One dilemma doctors have when performing a cancer surgery is how much tissue is to be removed to ensure maximum cancer removal. The current method of frozen section biopsy takes time and effort to detect boundaries between cancerous and healthy tissues, potentially leading to unintended removal of healthy tissues. University of Texas (UT) scientists came up with an alternative: a handheld pen called “MasSpec Pen” that can detect cancerous tissue fast and accurately. The findings are described in Science Traditional Medicine.
“If you talk to cancer patients after surgery, one of the first things many will say is ‘I hope the surgeon got all the cancer out’,” said Livia Schiavinato Eberlin, UT chemistry professor and leader of the research team. “It’s just heartbreaking when that’s not the case. But our technology could vastly improve the odds that surgeons really do remove every last trace of cancer during surgery.”
Tested on 253 human tissue samples, the pen’s detection is highly accurate at 96% and it takes only 10 seconds to complete the readout. Compared that to a biopsy which takes at least 30 minutes to prepare the sample and have a pathologist to study it. Having to wait that long elevates certain risks during the operation, like infection and the anesthesia’s negative effects. Also, the pathologist’s interpretation could be inaccurate sometimes, with 10 to 20% cases having unreliable results. Tested on live, tumor-bearing mice, the pen also detected presence of cancer. Moreover, it did not cause any harm or stress to the animals during surgery.
Using the MasSpec Pen is simple. The pen drops water into the tissue; the water absorbs proteins, lipids and metabolites (byproducts of metabolism) from the site; the pen then feeds the water into a mass spectrometer (hence the “MasSpec” name). This instrument has the ability to sort and analyze the tainted water to come up with the profile of all the absorbed molecules; it will simply flash the result as “Normal” or “Cancer”. The test can go even further in certain cases: the subtype of lung cancer can be detected, and thyroid cancer can be predicted if malignant or benign.
“Cancer cells have dysregulated metabolism as they’re growing out of control,” Eberlin said. “Because the metabolites in cancer and normal cells are so different, we extract and analyze them with the MasSpec Pen to obtain a molecular fingerprint of the tissue. What is incredible is that through this simple and gentle chemical process, the MasSpec Pen rapidly provides diagnostic molecular information without causing tissue damage.”
Doctors and patients should aim for maximum cancer removal but care must be taken not to remove too many healthy tissues as this can lead to profound negative consequences. For instance, in brain cancer patients, there will be pain and nerve damage on top of the aesthetic impacts. For thyroid cancer patients, it could lead to loss of speech or ability to regulate the body’s calcium levels. The pen prevents these things from happening as it can define the boundaries between healthy and cancerous tissues.
“Anytime we can offer the patient a more precise surgery, a quicker surgery or a safer surgery, that’s something we want to do,” said James Suliburk of Baylor College of Medicine, a project collaborator. “This technology does all three. It allows us to be much more precise in what tissue we remove and what we leave behind.”
Scientists expect the state-of-the-art diagnosis to be used in 2018 in cancer surgeries. They are waiting approval and patents have already been filed for this technology.