
Researchers use lasers to detect and destroy tumor cells in melanoma patients - headalgorithm
https://spectrum.ieee.org/the-human-os/biomedical/diagnostics/laser-destroys-cancer-cells-circulating-in-the-blood
======
ThomPete
I've had two melanomas luckily early stage, I will likely get more so I am
being checked 4-6 times a year plus doing molesafe.

I'm at Sloan Memorial because I have more than a thousand moles. One thing we
are using laser for is called Confocal wich basically allow them to see my
cells live without having to do a biopsy.

One of the two melanomas was found that way.

I am always hopeful about new advances but I have learned that this is a long
game and hopefully I am around long enough to reap the benefits if it goes
seriusly wrong.

~~~
JungleGymSam
Yes, this is exciting news. I've had melanoma once and one incident of basal
cell. I get checked regularly and had three of four biopsies in the third and
fourth stages of progression towards melanoma.

Wonder why none of the doctors I've visited have mentioned Molesafe? I'll
check it out when I get home.

edit: Because Molesafe is NY/NJ only.

~~~
Shihan
Dysplastic Naevus Syndrome? There is a bunch of doctors/researchers who are
telling that there isn't such a thing as dysplatic naevus. Well, of course you
have that special looking mole, but the term "dysplatic" is misleading and
also the concept that there is a development of moles from benign to
cancerous. A mole was either always a melanoma (or a melanoma inside a mole)
or it was and is a normal mole (and will be one).

~~~
JungleGymSam
I hope I can remember to ask my Dr. about this next time I go in.

------
cwkoss
It seems surprising that the laser has such selective activity on CTCs versus
healthy cells. Why are these cells so much more absorbtive? Is this specific
to melanoma CTCs (more pigment)?

I also wonder how they did this measurement. Seems like you'd need to take
pre- and post-laser measurements of healthy and CTC counts in the bloodstream
to have high confidence that it is disproportionately damaging CTCs. To what
extent does this damage healthy cells?

~~~
nvusuvu
Head researcher in 2003 pioneered the use of laser-induced vapor nanobubbles
around overheated plasmonic nanoparticle clusters to kill single tumor cells
without harming neighboring normal cells.

[https://news.uams.edu/2017/06/08/uams-researchers-kill-
cance...](https://news.uams.edu/2017/06/08/uams-researchers-kill-cancer-cells-
using-nanobubble-spaser-as-the-worlds-smallest-laser/)

~~~
codesnik
Wow. That sounded like something from a comic book.

~~~
JulianMorrison
Make it so, Geordi.

------
killjoywashere
The title should be updated to read "circulating tumor cells". Major biologic
difference.

------
drenvuk
I'm not sure if this is silly or not but why is it not possible to target
cancer cells with a bunch of weak lasers distributed around a person pointing
at the same location in 3d space and just selectively zapping them? We have
real time MRIs and CT scans. Can't we just lie people with cancer down daily
and shoot them with incredibly precise beams of light to cook the cancer cells
alive? Maybe just cauterizing the blood pathways that are feeding tumors in
the first place?

I'm seriously hoping someone can tell me why this idea is stupid.

~~~
sxg
It's not stupid, and we already do this. There are many different forms of
radiation therapy
([https://en.wikipedia.org/wiki/Radiation_therapy](https://en.wikipedia.org/wiki/Radiation_therapy)),
and they're commonly used in breast and brain cancers.

~~~
wizardforhire
Totally!

Also for whomever else reading this thread, I’ve been privy to quite a few
medical tech startups and let me please share, it’s much simpler than one
might imagine to create new medical tech. It’s a remarkably underserved area,
the requirements are not quite as hard to get through as it would seem from
first glance and I’ve been appalled at many of the systems that are in current
use at many hospitals. We’re talking Stone Age level in a lot of ways! If
you’re humble, willing to go in and actually listen to the doctors and nurses
to identify the real problems and willing to create robust solutions it’s
practically the Wild West of opportunities.

~~~
derefr
What I've always wondered is: how many medical "$100 bills laying on the
street" are there to pick up, if you don't care about the need to
commercialize (and thus go through FDA rigamarole for) a therapeutic approach,
but just want to improve _your own_ health, or the health of someone you love,
as a one-off?

For pharmaceuticals specifically this is what people call "nootropics"—but
there's so much to medicine _other_ than searching for new chemicals to put
into people's bodies.

I've got to assume that, for example, there's just as many things a clever
hardware hacker could do to with e.g. masers or ultrasound or electrolysis or
ferromagnetic nanoparticles, to influence the course of a disease; or things a
clever biochemist could do by, say, encapsulating existing drugs (or even
ordinary non-drug substances) in novel delivery vehicles like cyclodextrin
molecules or gel matrices.

What medical miracles have been performed once, on a rat in a university
research center somewhere, but have never even attempted commercialization?

~~~
wizardforhire
Spent the last few hours trying to track down this book to no avail but short
answer: you’re spot on!

Off the cuff in line with your thinking that’s been a life saver for me over
the last 20 years... super glue. Locktite gel blue resealable squeeze bottle.
Have saved myself at least a dozen trips to the hospital for stitches with
this stuff with only one complication last time due to my negligence. Take-
away: yes wounds can actually go septic if you don’t properly clean them prior
to dressing and yes wounds need to breathe and be dry to heal.

On the pharmaceutical side I can’t speak too much to, but I’m firmly convinced
after 15 years of personal experimenting that diet (real food, not too much,
mostly blah blah blah) and stress management via lifestyle design are the
miracles we read about. Add to that mild physical activity, drinking lots of
water, good sleep, good mental & physical hygiene and it’s practically a
wonder drug.

------
ricardobeat
Could this be made a lot more efficient by combining with dialysis, i.e.
targeting the cells in a dedicated blood-pumping machine with more surface
area, no skin layer and less worries about collateral damage?

~~~
reubens
The beauty of it is that no blood need be removed. That is a huge improvement
in terms of patient experience.

------
apo
The problem with fighting cancer is selectively destroying cancer cells while
leaving normal cells alone. This article unfortunately says nothing about how
this device does so (or even whether it does).

Without some handle on this aspect, side effects (some of which might show up
much later) could be a major problem with this treatment.

No time to plow through the original paper - does anyone know?

~~~
doctoboggan
Yes, the linked article addresses exactly that:

The laser, beamed at a vein, sends energy to the bloodstream, creating heat.
Melanoma CTCs absorb more of this energy than normal cells, causing them to
heat up quickly and expand.

This thermal expansion produces sound waves, known as the photoacoustic
effect, and can be recorded by a small ultrasound transducer placed over the
skin near the laser. The recordings indicate when a CTC is passing in the
bloodstream.

The same laser can also be used to destroy the CTCs in real time. Heat from
the laser causes vapor bubbles to form on the tumor cells. The bubbles expand
and collapse, interacting with the cell and mechanically destroying it.

------
nn3
And? Won't the migrating cells just keep coming unless you target the original
cancer too? It seems like a very temporary improvement at best.

Missing part of the idea here.

~~~
asdff
No one gets their cancer cured, just hopefully into remission. No matter the
therapy there will always be a few cancer cell populations that evade
treatment. This is why cancer patients are monitored for life.

------
LinuxBender
When will this be generally available everywhere?

------
maxander
An old XKCD is, as usual, highly relevant:
[https://xkcd.com/1217/](https://xkcd.com/1217/)

Granted, this is actually a trial in humans, so that's good! But if you look
at the study, the focus is on detecting circulating cancer cells; attempting
to use the technology to destroy them is relegated to one paragraph near the
end. There they note that this seemed to happen by accident, to a limited
degree, in 6 out of the 18 patients; so they tried again in a single patient,
whose melanoma cell melanin content was particularly favorable for this
process, and it again seemed to work ("up to a 48-fold reduction" in
circulating melanoma cells.)

They went on to do in vitro tests to try and show it would work in general,
aiming the laser at a test tube full of blood; this worked, which is
encouraging, but it shouldn't be taken as a strong indicator of anything
practical. (And even there, they note that the melanin content of the tumor
cells is important to the treatment's effectiveness.)

And yes, it's only targeting circulating melanoma cells. This tech can't just
aim a laser at a tumor and kill it; it probably isn't useful for non-solid
cancers like leukemia, either. So while this is cool and interesting, it's not
a huge breakthrough in cancer treatment.

~~~
arkades
The XKCD is spot-on here.

> “In one patient, we destroyed 96 percent of the tumor cells” that crossed
> the laser beam, says Zharov.

Just want to clarify: tumors will generally drop hundreds of thousands to
millions of cells into the blood stream on a daily basis. Most of the
circulating tumor cells are already unlikely to become mets at baseline, and
by the time you've found a tumor you've already seeded these cells in a number
of locations throughout the body. This seeding usually occurs long before we
can detect the primary tumor. We get "metastasis" when a number of other
factors come into play that allow a particular CTC / bundle of CTCs to start
growing into a met. For those interested, R. Weinberg's text on cancer is
pretty much _the_ authority, and he discusses this at length.

As it exists, as a therapy, it's for catching some of the horses that are
making it out of the barn - after the doors have been open for a while.

To be useful as a therapy, we'd need something that can be worn 24/7 - if I
catch a tumor that needs to be excised, I'd put it on your arm, and use it to
deplete the circulating population to reduce the likelihood of metastasis
happening in the period between detection and excision. And I'd need an RCT to
show me that this is actually going to result in a reduction of metastasis,
since there's every likelihood that the eventual met won't come from the CTCs
seeded in the period between detection and excision.

Don't get me wrong; I'm happy to see more ways to detect and kill tumor cells.
But this is still many steps away from becoming a technology with clinical
application. At this stage, its relationship to useful cancer therapy is the
relationship between my laser pointer from ten years ago and a sci-fi laser
pistol.

What this _is_ cool as, is as a mechanism for helping _detect_ cancers. I'm
all for having something I can slap on your arm and let me know if you've got
melanoma brewing, rather than having a dermatologist manually inspect all your
crevices for an overlooked mole.

------
tombert
These things never fail to get the same reaction from me: I get immediately
excited, thinking that we've cured cancer, and then a bit depressed because
this thing is probably a really long way away.

I don't work in the medical industry, but to those that do, do these headlines
irritate you?

~~~
throwaway5752
Usually the big advances are built on a number of small incremental advances.
Think about modern immunotherapy like CAR-T. Rather than recap myself I'm just
going to post this timeline of the milestones that led to CAR-T over many
decades: [https://www.mskcc.org/timeline/car-t-timeline-
progress](https://www.mskcc.org/timeline/car-t-timeline-progress).

You'll generally be disappointed, though. "Cancer" isn't really a thing. It is
a family of disorders characterized by several properties that arises from
different causes. At this point in my life, I am very confident that we will
never have a single general cure for cancer (killing mutated cells, repairing
carcinogenic dna damage).

------
Haga
If you could embed a Fibre web in deep tissue and give the machine a scan
technologie and a waytto move the endpoints, you could micro dose suspicious
tissue.

