Surgeons Use Laser To Examine Brain Cancers And How Much Tissue To Cut
Filipino entrepreneur Gilda Abelanio suffered seizures in 2012. Doctors found growth in her brain.
Abelanio was brought to Cebu City in central Philippines, where medical facilities were considered more sophisticated, to have the growth operated on. Her family afterwards decided to have the surgery done in Zamboanga City, Philippines.
She underwent craniotomy and tumor excision on Dec. 7, 2012 in order to remove the tumor.
The surgery was successful but her hearing was impaired. Her bodily movements were also greatly diminished.
Abelanio's doctor told her family that it was the result of the brain tumor having been removed.
There was no way at the time for doctors to determine how much tissue should be removed.
The Filipino entrepreneur could have been the kind of patient to have benefitted from the new laser-based microscopic technique to help doctors determine tumor tissue from healthy tissue.
The Challenge Of Removing Cancers
It has been a challenge for neurosurgeons to achieve the maximum removal of tumor without destroying healthy cells. Surgeons mostly rely on their judgement to determine where the edges of the tumor lie.
In a study published in Nature Biomedical Engineering, the technique called Stimulated Raman Scattering microscopy opens up new possibilities to help surgeons determine the exact size of the cancerous cells and amount of tissue to be cut.
The technique has only been tested on some 360 patients at the University of Michigan Medical School and Harvard University. Full clinical trials have yet to be conducted.
SRS Microscopy Maps Region Affected By Cancer Cells
SRS microscopy was developed in 2008. The technique is based on the Raman scattering effect of molecules discovered by Indian physicist Sir Chandrasekhara Venkata Raman in 1930. Raman was awarded the 1930 Nobel Prize in Physics "for his work on the scattering of light and for the discovery of the effect named after him."
It is an alternative technique that would enable surgeons to differentiate cancer cells from healthy cells.
Conventional procedures at present require brain tissue samples to be brought to a laboratory where they are stained with dyes. Technicians and clinicians analyze the samples, a process that could take 30 to 40 minutes. The procedure cannot be performed inside the operating room.
The new technique, on the other hand, uses a portable fiber-laser microscope that sits inside the operating room.
Faster, More Accurate Surgical Decisions
SRS microscopy collects images to help doctors see which is the normal brain tissue and cancerous tissue. It allows for instant tissue examination without the need for time-consuming staining and processing.
Neurosurgeon Daniel Orringer, who co-piloted the technology, said that the new technique leads to a faster and more accurate surgical decision-making process.
Orringer also said it is easy to define the center of the brain cancer. But to determine its edges exactly is most often left to the doctor's best judgement.
The technique is far better and more accurate compared to conventional procedures. In the absence of long-term clinical trials, however, it does not guarantee improved survival rates among cancer patients.