal and prostate surgery. A review of the treatment of more than 310 brain cancer patients concluded that there is a clear trend towards improved survival when PDT is used along with surgery.

SPDT, usually in conjunction with a lumpectomy or a mastectomy is expected to be particularly effective with early-stage breast cancer. Why? In early stage disease, there will not be much cancer to kill.

While we have not found reports in the medical literature regarding the use of SPDT for early-stage breast cancer, there are studies reporting good results with later-stage breast cancer. Wyss et al (16) treated chest wall recurrences in patients treated by mastectomy for breast cancer. They treated 7 patients with a total of 89 metastatic skin nodes. They achieved a complete response in all cases.

Allison et al (1) carried out a similar study of 9 patients at a total of 102 chest wall sites, with lesions up to 9 cm. Despite the fact that all patients had failed surgery, full dose radiation and multi-agent chemo-hormonal therapy, chest wall lesions healed with no scarring after SPDT was used. Clearly, if doctors can get such good results with metastatic breast cancer, it is reasonable to expect even better results earlier in the disease process.