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New Technology May Help Surgeons Remove Tumors From Pets and People

The April 25, 2009 Economist's science and technology section contained an article that discussed a promising technique to aid in treating cancers in all species....

Dr. Eric Barchas  |  May 9th 2009


The April 25, 2009 Economist’s science and technology section contained an article that discussed a promising technique to aid in treating cancers in all species.

A DIAGNOSIS of cancer is often followed by a prescription of surgery. Before chemotherapy, before radiation, the knife is frequently the oncologists first line of attack. If done early and well, it has the potential to stop the disease in its tracks. Even if it does not, it is the best way for the doctor to get a feel for what he is dealing with, how extensive it is, and what to do next. But, whereas therapies and diagnostics for cancer have been evolving steadily in response to new biochemical knowledge, surgical techniques have remained surprisingly primitive.

What happens at the moment is that a surgeon roots around inside a patient, removes as much tumour as he can find, and hopes he got it all. He then sends what he has excised to a laboratory, where pathologists sample all around the outside of the extracted mass to see if it is encapsulated by healthy tissue. If it is, the whole tumour has probably been removed. If not, the surgeon must go back in, and the time-consuming process starts again.

Roger Tsien and his colleagues at the University of California, San Diego (UCSD), are trying to halt this cycle by creating a luminous map for the surgeon to follow. Dr Tsien, who shared the 2008 Nobel prize in chemistry for his work on green fluorescent protein, has found a way to make cancer cells glow. That could help surgeons see precisely what to cut out and what to leave behind.

Tumor removal surgery definitely can be harrowing business. The mainstay of tumor excision is obtaining “wide margins”. This means that the capsule of healthy tissue surrounding the tumor should be as large as possible. But tumor tissue can only be definitively diffentiated from normal tissue when it is examined under a microscope.

The technique detailed in the Economist will do nothing to address the need for microscopic evaluation to definitively determine tumor margins. However, it definitely is a step in the right direction.