
Harvard Scientists Create Hand-Held Device to Detect Cancer at Bedside  - px
http://www.bloomberg.com/news/2011-02-23/harvard-scientists-create-hand-held-device-to-detect-cancer-at-bedside.html
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2mur
I'm a pathologist.

    
    
      "This is superior to even the pathologists," Castro said.
    

This is a stupid statement and a ridiculous conclusion in the linked article.
Let's talk about why this is a shitty conclusion.

1\. This study was looking at protein markers on cells that were aspirated out
of stomach masses and comparing the results to the pathology report. This
thinking completely discounts the other actor in the scenario, the
gastroenterologist who is doing the aspiration by endoscopy. If you give me a
sample with cancer, I'm going to report it. However, the GI doc has to sample
it and he has to give me a decent sample to work with. If he does not biopsy
your cancer, I can't call it. I don't practice faith-based medicine. The thing
is though, I spend a not-insignificant portion of my days in procedures just
like this immediately assessing the material (looking at it under the
microscope) and can tell the GI if he is sampling the material, or if it is
enough for us to make the diagnosis. He usually knows if it is cancer before I
leave the room (and it is a lot shorter than even 60 minutes).

2\. This small device has detected a single type of cancer in pre-screened
patients, that is patients who have a reason to have this done (maybe they're
just having a little stomach pain, or maybe they've been vomiting blood and
have had a 20 pound weight loss in the past 3 months). Try screening the
general population and let me know how your device fares. It is not portable.
It required an entire endoscopy suite, expensive endoscopy equipment, and a
highly trained (multiple years of clinical fellowship) operator. You ain't
gonna pull this off in a rural village in Africa (and let's face, what's the
point of that, you don't have anything to treat it with). Plus you were
directly sampling the tumor mass with a needle. I do this all damn day! I
don't really have much problem calling cancer, or even better, telling docs
that masses are benign if someone is able to stick a needle in something. Wake
me up when you can diagnose any form of cancer by sampling tumor cells
circulating in the peripheral blood (actually we are probably closer to that
than you think!).

3\. For lesions of the stomach, aspirating the lesion is a shitty way to make
the diagnosis. Forceps biopsy is a much better way and that is the way this
type of cancer is going to be diagnosed in the vast majority of patients. So
if you are already there with your endoscopy, just get a goddamn biopsy
already.

~~~
Vivtek
_So if you are already there with your endoscopy, just get a goddamn biopsy
already._

I love it when medical professionals express themselves clearly.

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niekmaas
This is a great finding. I'm doing braincancer research myself and that's
where my main concern comes from. By reading the abstract (on a train, no time
for the full article yet) I understand they are using fineneedle aspiration to
get their samples. That would work for most easy accessible tumors but for
braintumor the human skull will be too big of a barrier. I'm still hoping for
methods where samples from the peripheral blood will be used.

Secondly I wonder what the costs willbe when antibodies for more than just one
specific tumor will be used. Now they scan for one tumor by using 4 proteins.
Scanning for more types of cancer will increase costs dramatically thought.

Nevertheless great finding and hopefully available in clinics all over the
world soon (but it usually takes an other 10 years).

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joshes
The most fascinating portion of it, to me:

"The technology is also more accurate than current diagnostic tests, the
scientists said. The portable diagnostic device achieved 96 percent accuracy,
compared with the 84 percent rate associated with more traditional assays."

Not only is it significantly smaller and much faster, it is also more
accurate. Let's hope we see this deployed to the locations where it is most
needed.

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CWuestefeld
The article mentions the cost of the device itself, but I wonder how much it
costs to administer the test. Are there any consumables that must be used? How
much do they cost?

~~~
RK
Yes, there would be consumables. You would need something like nano Fe2O3
attached to biomolecules that specifically bind to the cancer cell type you
are testing for.

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RK
I heard a talk about this technology about 4 years ago from MRI/NMR
researchers at my university working on it. The big problem is getting the
right biomolecules that will bind with the target cancer. This is apparently a
common problem in many scenarios, especially targeted therapies. Other than
that the technology sounds very interesting, as you can potentially detect a
single cancer cell in the sample.

~~~
mechanical_fish
So, as a loyal alum of a lab studying tumor vasculature, I'm contractually
obligated to tell you that, alas, once you have built a biomolecule that
sticks preferentially to cancer cells you must still deliver that molecule to
the cells. And that is hard.

It is hard because tumors have lousy blood vessel networks. Normal cells have
nicely designed blood vessels an optimum distance away. Tumors do not.

I'm not surprised that this study was for stomach cancer biopsy alternatives.
Presumably it's relatively easy to deliver antibodies to cells that are
sitting there on the lining of the stomach. And this much is a big win, no
question - nobody who has actually had an invasive gastric procedure would
fail to applaud the invention of a better alternative. But other cancers may
be harder. Plenty of work left to do.

~~~
RK
I think the hope is that with a few mL of blood you can find at least one
cancer cell floating freely and detect that one cell.

Of course by the time any cells migrate to the blood you might be at the
metastatic stage for a lot of cancers (not an expert though).

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prat
Here is the link to the paper
<http://stm.sciencemag.org/content/3/71/71ra16.full.pdf>

~~~
RK
Seems to be behind a paywall and my university only gets Science, not this
sub-journal, unfortunately...

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51Cards
With relay back to a previous thread on 'advances seen in our lifetime' it
again amazes me how fast things are moving, especially in the medical field.
And for $200 yet... brilliant. Leonard "Bones" McCoy would be proud.

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prat
just wanted to share with anyone interested in cancer.. I finished reading
this amazing book "The Emperor of All Maladies: A Biography of Cancer" Great
for anyone but specially those outside the field who want to know abt the
history of cancer.

[http://www.amazon.com/Emperor-All-Maladies-Biography-
Cancer/...](http://www.amazon.com/Emperor-All-Maladies-Biography-
Cancer/dp/1439107955)

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mkinnan
The one bit of information left out in the article is how do you get the
magnetic nanoparticles in your blood stream in the first place. I wouldn't
think they are injected directly into a vein, but maybe they are ...

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zackattack
It is one of my dreams to be involved with cancer, perhaps a medical device
startup. One of my college professors (biology of cancer) urged me to go to
med school but cancer specifically has always been very attractive to me. If I
wanted to get involved with a biotech/med device startup where would I go
about looking?

~~~
absconditus
Move to Boston and work on an advanced biology degree.

~~~
zackattack
a great suggestion and one that i should seriously consider; however my
undergraduate major was psychology and i basically minored in math, and other
than core biology and cancer i didn't take any bio courses. so i'm not sure of
the best way to pursue an advanced biology degree. any hints?

edit: possibly i could take get involved through bizdev/marketing?

