New Tool May Help Mesothelioma Surgeon Identify Borders

A problem for doctors who perform mesothelioma surgery is that it can be frustratingly difficult to identify the border between the tumor and the healthy cells surrounding it.

As a result, your mesothelioma surgeon may end up cutting away too much tissue around the tumor’s edges — and, in the process, cause you to lose a many healthy cells you’re going to need.

Either that, or the doctor is going to cut away too little tissue and leave behind traces of the mesothelioma tumor, which will almost surely later on start regrowing and then spreading.

To solve this dilemma, a company in Vancouver, B.C., has developed an operating-room laser system said to reveal exactly where the border lies between the mesothelioma tumor and its nondiseased neighbor cells.

Mesothelioma Detection with Raman Spectroscopy Possible

The system is currently being tested in Britain on brain cancer patients. It hasn’t yet been tried out on mesothelioma patients.

However, the company — Verisante Technology Inc. — is convinced the technology has applicability for cancer surgeries of the lungs and abdomen.

In other words, it potentially could be used against malignant pleural mesothelioma and malignant peritoneal mesothelioma.

The technology is based on Raman spectroscopy. Raman spectroscopy is an optical measurement technique that permits otherwise imperceptible differences in biological, chemical or mechanical systems to become prominent.

What gets measured in Raman spectroscopy is the inelastic scattering of visible, near-infrared, or near-ultraviolet monochromatic light when a laser is shone on a system.

When the laser strikes the system, the energy contained in the beam’s photons increases or decreases in response to the different molecular vibrations coming from within the system.

A Raman spectrograph device measures the increases and decreases in photon energy caused by the vibration variances. The precise dividing line between the parts of the system under observation can then be discerned.

In this instance, the system of observational interest is a mesothelioma tumor, its component cancerous cells, and the healthy cells right next door to it. Mesothelioma molecules naturally vibrate at one frequency, while the neighboring healthy cells vibrate at another.

The reason the two cell types vibrate differently is that each has its own mix of internal chemical bonds at the molecular level.

Putting the Cancer Detector to the Test

Verisante’s laser Raman instrument is trade-named Core. It’s a fiber optic catheter that measures 1.8 mm in diameter and is designed to be inserted through a bronchoscope’s instrument channel.

The Raman spectrum data is collected from an area of interest identified by the surgeon while looking through the optical channel of the bronchoscope.

Some time ago, Verisante tested Core to see how well it can detect early cancer. The company reports that the tool was able 96 percent of the time to spot tumor precursors known as preneoplastic lesions.

Core’s detection of cancer tumors at so early a juncture gave Verisante reason to believe the device could also be used in the operating room to help surgeons “see” where the good cells end and the tumor begins.

That belief is now undergoing trialing in the United Kingdom at Imperial College Healthcare NHS Trust. According to Verisante, this is the first-ever application of laser spectroscopy during human brain surgery.

Results of the clinical trial might not be published until next year, at the earliest.