A prototype “pen” technology aims to give cancer surgeons a better sense of whether they’ve removed all of a tumour while in the operating room.
The new approach strives to answer a patient’s question after surgeons remove a tumour: “Did you get it all?”
To say yes confidently, doctors often send a sample of the tissue in question to a pathologist to freeze, check and test under a microscope. It’s the gold standard for accuracy, but takes at least 30 minutes per sample. As the clock ticks, the patient remains under anesthesia.
Cancer surgeons estimate that in up to 20 per cent of some operations, traces of tumour remain at the margin or edges of where they’ve cut, which can lead to repeated surgeries or recurrence of cancer.
In this week’s issue of the journal Science Translational Medicine, U.S. researchers describe an experimental pen-like tool for surgeons that quickly draws samples through a tube to test for traces of cancerous tissue in the OR, with results within 10 seconds.
The technology could achieve the goals of more precise, quicker and safer surgery, said study co-author Dr. James Suliburk, chief of endocrine surgery at Baylor College of Medicine in Houston.
“It allows us in real time to test tissue from the operative field as we actually operate and ensure that we’ve resected the tumour to appropriate surgical margins,” Suliburk said.
In a series of experiments, investigators in Texas tested the pen-sized prototype tip that’s connected to a conventional mass spectrometer, which varies from the size of a laser printer to a fridge.
In validation tests on samples taken from 253 people with known lung, ovary, thyroid or breast tumours from a tissue bank, the device was 96 per cent accurate in identifying cancers, the team said.
Giant leaps forward
The researchers also used what they call the “MasSpec Pen” to reliably identify breast tumours in mice. They hope to use it in surgery on human patients early in 2018 followed by clinical trials.
“Usually we take small step forwards and along the way we take several steps back,” Suliburk said. “Because of our multidisciplinary research team … we’ve been able to take giant leaps forward with only small steps backwards. And that’s something that in modern-day medical research seldom happens.”
Suliburk envisions the technology eliminating the need to send out tissue to be analyzed under the microscope.