Neurosurgeons Use MRI-Guided Lasers To Destroy Tumors 70
breadboy21 writes "In the seemingly perpetual battle to rid this planet of cancer, a team of neurosurgeons from Washington University are using a new MRI-guided high-intensity laser probe to 'cook' brain tumors that would otherwise be completely inoperable. According to Dr. Eric C. Leuthardt, this procedure 'offers hope to certain patients who had few or no options before,' with the laser baking the cancer cells deep within the brain while leaving the good tissue around it unmarred. The best part, however, is that this is already moving beyond the laboratory, with a pair of doctors at Barnes-Jewish Hospital using it successfully on a patient last month. Regrettably, just three hospitals at the moment are equipped with the Monteris AutoLITT device, but if we know anything about anything related to lasers, it'll be everywhere in no time flat."
Damn (Score:3, Funny)
They totally misread the request by the Dr. Evil, he asked for sharks with lasers ON their heads, not humans with lasers IN their heads.
These scientists, always get some mundane detail like that wrong and totally spoil the scheme.
--
OTOH this is freaking cool. How do they get the lasers only to burn the cancer cells and not burn tissue on the way to the cancer cells?
Re: (Score:2)
By focusing the light on the tumor.
Re: (Score:2)
If the nucleus of the cancer cell is black, then one can preferentially toast them like the balloon demos.
For lack of a better name, a liquid cover slip with an index of 1.533 to match cytoplasm would allow one to light things up without tiny lenses distorting the beam.
Maybe someone with good Google-fu can find the images of HeLa on a slide, cervical cancer with a surface like stucco, and a cervix that is gray with cancer that show the effect.
Re: (Score:3, Informative)
How do they get the lasers only to burn the cancer cells and not burn tissue on the way to the cancer cells?
It's not an external laser, it's a probe emits the laser beam from one side. So you still need to stick the probe into the brain until you get to the parts you want to light up.
Re: (Score:1)
When you look around from inside, everything looks like a tumor!
Re: (Score:3, Funny)
Re: (Score:2)
It's just a sign of how much technology has advanced.
The doctors have made the sharks obsolete.
Re: (Score:2)
They totally misread the request by the Dr. Evil, he asked for sharks with lasers ON their heads, not humans with lasers IN their heads.
But this would totally explain the "Why don't sharks get cancer?" meme that was going around [google.com] a few years back.
Re: (Score:1)
How do they get the lasers only to burn the cancer cells and not burn tissue on the way to the cancer cells?
Magic.
Re: (Score:2)
Or by using multiple lasers at lower intensities- so tumors will only burn where the beams cross.
Re: (Score:2)
I've got to agree with you on leaving the metal in there.
I've got a shunt in my skull that pumps the spinal fluid down into my abdominal cavity. (One of the joys of spina bifida.) As a consequence, I have plenty of plastic tubing in my head that's no longer attached to anything useful. It's just floating there. And the reason is simple: It's a lot safer to just leave it in there than it is to go in and get it.
Seemingly perpetual battle? (Score:2, Funny)
You're right... this pointless war has gone on too long, let's just legalize cancer and be done with it.
Re: (Score:1, Redundant)
Meanwhile (Score:3, Informative)
It's a good thing that great advances are being made in very specialized areas of medicine. Meanwhile, the leading killer world-wide is still heart disease which receives disproportionately inadequate funding despite recent progress in PTCA stenting, etc. Machines like this may grab funding dollars and headlines, but they don't save very many lives.
Re:Meanwhile (Score:5, Insightful)
Re:Meanwhile (Score:4, Insightful)
Many heart problems can be solved through prevention; sadly, the same cannot be said for many neurological conditions.
That's right. Just stop the smoking, drinking heavily, stop the junk food and get out and get some moderate exercise would prevent many if not most of the heart disease (and stroke) in the World. Not smoking would also prevent a lot of impotence too. It would be much more cost effective to spend a fraction of the money on education than whiz bang, usually obscenely expensive, gadgetry.
Re: (Score:2)
Just stop the smoking, drinking heavily, stop the junk food and get out and get some moderate exercise would prevent many if not most of the heart disease (and stroke) in the World.
The absolutely sure way to die of boredom in an "extremely healthy" condition.
Re: (Score:1)
Re: (Score:2)
Thank you for wishing me "Good riddance", anyway.
Re: (Score:2)
Many heart problems can be solved through prevention; sadly, the same cannot be said for many neurological conditions.
That's right. Just stop the smoking, drinking heavily, stop the junk food and get out and get some moderate exercise would prevent many if not most of the heart disease (and stroke) in the World. Not smoking would also prevent a lot of impotence too. It would be much more cost effective to spend a fraction of the money on education than whiz bang, usually obscenely expensive, gadgetry.
We already do spend money on "education" in all those areas - we still smoke, eat junk food, and laze around all day because we like things tht are enjoyable and not so much the things that will benefit us
Re: (Score:1)
Thank you. As someone who suffers from a hereditary neurological condition, ... I have little sympathy for folks who can avoid their conditions by eating healthy and exercising.
How about sterilization?
Re: (Score:1)
Many heart problems can be solved through prevention; sadly, the same cannot be said for many neurological conditions.
I just reduce my brain usage. Not a huge loss.
Re:Meanwhile (Score:4, Insightful)
Yes, coronary disease is a big problem and yes it's the major killer in the US [cdc.gov] but it isn't the major killer worldwide [who.int], just in developed nations. You'll notice on the first link that cancer is still way up on causes of death in the US and, despite your claims to the contrary, I can assure that now in my second year of medical school that coronary syndromes are a major focus in medical education and research.
The work these scientists did is certainly not the first implementation of this idea but it's quite worth the investment. Stenting is not a miracle cure and likely wont ever be; it's just delaying the inevitable. The only powerful approach to reducing heart related deaths is prevention and education; even then, most deaths due to 'old age' are written up as heart related deaths so they'll keep going up as we get better at fighting the world's real number one killer: simple infections.
Then again, I'm an idiot ......
Re:Meanwhile (Score:5, Informative)
but it isn't the major killer worldwide,
Yeah, that's why in the very last paragraph of the linked page you provided it's listed as the #1 killer worldwide.
As a second year med student please take some advice from this attending physician: while there are certain ways in which the data is sliced demographically that ends up presenting other pathologies as number one, the overall aggregate data clearly states that heart disease is #1 worldwide with 7.2 million cases per year. Right there at the bottom of the page where it says "World". Picking and choosing data is an error that is committed very often nowadays - people try to create "meta-analyses" that demonstrate their pet theory but conveniently leave out all the studies that fail to support their theories. This is bad science. Don't do it. Either look at all of the data, or make sure that have have the right tools to evaluate your special subset of data in the context of the big picture.
I agree that stenting is a stop-gap at best, and long term patient compliance with CAD medications will always be a challenge. The future, as you say, lies in prevention and raising awareness of the real causes of CAD: Smoking, sedentarism/obesity, diet and lastly genetics.
Good luck in your studies.
Re: (Score:1)
I suppose one could argue that the only reason that heart disease is above cancer on the list is because we are 'curing' cancer in enough people now that their hearts are giving out before cancer rears its ugly head again. I have no number in front of me so that is just speculation.
To build upon the post above mine, something has to kill us or rather something has to wear out. I imagine that if treating cancer becomes a semi-trivial procedure and people start taking better care of their hearts then all the
Re: (Score:2, Insightful)
How many of those deaths are preventable by proper diet and exercise?
Now how many brain tumors are preventable with proper diet and exercise?
Re: (Score:1)
It's great that you make bold statements like this. However, my inclination is to disbelieve you unless you provide some verifiable facts.
Re: (Score:1)
Actually, the leading world wide killer is malnutrition.
Re: (Score:2)
Strictly speaking, it's coronary artery disease that's the problem, not heart disease, isn' t it?
We've been able to replace ailing hearts for some time now. Obviously, there are supply-side problems, but there are absolutely people working on that by using stem cells to generate new organs.
Write your own damn summaries... (Score:2)
Here the summary is a verbatim copy of TFA.
This is not cool.
Re:Write your own damn summaries... (Score:4, Funny)
a better article (Score:5, Informative)
this text is better [wustl.edu] in that it explains that first, a hole is drilled in the scull, then MRI is used to image the brain and these images help to insert a probe that's similar to a pencil in shape into the tumor through the brain, so it looks like this will go through other brain tissue first, and then this device discharges what basically amounts to heat and cooks the tumor.
Re:a better article (Score:5, Informative)
It is a better article, mostly because it doesn't have the gushing enthusiasm of the Endgaget story (Technology nyphomaniac: Never met a technology I didn't immediately fall in love with.)
I used to write about medical lasers for a few years, and I learned one important lesson:
Don't believe it until they have a randomized, controlled trial that shows patients who get the laser treatment actually do better than the patients who don't. (It doesn't do any good to remove a tumor if the tumor comes back right away.) A lot of laser treatments didn't look too good after the controlled trials.
(It is true that there are some procedures that are so rare that they can't do a randomized controlled trial.)
This system looks like it might be useful in certain not-too-common situations where you can't reach the tumor with anything else. It's like, when you're working on a car, having an offset screwdriver that can reach a blind screw that's hard to reach any other way. It's FDA approved for brain surgery so it passed some kind of review.
There are other ways of doing it. Notice that WUSL also offers a gamma knife http://plexus.wustl.edu/surgery/neuro/website.nsf/WV/23077ADDD22341B28625729F00713CFC [wustl.edu] which focuses 201 radiation sources on a small spherical target. Brain surgeons are clever.
A lot of times, a $50 cautery can do just as good a job as a $100,000 laser.
This isn't rocket science.
The fundamental problem is, sadly, those cancers they mentioned are inevitably fatal, within 6 months to a few years. The main purpose of surgery is to make your last few years more comfortable, like when they remove a tumor that's near the optic nerve threatening to make you blind. There are some benign brain tumors that can be cured, though. "Benign" is a relative term when something's growing in your brain. You want to get it out.
Re: (Score:2)
It "isn't rocket science", but it "is like brain surgery". In fact, it is brain surgery. The two idioms, BTW, are nearly synonymous.
Re: (Score:2)
You forgot the last step where you realise it's intentional.
Re: (Score:2)
I always thought brain surgery was pretty easy.
Re: (Score:2, Funny)
Re: (Score:2)
Yes, but it isn't rocket surgery you know :-)
Re: (Score:1)
...This isn't rocket science....
Nope, it is brain surgery.
...This system looks like it might be useful in certain not-too-common situations where you can't reach the tumor with anything else. It's like, when you're working on a car, having an offset screwdriver that can reach a blind screw that's hard to reach any other way.... sadly, those cancers they mentioned are inevitably fatal, within 6 months to a few years....
I am one of these "not-too-common situations".
Thanks for the write-up, but I am not sure I feel a lot better now.
I have had a biopsy so I already have an extra hole in my head. My tumor interfeers with the muscles of my right eye. My tumor is in my mid-brain. My lungs or heart will likely stop getting signals from my brain at some point. I will likely suffocate or drown despite not being in water or having any damage to my lungs or breathing muscles.
I must admit it is frustrat
Re: (Score:2)
I must admit it is frustrating to see this kind of potential treatment stagger through clinical trials when people like me have little to nothing to lose. I have 3 young children so I actually have reason to try and prolong the inevitable.
Read the program description again. This device is FDA-approved. If it would benefit your condition, and you could afford it, you could go to WUSL for treatment. http://plexus.wustl.edu/surgery/neuro/website.nsf/WV/0800D693FDE25183862577A60063101C?OpenDocument [wustl.edu]
This would be appropriate for a tumor that can't be removed by any other method, and that can be removed by this device.
Re: (Score:2)
Well that seems kind of stupid compared to gamma knife [wikipedia.org] treatment.
Re: (Score:3, Informative)
this text is better [wustl.edu] in that it explains that first, a hole is drilled in the scull, then MRI is used to image the brain and these images help to insert a probe that's similar to a pencil in shape into the tumor through the brain, so it looks like this will go through other brain tissue first, and then this device discharges what basically amounts to heat and cooks the tumor.
The same is already done in the clinic using an RF probe to induce localized heating. Gamma knives (see the plethora of other comments) do the same by concentrated radiation damage, although the MRI is done beforehand (and a CT ... I once asked a neurosurgeon I work with why use both, and he replied that neither method is as accurate as one might hope, so they combine techniques to reduce measurement errors).
has been around for a bit (Score:4, Informative)
There've been experimental uses of this kind of thing since the 1990s. The AutoLITT system mentioned in this mini-article, and Visualase [visualaseinc.com] are two commercial systems. There've been some preliminary clinical trials [clinicaltrials.gov] as well.
Gamma Knife (Score:1, Offtopic)
Unfortunately, we're seeing an advance in health care just in time for it to be taken over.
Re: (Score:3, Informative)
Re: (Score:3, Insightful)
Actually it does have a lot of similarities - they use MRI imaging to figure out which parts of the brain to fry, then use a fairly localized beam of Something Evil (gamma rays in
Re: (Score:2, Informative)
The majority of people who get cancer are already 40+, past the age where they would be having new children. Unless you plan to kill the children of people who get cancer, keeping treatment from the patients will make any difference.
Re:So, let me get this straight (Score:4, Insightful)
Sir, your opinion is both ugly and wrong.
Cancer is not a simple disease caused by a damage of a single gene. There are too many genes that can, under "proper" circumstances, cause or promote cancer. In most cases, this is not a type of one genetic damage but a complex structure of various events, some of them external. Even with the hardest eugenics, you won't be able to eradicate, or even limit, this type of disease; in fact, you will probably end with the contrary. The risk of malignant growth is too intertwined with the very basical functioning of cells themselves; there is always a need for creation of new cells, and always there is a risk of a runaway loop.
Secondly, if a young person is diagnosed with a type of cancer that is known to be hereditary, he or she is informed by the doctor and probably will decide either not to try having his/her own children, or take special care to minimize the risks.
Re: (Score:2)
That mentality is a slippery slope. Do you believe in sterilization of mentally challenged people? How about sterilization of dumb people, which I might add was still done in North America up until the 70s? How about government efforts to promote the dissemination of DNA in those individuals deemed "stronger"? Take these ideas further and you end up with the Holocaust.
Re: (Score:3, Interesting)
Vitamin D deficiency, toxins, junk food, memetics (Score:3, Insightful)
There is no doubt a genetic component to cancer but you can't jump from there to the kind of social processes you are implyimg without considering a lot of issues (including how our genes related to compassion towards each other may let us survive as a collective when individually we would all die).
As an example of that, here are two links to two compassionate people, Dr John Cannell and Dr. Joel Fuhrman, with advice that, used together, may prevent most cancers and even treat a few (by boosting the body's
'Baking' brain cells? (Score:2)
Sounds like high school. Ridgemont High, to be specific.
Right... (Score:1)
No time like the present (Score:1)
...but if we know anything about anything related to lasers, it'll be everywhere in no time flat....
Good because I am already 29 months into a 12 month prognosis. My need was in 2008 like many others.
sniff sniff (Score:2)
this smells more like an add than an article.
more standard treatment is .. (Score:2)
So what's left after surgery (and I'll guess, even with this laser thing) is a smaller tumor, which gets killed through radiation therapy (first/mostly) and also by chemotherapy. With brain tumors, the chemoth