[Times photo: Lisa DeJong]
Alicia Rhodes leans over to kiss her husband, Ken Rhodes, as they watch Alicia's son, Christopher Emmons, 7, play his first soccer game.

By WES ALLISON

ST. PETERSBURG -- His doctors were sure he had kidney stones.

And it seemed reasonable to Ken Rhodes. But the pain, the blood in his urine, the stubborn fatigue wouldn't go away. He lost 25 pounds in three months. He was weak. His wife thought he might be dying.

By August 1997, Alicia Rhodes had had it. She screamed at her husband's doctor and demanded more tests. The doctor ordered them.

"I remember the doctor coming down the hall, the look on his face," Mrs. Rhodes, 36, recalled recently. "He said, "Let's go into the waiting room,' and I said, "No, please just tell me right here. I don't want to hear this in front of a whole lot of people. . . .'

"He told me how bad it was, and how large it was, and that from its size it had probably gone somewhere else. And there probably wasn't much hope."

The tests found a massive tumor on Ken's left kidney. Renal cell cancer, as it's known, is tough and aggressive, and it tends to spread once it grows to about an inch and a half. This tumor was three times that size.

Eventually, the cancer spread to both lungs, and chemotherapy failed to stop it. As he sipped a beer on the sun porch of his home in St. Petersburg's Old Northeast neighborhood recently, Ken Rhodes acknowledged he should be dead by now, or close to it.

He and his wife credit his survival to persistence and luck, but mainly to an experimental treatment offered by an enterprising young doctor at the University of Mississippi that has extended his life.

"It was my last chance. I had no other options," said Rhodes, 55. "I didn't have a choice. Seriously."

The treatment is called Radio Frequency Ablation, or RFA, and involves inserting a probe akin to a plastic coffee stirrer into the tumor, then zapping the cancer cells with extreme heat. It was designed to treat tumors of the liver, but Dr. Patrick E. Sewell Jr. an interventional radiologist at the University of Mississippi Medical Center in Jackson, has adapted it to treat cancers in the lung.

That sort of treatment is almost unheard of, and many oncologists question how much it helps. But if ablation proves as successful in others as it has for Ken Rhodes, it could significantly change the way certain types of cancer are treated.

Sewell first used RFA in a lung two years ago, on a 40-year-old man who developed an inoperable lung lesion. Sewell already was using it to treat liver tumors, and he figured he could tinker with the frequency, heat and other variables to make it work in the lung as well.

"He had a rare tumor, and no options, and he decided to try it," Sewell, 37, said in a recent phone interview. "He did great. And the next day, he was ready to go home.

"More and more patients came into my life that could benefit from it and had no other options, and it became a project."

Sewell and Dr. Ralph Vance, an oncologist at the University of Mississippi, have been experimenting with it since, trying to determine how well it kills cancer and who may benefit most. Sewell said he has treated about 110 lung cancer patients, all of whom would have died. Some have died anyway.

Six months ago, he and Vance launched a clinical trial of 10 terminally ill lung cancer patients in Guangzhou, China, where Sewell trained doctors in ablation. They hope to publish their findings within the next year.

"If, in fact, we can show that there's a significant difference in survival, it would be a huge (development)," Vance said.

"If the results are positive, we'll be able to sit down then and see about expanding this to some other tumors."

Researchers also are testing it, for various cancers, at Wake Forest University, the University of Maryland, University of California at San Diego and the University of Toronto, among others.

The procedure is fairly simple: Using a real-time MRI or CT scanner, which are to tissue what an X-ray is to bone, the doctor guides the probe to the tumor and fries it. Sewell also is experimenting with a similar probe that uses extreme cold, rather than heat, to treat tumors of the kidney.

The notion behind ablation, however, is somewhat radical. Rather than trying to cure the cancer, ablation simply attempts to control it.

Only a systemic treatment that destroys cancer cells throughout the body, such as chemotherapy or interferon, can rid someone of cancer once the cancer has spread, or metastasized. And when it's necessary to remove a tumor, the preferred treatment has always been to cut it out, along with the surrounding tissue.

Some types of cancer don't repond well to chemotherapy, however, and some tumors are inoperable. Lung cancer is especially difficult, because it's almost always fatal and lung surgery is extremely hard on the patient.

And if tumors keep returning -- as they usually do when the cancer has metastasized -- the patient loses lung capacity with each operation. For someone like Rhodes, who had several tumors and whose cancer likely will return, surgery would have been impractical.

"In that group, if you cannot cure them, if all you can do is treat what you can see, then you want to pick the treatment that causes the least pain and suffering," Sewell said.

"You can't remove it all, because you can't find it all. This is a new way to treat the visible tumor with a lower misery quotient. It also preserves more functioning lung."

Unlike surgery, ablation requires no cutting and little recovery time. Patients are watched closely afterward, and new tumors can be zapped before they take over healthy lung or spread further. Sewell calls it a maintenance program, much like one that would control high blood pressure or diabetes.

Cancer specialists aren't altogether comfortable with this approach. Many prefer to try to kill the cancer outright, rather than a single tumor, because the cancer will almost always return. Ablation doesn't always kill every cancer cell, either, so the tumor may continue to grow.

"I don't think the experience is even out there to say how effective it's going to be in a long term in terms of survival," said Dr. Junsung C. Choi, associate professor of radiology at the H. Lee Moffitt Cancer at the University of South Florida in Tampa.

But, he added, "I think the assumption is that by treating the areas that you're seeing, you're at least slowing down or reducing the symptoms from those lesions -- knowing full well that there could certainly be other areas that are cancer."

Choi said Moffitt is considering using radio frequency ablation on liver tumors, and Dr. Gerald A. Niedzwiecki, an interventional radiologist at Mease Countryside Hospital in Clearwater, has used it to treat 20 to 30 patients with liver cancer.

His first was a breast cancer patient who developed a tumor in her liver. Chemotherapy shrank the tumor to a manageable size, then Niedzwiecki ablated it. That was about a year ago, and the patient's liver cancer appears gone.

"The criticism is that you go in and treat patients over and over again," Niedzwiecki said. "If you took 1,000 patients, and did 500 with (ablation) and 500 without, are you improving and extending life? No paper has shown this. Theoretically, it does."

When Sewell returned to China earlier this month, six months into the trial, tests showed no cell activity in the tumors he had ablated. One patient had died from metastatic brain cancer.

"Given a situation where all of a patient's cancer can be identified and located and treated, eradication of all of that cancer could be possible with RFA," Sewell wrote in a post-China report.

When Ken Rhodes was diagnosed with kidney cancer in August 1997, a surgeon quickly removed the kidney and told the Rhodeses he thought he had gotten all the cancer, but there was no way to tell for sure.

Because renal cell cancer responds poorly to chemotherapy, there was little they could do but wait.

The cancer announced itself a year later with a nagging cough that wouldn't go away. Probably bronchitis, his doctor told him at first, until the CT scans showed each lung peppered with tumors, like the spray of a shotgun blast.

He started a new treatment that stimulates the body's immune system to fight cancer, and which works on renal cell cancer 10 to 20 percent of the time. It lasts a year and demands a shot a day for six weeks at a time, with breaks of three weeks.

Within three hours of his afternoon shot, Rhodes would crumple into bed, fighting fever and chills and nausea. He kept working at Sailnet.com, a sailboat supplier, where he manages the canvas department, thanks in part to co-workers who donated their sick days to him. But the man who used to wolf down three steaks could stomach only watermelon. His weight dropped from 199 to 167.

Last November, after a year of treatment, CT scans of his lung showed virtually no change. He was advised to start thinking about hospice, and a counselor was assigned to work with his 7-year-old stepson, Chris.

Then a sister in Mississippi sent him a news clipping about Sewell's work. Rhodes' doctors had never heard of ablation, and they shipped his medical records to Jackson for Sewell and his team to examine. Sewell's nurse called soon after.

You're a candidate, she told him. Come on out.

Ken Rhodes was treated June 5. Although he doesn't quite have his old energy back, he again is robust and healthy, working on their house and attending Saturday night football. He gets regular CT scans and sends them to Sewell. And his wife worries about that nagging cough.

"I basically live CAT scan to CAT scan. That's the way it'll be for the rest of my life," Rhodes said.

He knows the cancer could outrun the treatment and spread to another part of his body where ablation or other measures won't work. His most recent CAT scan, in August, showed a speck that's probably cancer, but it's still too small to tell. If it grows, Sewell will zap it.

"Hopefully, he'll live long enough until they find an effective chemotherapy, or a cure, for his type of cancer," Sewell said. "I'm just trying to keep him alive and keep him feeling good."

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