Five Questions With: Dr. Ponnandai S. Somasunda

Associate chief of division of Surgical Oncology at Roger Williams Medical Center talks about the recent acquisition of the NanoKnife. More

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Five Questions With: Dr. Ponnandai S. Somasunda

COURTESY ROGER WILLIAMS
"ROGER WILLIAMS continues with this treatment modality as a technology leader for cancer care," said to Dr. Ponnandai S. Somasundar, associate chief, division of Surgical Oncology at Roger Williams Medical Center.
Posted 4/30/12

Roger Williams Medical Center is the first hospital in Rhode Island to acquire the NanoKnife, which uses high-voltage but low-energy pulses to create defects in a cancer tumor cell’s membrane. This treatment leads to the death of the tumor cell, mimicking natural cell death.

The treatment can be used around sensitive tissues and organs, such as the pancreas and the liver, without damaging the natural architecture of the organs.

The willingness to investment in cutting-edge technological innovations such as the NanoKnife, according to Dr. Ponnandai S. Somasundar, associate chief, division of Surgical Oncology at Roger Williams Medical Center, is a major reason why the hospital has become one of the region’s best for cancer care.

PBN: How does the new NanoKnife system of cancer treatment work?

SOMASUNDAR: The NanoKnife utilizes two or more probes, which are placed into or and around the tissue to be treated. The treatment is delivered to tissue in areas such as the liver or pancreas. The probes transmit a rapid series of short, electrical pulses over a few minutes. These are high voltage but low energy (non-thermal) electrical pulses that create defects in the tumor cell membrane, which are permanent; creating what’s known as “irreversible electroporation.” When pores are created in the tumor cell membrane, the tumor cell dies. This mimics natural cell death. Furthermore, this type of tumor destruction also enhances local chemotherapy absorption by tumor tissue.

PBN: Why is it such a big improvement over previous cancer treatments for sensitive organs?

SOMASUNDAR: This is a non-thermal means of ablation for tumor tissue, meaning it is non-heat generating. That means it spares vital structures such as blood vessels, ducts and other tissues containing collagen or elastin. This is of particular value in the liver, since it preserves the natural architecture of bile ducts and blood carrying structures. Other tumor ablation modalities that use heat or extreme cold commonly destroy architecture that is necessary. Patients that can be treated by the NanoKnife are those that may not have any other options for treatment.

PBN: With Roger Williams Medical Center being the first hospital in Rhode Island to acquire the NanoKnife, does that make the hospital the “go-to” place for such treatments?

SOMASUNDAR: Roger Williams continues with this treatment modality as a technology leader for cancer care. Roger Williams has the only active laparoscopic liver, pancreas, esophageal program in the region.

It was the first facility in the country to introduce Bipolar Radiofrequency Ablation, and the pMTA microwave ablation system. Roger Williams provides a comprehensive and complete single geographical setting for multidisciplinary complex cancer care.

Additionally, our Department of Surgery boasts of four fellowship-trained surgical oncologists and three surgeons expert in surgery of the Foregut (stomach, liver, pancreas, bile ducts). The comprehensive nature and wide range of treatment options define Roger Williams as the regional institution for cancer care.

PBN: How many patients a year will be able to benefit from NanoKnife treatments? When did it become operational?

SOMASUNDAR: In our estimation, about 30 patients annually could potentially benefit from this modality, given the analysis of past patients for whom there were no other surgical options. At Roger Williams, this treatment became operational in October 2011, and is presently on track to meet the estimated population whom will benefit.

PBN: Will Roger Williams Medical Center serve as a training center for other physicians in Rhode Island to learn the technique and the technology?

SOMASUNDAR: The Surgical Oncology team at Roger Williams is already a national center for advanced training in several of the modalities we use for complex cancer. Most recently, in November 2011, Roger Williams hosted 30 surgeons from across the nation in the region’s first “advanced hepato-pancreatico-biliary post graduate course.”

As one of only 15 centers in the country with a formally accredited surgical oncology fellowship, Roger Williams is training the next generation of cancer surgeons. They leave the fellowship with extensive training on this and other cutting-edge treatment modalities. Importantly, some of those surgeons stay in Rhode Island, which stands to improve the overall care in our state.

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