Laser interstitial thermal therapy gives relief to stage IV melanoma survivor
BY Meagan Raeke
March 09, 2017
Medically Reviewed | Last reviewed by an MD Anderson Cancer Center medical professional on March 09, 2017
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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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 Weihe
Survivor