Brain laser that zaps ‘impossible to treat’ tumours

ANEW precision laser beam that heats and obliterates previously inoperable brain tumours has been used on the first British patient. Father-of-one Pablo Casasbuenas, 36, had his aggressive and deepseated tumour treated with the laser in October after being told he had only a year to live – and now says he is ‘living life again’.

The procedure involves a fine narrow tube being inserted into the tumour before a laser is beamed down it, gradually heating up to about 70C, breaking down and killing the cancerous cells.

Real-time MRI images of the brain are sent to a computer screen, allowing surgeons to monitor where the laser is working.

Studies found that this pioneering laser procedure almost doubles survival time, from five to 11 months, for patients with inoperable brain tumours.

It also provides an alternative to aggressive chemotherapy or radiotherapy, which can further damage the sensitive brain tissues.

Hundreds of brain tumour patients are denied surgery every year because of the damage it can cause to surrounding healthy tissue. But the laser, called Visualase, is so precise that it can treat aggressive, hard-to-reach brain tumours with minimal damage. Often patients can go home the following day, compared to a ten-day hospital stay after conventional brain surgery.

More than 11,000 people are diagnosed with brain tumours each year in the UK and just 14 per cent of adults survive for five years after diagnosis. Mr Casasbuenas, a PhD student from Richmond in London, was diagnosed with glioblastoma, an aggressive form of the disease, in 2014.

He became the first UK patient to undergo the £35,000 treatment at The Harley Street Clinic in London after it was given European approval for use in April.

Following his initial diagnosis, he had radiotherapy to shrink the tumour and he also needed chemotherapy. But a routine scan in early 2017 showed that the tumour on the left frontal lobe had grown and there was a tiny speck in the right lobe too.

Doctors used targeted radiotherapy to treat the right side, and Pablo had open brain surgery to remove more than 90 per cent of the tumour. Although the left side was cancer-free, the right speck continued to grow. He says: ‘I was pretty shocked, especially when doctors told me that average survival is only 14 months. It felt like a ticking time bomb in my head – living with uncertainty was horrible.

‘Yet more brain surgery would put me at high risk of waking up a zombie, since one frontal lobe compensates for another.

‘I didn’t want to burden my wife Ingrid, and I wanted to be there for my son Ernie.’

Pablo was given a general anaesthetic for the three-hour Visualase procedure, which is currently unavailable to NHS patients.

Doctors drilled a 3mm hole in the skull and, guided by MRI, the laser was navigated to the tumour via a catheter measuring 1.65mm in diameter.

The laser was then fired into the tumour and heat of the light energy gradually increased to destroy the cancer cells.

The treatment was monitored using MRI and once the entire area of the tumour was targeted, the surgeons withdrew the catheter and laser, closing the hole in his head with a single stitch.

Professor Keyoumars Ashkan, the consultant neurosurgeon at The Harley Street Clinic and King’s College Hospital in London who carried out the procedure, was thrilled with Mr Casasbuenas’s result.

Prof Ashkan said: ‘This laserassisted brain surgery with robotics, through a keyhole, is delivered under real-time MRI control, which means that we can safely treat brain tumours in places previously not considered possible to treat.

‘We are pleased with the results so far, since we want to see the MRI showing heat damage to the whole area of the tumour, indicating the whole mass has been treated. This was exactly the case for Pablo.

‘We hope future MRI scans will show no increase in size in the tumour, because the Visualase has killed the tumour cells. The hope is to see the tumour not increasing in size, but the old tumour sitting there dead as a ghost

Mr Casasbuenas said: ‘I woke from surgery feeling pretty good, with just a tiny plaster on my head instead of bandages and stitches as before.

‘The next day I went home with paracetamol, but didn’t really need it. After seven days I was back to running, and three weeks later I competed in a duathlon.

‘I’m living my life again. I thought I had exhausted all treatment options, but to be given this chance makes me feel truly blessed.’