- For many cancers, one of the main forms of treatment is surgery;
however, even if a small margin of cancer tissue is left behind, there is
bound to be recurrence
- New potent tool developed, that can identify cancer tissue
accurately and rapidly during surgery, thereby enabling surgeons to remove
cancer tissue more precisely with reduced chances of a recurrence
Scientists at The University of
Texas at Austin have invented a novel device called the MasSpec Pen that can be
employed during surgery to identify cancer tissue quickly as well as precisely,
making it possibly to give better treatment and improve the outcome of surgery.
Diagnosis Of Cancer - Critical To Improve Patient Outcome
Currently, surgeons employ frozen section analysis of excised
tissue to get a quick diagnosis
of cancer and to check for completeness of
tumor removal so that cancer does not
At the same time, overzealous surgery with removal of normal
tissue in excess can have undesirable effects
. For example, there is a
higher risk of painful side effects and nerve damage, not to mention the
aesthetic impacts in breast cancer
patients. Similarly, patients
with thyroid cancer may lose speech (due to nerve damage) and ability to
maintain normal serum calcium levels with serious consequences.
analysis requires the tissue to be taken to the Histopathology Lab where the
tissue has to be processed and stained
by experienced technical staff.
The stained tissue should then be interpreted by a skilled pathologist
On an average this
takes about 30 minutes
patient is still under anesthesia) while the surgeons wait for the report to
decide whether further surgery may be necessary. In addition, the frozen
section diagnosis is inaccurate in
approximately 10-20 percent
of the cases and interpretation is not always easy.
To overcome these
pitfalls, the current team hoped to develop a tool that would rapidly and
accurately identify cancer tissue during surgery. To this end they invented and tested the MasSpec Pen
. The findings of their study appear in the Sept. 6 edition of the
journal Science Translational Medicine.
Testing the MasSpec Pen Tool in Patients - Findings Of the
- The MasSpec tool was tested on
tissues removed surgically from 253 cancer patients.
- In each case, the device provided a
diagnosis that was more than 96 percent accurate within 10 seconds.
- The device also correctly detected
cancer in marginal areas between normal and cancer tissues that are
critical to identify for precise surgery.
"Any time we can
offer the patient a more precise
surgery, a quicker surgery or a safer surgery,
that's something we want to
do," says James Suliburk, head of endocrine surgery at Baylor College of
Medicine and a collaborator on the project. "This technology does all
three. It allows us to be much more precise in what tissue we remove and what
we leave behind."
In the words of Livia
Schiavinato Eberlin, an assistant professor of chemistry at UT Austin who
designed the study and led the team, "If you talk to cancer patients after
surgery, one of the first things many will say is 'I hope the surgeon got all
the cancer out'. It's just heart breaking when that's not the case. But our
technology could vastly improve the odds
that surgeons really do remove every last trace of cancer during surgery
How The MasSpec Pen Works
All living cells,
whether they are healthy or cancerous, produce small molecules called
metabolites that perform a wide variety of bodily functions. Every form of
cancer thus produces a distinct set of metabolites and other biomarkers that
behave like fingerprints.
have dysregulated metabolism as they're growing out of control," says
Eberlin. "Because the metabolites in cancer and normal cells are so
different, we extract and analyze them with the MasSpec Pen to obtain a
molecular fingerprint of the tissue. What is incredible is that through this
simple and gentle chemical process, the
MasSpec Pen rapidly provides diagnostic molecular information without causing
- When the "MasSpec Pen" is
placed on the suspect tissue, a drop of water is released which absorbs
the cancer biomarkers that may be present in the tissue.
- The biomarker molecules are then fed
into a much larger machine called a mass spectrometer which analyzes the
molecules and detects the presence of cancer.
- The team tested the pen on 253 human
tissue samples of breast, lung, ovarian and thyroid cancer, as well as
healthy tissue. The pen was found to be accurate 96 percent of the time.
- The MasSpec Pen was also tested
while operating on mice with tumors, and it was seen that the device did
not damage the tissue or harm the animals.
- Once the MasSpec Pen completes the
testing, the words "Normal" or "Cancer" automatically
appear on a computer screen. In some cases, such as lung cancer, the name
of the cancer subtype might also appear.
Scope of the Study and Future Plans
- The study offers a simple and accurate method that can be
easily operated by surgeons to detect cancer in patients during
- It is a non-invasive procedure and safe for the patients as well.
- More tissue samples obtained during
actual surgeries in clinical trials have to be tested. It also needs the
US Food and Drug Administration approval.
- The team hope to begin testing this new technology during cancer surgeries
- The current analyzer is bulky and
takes up a lot of space, but the team is working on a smaller model.
In conclusion, the
MasSpec Pen if approved for clinical use could become a game changer in cancer
treatment with better longterm prognosis for the patient.
- J. Zhang, J. Rector, J. Q. Lin, J. H. Young, M. Sans, N. Katta, N. Giese, W. Yu, C. Nagi, J. Suliburk, J. Liu, A. Bensussan, R. J. DeHoog, K. Y. Garza, B. Ludolph, A. G. Sorace, A. Syed, A. Zahedivash, T. E. Milner, L. S. Eberlin, Nondestructive tissue analysis for ex vivo and in vivo cancer diagnosis using a handheld mass spectrometry system. Sci. Transl. Med. 9, eaan3968 (2017).