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.
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.
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?
I'm seriously hoping someone can tell me why this idea is stupid.
More penetrating radiation is far less scattered and retains its energy density deep into the body. By concentrating several high energy (x-ray, positrons) sources at the same point, the combined energy at that point can be high enough to cause tumor destruction, while the energy along the path of the individual beams is not high enough to damage healthy tissues.
The technique can be applied to optical sources, but it's much more difficult because of the scattering.
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.
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?
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.
The body scatters light. Just like the body scatters sound. Maybe sometime in the future we will have precision devices that can access every frequency of electromagnetism and sound waves to observe and manipulate every cubic millimeter inside a person's body. But that technology doesn't seem to be coming anytime soon.
Much like any other form of electromagnetic radiation, they are subject to inverse square law.
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?
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.
Missing part of the idea here.
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.
> “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.
I don't work in the medical industry, but to those that do, do these headlines irritate you?
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).
Sometimes, but I'm usually not exposed to these news articles unless they are posted to hn or something. I prefer to go to the journal article over these written by journalists who don't have time to dig in and do a proper summary of the findings. Usually it goes something like this:
1. Interesting thing published in decent journal, but years away from clinical trials or even animal models and things fail during those tests all the time.
2. Journalist pumps out a half assed article about how its the new silver bullet.
3. Public reads the article, picks up that its remarkably similar to the half assed article they read on tuesday about a completely different thing in a completely different disease.
4. Public complains that there's "a new cure for cancer every day."
5. Public looses confidence in scientific authority.
6. Rinse and repeat when journals push the next batch of manuscripts next week.
What's remarkable is that some of the biggest advances don't get very much coverage at all, or are covered for like a week or two and forgotten, despite the field mulling over and improving that finding for years. Clickbait-style news and scientific findings aren't compatible.
Also, remember that the fight against cancer is a marathon, not a sprint. It is like curing "virus infections" or curing "bacterial infections". It's imposible to cure them all with a magic weapon. Someone makes a new antibiotic/antiviral drug, someone makes a new vaccine, someone makes a new mixture to prevent dehydration, someone makes a new procedure to detect the infections. Each is only a step. Get happy for every step, but remember that it is only a step and there are a lot ahead. (Just ignore the press titles, assume they are always linkbait.)