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When Helen Streaker first battled breast cancer, her options were limited — surgery and then radiation, the gold standard for treatment at the time.

It was an approach that left Streaker feeling wrecked after her mastectomy in 1993. She compared the surgery to “an amputation or mutilation.”

These days, Streaker, 87, has another less invasive option to treat the tumors that returned.

Cryoablation literally puts tumors in a deadly deep freeze — with no surgery, radiation or chemotherapy required.

Streaker has undergone the innovative treatment to remove her past two tumors—one in 2016 and another last summer.

And on Jan. 25, Streaker became the first patient at Houston Methodist Hospital to undergo the procedure for breast cancer.

“This is my mission,” Streaker said of spreading the word about the therapy. “I want to tell people about this. It is my joy — but I also consider it my duty.”

Dr. Luz Venta, Streaker’s doctor at Methodist, described the procedure in a simple way.

It’s almost exactly the same as performing a biopsy, said Venta, who is medical director of the Houston Methodist Breast Care Center.

The ‘aha’ moment

When an additional breast tumor surfaced in 2016, Streaker was a patient at another hospital. She was informed that her age made her too high a risk for surgery. The same was true for chemotherapy.

Radiation was also no longer an option, since she had already received the maximum amount allowed during her previous breast cancer treatment.

Her only path forward was a pharmaceutical treatment that ended up making her terribly ill.

“Maybe I should just stop taking the medication and let the cancer take its course,” she said she thought.

What happened next, she is convinced, was divine intervention.

Streaker was having dinner with a friend, when neighbors dropped in.

“They were so excited,” she said. “They met a doctor in California who was doing cryoablation.”

As the couple described the procedure, Streaker stared in disbelief. They were describing an answer to her prayers. “I said, ‘I have breast cancer. I want the doctor’s name and phone number.’”

She called his office and sent in her records. And when she asked if she would be a candidate for the therapy, the doctor said, “You are.”

“It was the best two words I’d heard in my life,” she said.

No surgical suite required

Getting to California was the hardest part, Streaker said. The procedure itself was straightforward.

“You’re in a doctor’s office, not a surgical suite,” Streaker said.

Then the doctor numbered her breast. “That’s all the bread that you feel,” she said.

For the procedure, physicians rely on ultrasound imaging to know exactly where the breast tumor is located, allowing the proper placement of a needlelike device to inject the growth with liquid nitrogen.

The tumor cell is frozen and destroyed.

“You can lay on the table and watch,” Streaker said. “And there are no side effects.”

That includes no sedation, pain or scarring, as well as no lengthy hospital stay. It all happens in real time, in a matter of minutes.

“All of a sudden my tumor was gone,” Streaker said. “You’ve just never seen anyone so happy.”

And that’s why, when Streaker discovered another tumor last summer, there was no question in her mind. She wanted cryoablation.

There was only one problem. No one locally was offering the treatment for breast cancer.

A third tumor

After cryoablation, patients have regular follow-up appointments and mammograms.

Streaker’s third tumor was found during one of those frequent visits at Houston Methodist. Doctors suggested that she watch and wait. The growth was progressing slowly.

Streaker, however, had another idea.

She told Venta about cryoablation and gave her doctor a copy of a 2016 study from the National Institutes of Health.

The paper describes success treating breast cancer with the procedure, which previously was reserved for fibroadenomas, benign tumors made of both glandular tissue and connective tissues.

The Phase 2 clinical trial, referred to as Z1072, showed successful ablation in 92 percent of the cancers.

Streaker told her doctor, “This procedure is less invasive than having your teeth cleaned.”

Venta said cryoablation has been used to treat tumors in the kidneys and prostate. The technology had been around for about two decades.

She pointed to studies in France and Germany, in addition to Z1072 in the US, which recorded the efficacy for treating breast cancer. “All of these studies proved, ‘Pay attention to this. It has a role,’” Venta said.

Cryoablation has not been a popular treatment for breast cancer. Venta says it’s because “we were really stuck in the paradigm of surgical treatment,” she said. “We thought of breast cancer like an appendectomy. You have to take it out.”

In the past two years, however, medical thinking has changed significantly, Venta said.

For instance, immunology has become a key to treatment. There’s also greater understanding of nuanced types of breast cancer.

“You can’t use the same tools for all of them, because they are all different,” Venta said.

Dr. Richard E. Fine, a breast surgeon at the West Cancer Center & Research Institute in Tennessee, presented a paper on his cryoabalation clinical trial at the 2021 annual meeting of the American Society of Breast Surgeons.

“For some tumors, less aggressive therapies can be as effective and deliver greater patient satisfaction at a lower cost than traditional interventions,” Fine wrote. “In keeping with that trend, cryoablation is a promising, high-value treatment for certain forms of less aggressive cancers.”

Venta added that doctors now take a more holistic approach toward patients, as well as an understanding that certain breast cancers cannot be “cured.” Instead, some women have to deal with recurring tumors.

“It’s not just an acute disease,” Venta said. “It’s something that may come and go and need different treatments.”

She compared the formula of treatments working in unison to the Olympics, bringing endurance, speed and technique into play.

“In this, cryoablation is speed, immunology is endurance and surgery is the technical aspect,” she said.

All three areas are fundamental, Venta said.

The role of cryoablation as a breast cancer treatment is still being studied.

“For that we need thousands of participants,” she said. “Right now, we only have hundreds.”

But Venta is enthusiastic about the role cryoablation could have in treating older patients who have more fragile health.

“For years, we’ve had this problem of patients who don’t want surgery. We really did not have anything else to offer,” she said.

Giving women a voice

On Jan. 25, Streaker became the first patient at Houston Methodist to undergo the procedure for breast cancer.

Venta is currently opening a medical trial and starting to screen potential participants.

Ideal candidates include those who are at high risk for surgery, respond poorly to general anesthesia and have a breast tumor 1.5 centimeters or smaller.

She is particularly enthusiastic about a finding in cryoablation studies that shows the treatment can support immune function in a unique way.

Certain cancer cells can go undetected by the immune system. With cryoablation, however, when the tumor dies, an alarm basically goes off, she said.

“It’s like a red flag to the immune system,” Venta said. “It’s a call to arms.”

The immune system can then recognize cancer cells in other parts of the body.

This phenomenon is what she hopes to study in greater detail during the trial.

In the meantime, she appreciates Streaker’s persistence in drawing attention to the procedure.

“Helen is really inspirational to all of us,” Venta said. “Helen has pointed out cryoablation is a technique that gives women a voice.”

Streaker is confident that women asking for cryoablation can push hospitals to offer the procedure.

And she’s been spreading the word since her first procedure, bringing back manufacturers’ brochures from California, speaking at her condominium complex and at churches across the country.

“I’m just thrilled to be part of the program and to get the word out,” she said. “I believe this is a God thing, because God knew if I did this, it would become my moral obligation to tell others. I’m supposed to do this.”

Peyton is a Houston-based freelance writer.

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