Mercy Medical Center oncologist one of first to use new device to remove cancerous tissue

CEDAR RAPIDS - Dr. Vincent Reid wakes up every day with one goal - to create a cancer survivor.

And for the past three years, the surgical oncologist and medical director at Mercy Medical's Hall-Perrine Cancer Center has wielded a powerful sword, the MarginProbe.

The handheld device roots out cancerous cells through the use of radio-frequency spectroscopy, allowing the surgeon to analyze tissue and remove any remaining positive margins - tissue with lingering cancer cells - during a lumpectomy.

It provides real time results, flashing red when a cluster of cancer cells are found and flashing blue when the cells are normal.

This helps cut down on the need for a second surgery, sparing the patient from psychological and financial hardships while saving the hospital time and money.

Data shows that lumpectomies - where portions of the breast are conserved - combined with radiation can be just as effective as a mastectomy, for those with tumors under four centimeters.

But before the MarginProbe was approved by the U.S. Federal Drug Administration in 2013, the 'gold standard” to ensure the cancer was completely removed was by having a pathologist examine the tissues in the operating room, Reid said. But this option isn't always possible, depending on a hospital's resources.

That means women would have to come back for a second or even third surgery to eradicate all the cancer cells, Reid said - an outcome that would happen between 18 percent and 24 percent of the time.

He first heard of the tool several years ago after a New York doctor had discovered its success.

'I'm always in search of new technology and treatment,” he said.

He read up on the device and looked at the data in a handful of peer-review journals before deciding Mercy Medical should invest in the technology - which has a hefty upfront cost of about $20,000.

Reid, the first in Iowa and one of the first in the nation to use the MarginProbe, analyzed the outcomes and effectiveness of the tool. The results were published in the December edition of the American Journal of Surgery.

'Looking critically at our own data was the next logical step,” he said.

He looked at more than 300 lumpectomies done at Mercy Medical Center - 137 in which the tool was used and 199 where it wasn't. He found that in the cases where the MarginProbe wasn't used, there was a re-excision rate of 14.9 percent. In the cases where is was used, the re-excision rate fell 56 percent to 6.6 percent.

Reid added that re-excision rates likely are even lower today as Mercy's doctors have become more familiar with handling the tool. But he cautioned that the MarginProbe isn't the Holy Grail.

Targeted radiation still is needed after surgery, and it is possible doctors have to go in again.

Created and manufactured by Israel-based Dune Medical Devices, each disposable probe costs about $1,000. And while prior-authorization is needed by the insurer, Reid said there have been very few instances in the nearly 250 cases in which he used the MarginProbe where it has been denied.

'I think only about three or four patients have been denied,” he said. 'And when we explained to them it was denied, they offered to pay for it out-of-pocket.”

After talking through her options with Reid, Kathy Frieden of Fairfax, who recently was diagnosed with breast cancer, decided to allow use of the MarginProbe in her Feb. 15 lumpectomy. Frieden, who spoke with The Gazette the day before her surgery, said her cancer was caught very early during her annual mammogram.

She anticipates needing a short course of radiation afterward.

It's been a bit of a whirlwind since diagnosis, Frieden said, but she has a big support network, including her husband and friends.

'I've never been through anything like this,” she said. 'I'm still going through the experience and remaining optimistic.”

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