Groundbreaking Treatment Helps Patients Battle Liver Cancer

There was a time, no so long ago, that few effective treatment options existed to help patients like Roberto Arguello, who was diagnosed with liver cancer at age 80.

Fortunately, Mr. Arguello sought help at Miami Cancer Institute, where his tumor was treated in a minimally invasive fashion that allowed him to quickly bounce back and resume his normal activities.

Miami Cancer Institute and Miami Cardiac & Vascular Institute, both part of Baptist Health, were the first in the United States to successfully treat a patient with liver tumors by using the image-guided Quantum Surgical Epione® robot.

Govindarajan Narayanan, M.D., chief of interventional oncology at Baptist Health Miami Cancer Institute and a vascular interventional radiologist with Baptist Health Miami Cardiac & Vascular Institute

The technology used a robotic arm and CT-scan imaging to navigate the microwave ablation of Mr. Arguello’s cancer. His procedure was the 100^th robotic assisted tumor ablation performed at the Institute with the robotic system under the guidance of Govindarajan Narayanan, M.D., chief of interventional oncology at Miami Cancer Institute and a vascular interventional radiologist with Miami Cardiac & Vascular Institute.

“I was honored to be the first physician to utilize this technology in the United States, as this robotic-assisted equipment is going to change the way we deliver effective treatments to our patients for cancerous tumors,” Dr. Narayanan said. “Baptist Health has always been at the forefront when it comes to providing the very best care to the South Florida community and beyond.”

How the Technology Works

Image guided ablation is a minimally invasive treatment that destroys liver tumors without taking them out. Different energies are used to kill tumors, such as the heat in microwave ablation, freezing the tumor with cryoablation, or electrocuting it with irreversible electroporation.

Govindarajan Narayanan, M.D., with the image-guided Quantum Surgical Epione® robot

The Epione® robot allows physicians to treat tumors in difficult to reach locations. Using CT scans for guidance, the technology allows the Interventional radiologist to insert one or more needles through the skin directly into the tumor to destroy it. A robotic arm guides physicians to the best entry point, allowing them to precisely insert needles while avoiding critical structures.

“Many patients cannot undergo extensive surgery, or their tumors are considered inoperable for various reasons,” Dr. Naranayan explained. For them, image-guided ablation is an established alternative treatment. “The addition of robotic technology allows physicians to quickly plan where to go and achieve higher precision when performing ablations, resulting in patients having a quicker and more seamless recovery.”

In less than two years, Dr. Narayanan and his colleagues have performed almost 150 ablation procedures using the Epione® robot, which was approved by the FDA for use on abdominal cancers.

“Our goal is to work quickly, precisely and efficiently to be able to provide the best care to our patients,” Dr. Naranayan said. “There are other significant benefits as well, including the reduction in radiation exposure to patients and doctors.”

Some Background on Liver Cancer

Liver cancer incidence rates have more than tripled since 1980, and the death rates have more than doubled during this time, according to the American Cancer Society. It is estimated more than 41,000 new cases of primary liver cancer will be diagnosed in the United States 2024. Almost 30,000 people will die of the disease.

Liver cancer has many causes. Research seeks to build a more complete understanding of how it forms in order to improve prevention and treatment. At this time, there are no widely recommended screening tests for liver cancer in people who are at average risk. Some testing might be appropriate for people at higher risk.

Liver cancer often goes unnoticed in the early stages, when it is easier to treat, because symptoms are vague or often don’t appear until the cancer is more advanced. Small liver tumors are hard to detect on a physical exam because most of the liver is covered by the rib cage. By the time a tumor can be felt, it might already be quite large.

The average five-year survival rate for all stages of liver cancer is about 22 percent, according to the American Cancer Society. Surgery, when possible, offers the best possibility for a cure. However other treatments such as ablation, embolization, radiation and certain medications can improve the prognosis and extend a patient’s life.

Looking Ahead

Mr. Arguello’s treatment has allowed him to resume his regular travels, including trips to his beloved Nicaragua that bring much joy to his life. And he is grateful to have more time with his daughter, who has been beside him throughout his cancer journey.

“The technology available today and the skill of physicians like Dr. Naranayan are just incredible,” he said. “I’m so glad I got my treatment at Miami Cancer Institute. They have never given up on me.”