The Cutting Edge of Cancer Treatment

Surgery, radiation and chemotherapy are still the first line of defense against breast cancer. But exciting new techniques are entering clinical trials and, if they work, may eventually replace the old standards with kinder, gentler treatments

TUMOR ABLATION

--HOW IT'S DONE Cancers can be frozen or vaporized with lasers or high-energy radiowaves delivered by a probe through a tiny incision. In one technique, the probe opens like an umbrella inside the breast

--AVAILABILITY Already used for liver tumors. Clinical trials for breast cancer are under way, but could take five years to complete

ENDOSCOPY

--HOW IT'S DONE Tumors can be examined with a miniature fiber-optic camera that is inserted through the nipple and into a milk duct. Eventually surgeons may be able to treat tumors through the same tiny probe

--AVAILABILITY The fiber-optic scope was okayed by the FDA last summer. Using it for treatment may be less than five years away

TARGETED RADIATION

--HOW IT'S DONE After a lumpectomy, a tiny radioactive bead is delivered directly into the tumor site through a small balloon-tipped catheter. Treatment takes a matter of days, not weeks

--AVAILABILITY Clinical trials on 70 patients nationwide have been completed. The procedure is awaiting FDA approval

MOLECULAR FORECASTING

--HOW IT'S DONE With microarrays, scientists can study patterns of gene activity using strands of cancer DNA and predict which tumors are likely to spread. The technique may someday be used to design customized treatments

--AVAILABILITY Clinical trials for breast cancer are starting this year; treatment may be widely available within the decade

SMART DRUGS

--HOW IT'S DONE As scientists come to understand at the molecular level precisely how tumors form, they are designing a new generation of smart drugs that bind to specific receptors or block particular proteins

--AVAILABILITY Herceptin, the first of these smart drugs for breast cancer, is available for certain advanced cancers

Sources: Acueity, Proxima Therapeutics, M. D. Anderson Cancer Center, Rosetta Inpharmatics