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Shedding Light on Cancer


 

WEDNESDAY, July 5 (HealthSCOUT) -- When your doctor says cancer, the next word he often says is biopsy -- cutting away a bit of the suspect tissue to have a lab analyze it.

But in the future, there may be a way to make the same diagnosis without a painful biopsy. In tomorrow's issue of Nature, researchers at the Massachusetts Institute of Technology describe an experimental technique that uses light to detect pre-cancerous and early cancerous cell changes.

Senior investigator Michael Feld, the director of MIT's George R. Harrison Spectroscopy Laboratory in Cambridge, Mass., led the first tests of the technique, called light scattering spectroscopy (LSS).

As cells go through pre-cancerous changes, their nuclei become swollen and crowded together, and in a stain test, they look abnormally dark. LSS looks for these changes by analyzing the light produced when white light passes through epithelial cells -- those lining the inner surface of the body's organs. More than 85 percent of all cancers start in epithelial cells.

Patients having routine tests for pre-cancerous cells in the mouth, esophagus, colon and bladder were signed up for the trial, and during their examination an optical fiber probe was threaded through a flexible tube and placed gently against the tissue in question. Using a foot pedal, a physician activated the light on the optical probe to take the reading, providing a particular series of wave patterns on a monitor that the researchers could analyze and translate into real terms.

A normal biopsy was then taken of the same tissue. It provided pathologists with the conventional way to examine cells, but it also gave Feld and his team a way to compare their findings against the diagnostic gold standard. They found that the LSS readings were almost identical to what could be found with a standard biopsy.

Dr. Charles Boone, formerly the program director of the National Cancer Institute in Bethesda, Md., is familiar with Feld's work. "By analyzing the reflected light, it can determine whether it is normal or cancerous -- or even better, pre-cancerous," says Boone. "This technology diagnoses cancerous change before you can see it under a conventional microscope."

According to Feld, LSS has the potential to replace biopsy in the future, but in the short term it's more likely that it will guide conventional biopsy forceps to pre-cancerous lesions that aren't visible to the naked eye.

"The colon, for example -- the area is so huge, and you can only biopsy a small number of samples, that your sampling error could be very large. You could miss [pre-cancerous cells]," says Feld. "If this could be used as a guide to biopsy, then it would reduce the randomness in ordinary biopsy."

Doctors might also diagnose cancer immediately, saving money and cutting the time it takes to start treatment. Boone points out that this technique could be used to test the edges of an incision around known cancerous cells, to make sure that all of the cancer is cut away.

What To Do

The optical probe technique could be available within two years, but creating software that provides information on nucleus size and the dark color the cells stain will take longer, says Feld. He also points out that larger trials are needed to confirm these results.

Check out the MIT Web site to see a slide of a pre-cancerous colon cell.

The American Cancer Society provides this information on biopsies, while the National Cancer Institute provides answers about many other types of cancer-related diagnostic tests.


  (From HealthSCOUT)

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