Smart Knife Helps Surgeons Cut Cancer
Cancer is one slippery SOB. It can appear mysteriously, then hang out, thrive, and grow for ages without being spotted. When it is detected, cancer is often unpredictable: It can be fatal, it can be harmless. When under attack, it doesn’t easily fall. Radiation, chemotherapy, and other drugs might curb its spread or substantially shrink it, but they rarely wipe it out. Even under the swift and steady surgeon’s knife, bits of cancer manage to escape.
Take breast cancer. Nearly 700,000 women are diagnosed with it every year in the United States and Europe. About half undergo breast conserving surgery, in which surgeons attempt to excise the tumor while preserving as much healthy tissue as possible. The procedure is tougher than it sounds. Surgeons rely on images of the tumor to guide their cuts, but often have trouble determining its precise borders while the patient is on the table. If they’re not sure whether a piece of tissue is cancerous, they can snip it out and send it to a nearby laboratory for analysis. Then they wait, anywhere from 20 minutes to an hour, all while the patient is still under anesthesia, to get the results. It’s no wonder that even the best surgeons can miss part of the tumor; an estimated 20 percent of women who go through the surgery end up repeating it.
Those numbers may improve thanks to a new surgical tool called the iKnife (i for intelligent). As described in today’s issue of Science Translational Medicine, the tool does sophisticated chemical fingerprinting to help surgeons identify — in real time, right there in the operating room — whether tissue is cancerous or healthy.
“With our technology, identification takes a second — actually, 0.7 seconds,” says Zoltán Takáts, an analytical chemist at Imperial College London who invented the new tool. “One can sample thousands of points during a surgical intervention and it still wouldn’t increase the length of the surgery.”
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