Summer 2009

Cold Case

Kidney Malignancy Treated with Cryotherapy

Urologist Robert Hanley, M.D. (L) removed a 3-centimeter tumor from the kidney of Charles Jones using minimally invasive surgery.

The way Charles Jones tells it, his kidney cancer was diagnosed in a round-about way— a way that leaves listeners with wide eyes and a silent prayer on their lips that they always find themselves as lucky as this Tracy’s Landing resident.

Last winter, tired of an upset stomach that just wouldn’t go away, Mr. Jones visited his primary care physician, Wayne Bierbaum, M.D. of Owensville Primary Care in West River. After examining Mr. Jones, Dr. Bierbaum recommended a CT scan. “The thing we found wrong had nothing to do with my upset stomach,” recalled Mr. Jones. “They found a growth on my kidney. I wasn’t expecting that.”

He was referred to Anne Arundel Urology, where he consulted with Robert S. Hanley, M.D., a urologist who specializes in minimally invasive surgery. An MRI confirmed the mass.

“Mr. Jones had a 3-centimeter malignant tumor sitting on top of his kidney, like a golf ball,” said Dr. Hanley. “It was easily exposed, easily accessible. Instead of taking his kidney out or performing an open procedure, we used a minimally invasive approach to expose the tumor and treat it with cryotherapy.”

Nothing in Mr. Jones’ 20+ years as a District of Columbia firefighter or as a veteran of the Korean War prepared him for cryotherapy, which uses ice balls below negative 30 degrees Celsius to kill cancer cells. “Dr. Hanley gave me many options. When he told me he could use a camera and small tools and go in and freeze the tumor, why, I had never heard of such a thing!” said Mr. Jones.

“Cryotherapy has become a well-established treatment option for a wide variety of malignant conditions,” Dr. Hanley said. “Recent technological advancements in needle design and the freezing process have allowed cryotherapy to play an active role in treating urologic malignancies.” After the patient is sedated, long, slim hollow needles are inserted through the skin, delivering small amounts of argon gas, which produces an ice ball that engulfs the tumor, killing the cancerous cells as well as a small margin of surrounding tissue while sparing healthy kidney structures. The gas freezes the tumor. “We can see what’s being frozen and killed,” Dr. Hanley said. “The procedure is best used on small tumors up to 4 centimeters.”

This inpatient procedure takes about two hours and has a low risk of bleeding and fewer complications. In addition, the healthy portion of the kidney is not disturbed. Patients spend between 24 and 48 hours in the hospital.

Mr. Jones, who turns 80 on July 4, was home in little more than 24 hours. He has spent the spring tending his two acres of property. Over the years he has had both knees replaced and two back surgeries at AAMC, and he wouldn’t think of going anywhere else for medical treatment.

“AAMC has been good to me,” he said. “The whole world has been good to me.”

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