EUROPE: British hospital is the first to use lasers to identify cancerous tissue during surgery to remove a brain tumour.
- First time in Europe that the procedure carried out.
- Measuring the light reflected from it, doctors could work out how much tissue to remove.
- Medical practitioners hope the new technique could help the accuracy of some of the most delicate types of surgery.
According to Neurosurgeon Babar Vaqas, the trial chief investigator, “Optical technologies like this are the future. They are fast and don’t destroy any tissue and could be used during many types of cancer surgery or when dealing with infection like a brain abscess.”
A near-infrared laser probe is used to point the beam of light on to the exposed brain, causing the molecules in the cells to vibrate. Fibre optics collect the scattered light that reflects from the tissue, using a device which measures the frequency of vibrations. As a result, doctors are able to distinguish between healthy and unhealthy tissue, in a procedure that takes just a couple of seconds, and is entirely non-invasive.
The patient, Reuben Hill, 22, is making a good recovery after the operation at Charing Cross Hospital, part of Imperial College Healthcare NHS Trust.
Kevin O’Neill, head of neurosurgery at Imperial said the combination of new technologies would revolutionize brain surgery. “This is bringing the laboratory into theatre, giving a real-time molecular fingerprint of tissue,” he said. “The potential is amazing, not just to differentiate between normal brain and tumour, but whether the patient is likely to respond to specific treatments”.
The research at Imperial College is part-funded by the charity Brain Tumour Research.
Chief executive Sue Farrington Smith said: “Advances in brain tumour surgery such as this are very exciting and give hope to the thousands of patients and their families diagnosed with a brain tumour each year.”
A brain tumor or intracranial neoplasm occurs when abnormal cells form within the brain. There are two main types of tumors: malignant or cancerous tumors and benign tumors. Cancerous tumors can be divided into primary tumors that start within the brain, and secondary tumors that have spread from somewhere else, known as brain metastasis tumors. This article deals mainly with tumors that start within the brain. All types of brain tumors may produce symptoms that vary depending on the part of the brain involved. These may include headaches, seizures, problem with vision, vomiting, and mental changes. The headache is classically worst in the morning and goes away with vomiting. More specific problems may include difficulty in walking, speaking and with sensation. As the disease progresses unconsciousness may occur.
The cause of most brain tumors is unknown. Risk factors that may occasionally be involved include a number of inherited conditions known as neurofibromatosis as well as exposure to the industrial chemical vinyl chloride, the Epstein-Barr virus, andionizing radiation. While concern has been raised about mobile phone use, the evidence is not clear. The most common types of primary tumors in adults are: meningiomas (usually benign), and astrocytomas such as glioblastomas. In children, the most common type is a malignant medulloblastoma. Diagnosis is usually by medical examination along with computed tomographyor magnetic resonance imaging. This is then often confirmed by a biopsy. Based on the findings, the tumors are divided intodifferent grades of severity.
Treatment may include some combination of surgery, radiation therapy and chemotherapy. Anticonvulsants medication may be needed if seizures occur. Dexamethasone and furosemide may be used to decrease swelling around the tumor. Some tumors grow gradually, requiring only monitoring and possibly needing no further intervention. Treatments that use a person’s immune system are being studied. Outcome varies considerably depending on the type of tumor and how far it has spread at diagnosis. Glioblastomas usually have poor outcomes while meningiomas usually have good outcomes. The average five-year survival ratefor brain cancer in the United States is 33%.
Secondary or metastatic brain tumors are more common than primary brain tumors, with about half of metastases coming fromlung cancer. Primary brain tumors occur in around 250,000 people a year globally, making up less than 2% of cancers. In children younger than 15, brain tumors are second only to acute lymphoblastic leukemia as a cause of cancer. In Australia the average economic cost of a case of brain cancer is $1.9 million, the greatest of any type of cancer.IMAGE/Alamy