Neurosurgeons Use MRI-Guided Lasers To Destroy Tumors

breadboy21 writes "In the seemingly perpetual battle to rid this planet of cancer, a team of neurosurgeons from Washington University are using a new MRI-guided high-intensity laser probe to 'cook' brain tumors that would otherwise be completely inoperable. According to Dr. Eric C. Leuthardt, this procedure 'offers hope to certain patients who had few or no options before,' with the laser baking the cancer cells deep within the brain while leaving the good tissue around it unmarred. The best part, however, is that this is already moving beyond the laboratory, with a pair of doctors at Barnes-Jewish Hospital using it successfully on a patient last month. Regrettably, just three hospitals at the moment are equipped with the Monteris AutoLITT device, but if we know anything about anything related to lasers, it'll be everywhere in no time flat."

Comments

Damn

[roman_mir]

They totally misread the request by the Dr. Evil, he asked for sharks with lasers ON their heads, not humans with lasers IN their heads.

These scientists, always get some mundane detail like that wrong and totally spoil the scheme.

--

OTOH this is freaking cool. How do they get the lasers only to burn the cancer cells and not burn tissue on the way to the cancer cells?

Re:Damn

[Znork]

How do they get the lasers only to burn the cancer cells and not burn tissue on the way to the cancer cells?

It's not an external laser, it's a probe emits the laser beam from one side. So you still need to stick the probe into the brain until you get to the parts you want to light up.

Re:Damn

[EdZ]

"See, you can check your anatomy all you want, and even though there may be normal variation, when you get down to it this far inside the head it all looks the same. No nonono, don't tug on that, you never know what it might be attached to".

Seemingly perpetual battle?

[Anonymous Coward]

You're right... this pointless war has gone on too long, let's just legalize cancer and be done with it.

Meanwhile

[Dunbal]

It's a good thing that great advances are being made in very specialized areas of medicine. Meanwhile, the leading killer world-wide is still heart disease which receives disproportionately inadequate funding despite recent progress in PTCA stenting, etc. Machines like this may grab funding dollars and headlines, but they don't save very many lives.

Re:Meanwhile

[npuzzle]

Many heart problems can be solved through prevention; sadly, the same cannot be said for many neurological conditions.

Re:Meanwhile

[Kurofuneparry]

Yes, coronary disease is a big problem and yes it's the major killer in the US but it isn't the major killer worldwide, just in developed nations. You'll notice on the first link that cancer is still way up on causes of death in the US and, despite your claims to the contrary, I can assure that now in my second year of medical school that coronary syndromes are a major focus in medical education and research.

The work these scientists did is certainly not the first implementation of this idea but it's quite worth the investment. Stenting is not a miracle cure and likely wont ever be; it's just delaying the inevitable. The only powerful approach to reducing heart related deaths is prevention and education; even then, most deaths due to 'old age' are written up as heart related deaths so they'll keep going up as we get better at fighting the world's real number one killer: simple infections.

Then again, I'm an idiot ......

Re:Meanwhile

[AnonymousClown]

Many heart problems can be solved through prevention; sadly, the same cannot be said for many neurological conditions.

That's right. Just stop the smoking, drinking heavily, stop the junk food and get out and get some moderate exercise would prevent many if not most of the heart disease (and stroke) in the World. Not smoking would also prevent a lot of impotence too. It would be much more cost effective to spend a fraction of the money on education than whiz bang, usually obscenely expensive, gadgetry.

Re:Meanwhile

[Dunbal]

but it isn't the major killer worldwide,

      Yeah, that's why in the very last paragraph of the linked page you provided it's listed as the #1 killer worldwide.

      As a second year med student please take some advice from this attending physician: while there are certain ways in which the data is sliced demographically that ends up presenting other pathologies as number one, the overall aggregate data clearly states that heart disease is #1 worldwide with 7.2 million cases per year. Right there at the bottom of the page where it says "World". Picking and choosing data is an error that is committed very often nowadays - people try to create "meta-analyses" that demonstrate their pet theory but conveniently leave out all the studies that fail to support their theories. This is bad science. Don't do it. Either look at all of the data, or make sure that have have the right tools to evaluate your special subset of data in the context of the big picture.

      I agree that stenting is a stop-gap at best, and long term patient compliance with CAD medications will always be a challenge. The future, as you say, lies in prevention and raising awareness of the real causes of CAD: Smoking, sedentarism/obesity, diet and lastly genetics.

      Good luck in your studies.

a better article

[roman_mir]

this text is better in that it explains that first, a hole is drilled in the scull, then MRI is used to image the brain and these images help to insert a probe that's similar to a pencil in shape into the tumor through the brain, so it looks like this will go through other brain tissue first, and then this device discharges what basically amounts to heat and cooks the tumor.

Re:a better article

[nbauman]

It is a better article, mostly because it doesn't have the gushing enthusiasm of the Endgaget story (Technology nyphomaniac: Never met a technology I didn't immediately fall in love with.)

I used to write about medical lasers for a few years, and I learned one important lesson:

Don't believe it until they have a randomized, controlled trial that shows patients who get the laser treatment actually do better than the patients who don't. (It doesn't do any good to remove a tumor if the tumor comes back right away.) A lot of laser treatments didn't look too good after the controlled trials.

(It is true that there are some procedures that are so rare that they can't do a randomized controlled trial.)

This system looks like it might be useful in certain not-too-common situations where you can't reach the tumor with anything else. It's like, when you're working on a car, having an offset screwdriver that can reach a blind screw that's hard to reach any other way. It's FDA approved for brain surgery so it passed some kind of review.

There are other ways of doing it. Notice that WUSL also offers a gamma knife http://plexus.wustl.edu/surgery/neuro/website.nsf/WV/23077ADDD22341B28625729F00713CFC which focuses 201 radiation sources on a small spherical target. Brain surgeons are clever.

A lot of times, a $50 cautery can do just as good a job as a $100,000 laser.

This isn't rocket science.

The fundamental problem is, sadly, those cancers they mentioned are inevitably fatal, within 6 months to a few years. The main purpose of surgery is to make your last few years more comfortable, like when they remove a tumor that's near the optic nerve threatening to make you blind. There are some benign brain tumors that can be cured, though. "Benign" is a relative term when something's growing in your brain. You want to get it out.

Re:a better article

[pz]

this text is better in that it explains that first, a hole is drilled in the scull, then MRI is used to image the brain and these images help to insert a probe that's similar to a pencil in shape into the tumor through the brain, so it looks like this will go through other brain tissue first, and then this device discharges what basically amounts to heat and cooks the tumor.

The same is already done in the clinic using an RF probe to induce localized heating. Gamma knives (see the plethora of other comments) do the same by concentrated radiation damage, although the MRI is done beforehand (and a CT ... I once asked a neurosurgeon I work with why use both, and he replied that neither method is as accurate as one might hope, so they combine techniques to reduce measurement errors).

Re:a better article

[kurzweilfreak]

Then try rocket surgery! It's a bitch!

has been around for a bit

[Trepidity]

There've been experimental uses of this kind of thing since the 1990s. The AutoLITT system mentioned in this mini-article, and Visualase are two commercial systems. There've been some preliminary clinical trials as well.

Re:Gamma Knife

[icegreentea]

This is nothing like the gamma knife, aside from that it uses radiation. They're using an MRI to guide a physical probe through the brain to the tumor where the probe then does a thermal discharge. So instead of shooting intersecting deathrays (very cool stuff by the way), they're sending a guided killbot that gets right up close.

Re:Gamma Knife

[ColdWetDog]

This is nothing like the gamma knife, aside from that it uses radiation. They're using an MRI to guide a physical probe through the brain to the tumor where the probe then does a thermal discharge. So instead of shooting intersecting deathrays (very cool stuff by the way), they're sending a guided killbot that gets right up close.

Actually it does have a lot of similarities - they use MRI imaging to figure out which parts of the brain to fry, then use a fairly localized beam of Something Evil (gamma rays in the Gamma Knife, light energy in this device) to toast the 'bad' tissue. So it's really just another techy way of doing the same thing - minimally invasive surgery and will likely have the same efficacy (excellent to poor depending on the type of tumor) and cost shitloads of money.

Watch to see the hype (ooh! lasers!) run right past the research showing that it works just as well as extant technology and costs more.

/grouchy cynical mode OFF temporarily

Re:Write your own damn summaries...

[XnavxeMiyyep]

Have you ever read the Slashdot summaries? I'm pretty sure most of them are just excerpts from the articles put through a few online translators.

Re:So, let me get this straight

[Anonymous Coward]

The majority of people who get cancer are already 40+, past the age where they would be having new children. Unless you plan to kill the children of people who get cancer, keeping treatment from the patients will make any difference.

Re:So, let me get this straight

[Czech Blue Bear]

Sir, your opinion is both ugly and wrong.

Cancer is not a simple disease caused by a damage of a single gene. There are too many genes that can, under "proper" circumstances, cause or promote cancer. In most cases, this is not a type of one genetic damage but a complex structure of various events, some of them external. Even with the hardest eugenics, you won't be able to eradicate, or even limit, this type of disease; in fact, you will probably end with the contrary. The risk of malignant growth is too intertwined with the very basical functioning of cells themselves; there is always a need for creation of new cells, and always there is a risk of a runaway loop.

Secondly, if a young person is diagnosed with a type of cancer that is known to be hereditary, he or she is informed by the doctor and probably will decide either not to try having his/her own children, or take special care to minimize the risks.

Re:So, let me get this straight

[pandrijeczko]

Seems to me the way to eradicate cancer is to allow natural selection to run its course and remove faulty DNA from the gene pool.

Actually, can we start with eradicating insensitive people with faulty DNA that clearly leaves them bereft of any concern for those who are either suffering from cancer at this moment or have lost people dear to them due to cancer?

Vitamin D deficiency, toxins, junk food, memetics

[Paul Fernhout]

There is no doubt a genetic component to cancer but you can't jump from there to the kind of social processes you are implyimg without considering a lot of issues (including how our genes related to compassion towards each other may let us survive as a collective when individually we would all die).

As an example of that, here are two links to two compassionate people, Dr John Cannell and Dr. Joel Fuhrman, with advice that, used together, may prevent most cancers and even treat a few (by boosting the body's own immune system):
    http://www.vitamindcouncil.org/treatment.shtml
    http://www.diseaseproof.com/archives/cat-cancer.html
Should we honor these two people for those contributions to humanity (including treating any early genetic diseases they might get) or should we just say, "tough luck, bad genes" if they do get sick somehow and let them die right outside of hospitals?
    "Andy Bales- SiCKO: What Has Happened to Health Care?"
    http://www.youtube.com/watch?v=aC7zI7VXcCA

Besides, you've seen the movie "Gattaca", right? How long before people are designing their DNA? I'm not saying they will do a good job for it, though, and there may be other social and personal consequences too, like shown in that movie. :-( What nature tends to prize is disease resistance and hardiness more than almost anything else, although many people might opt for optimizing some things with unknown consequences. I'm just saying that idea of geen manipulation shows another problematical assumption you are making that the only way genetic material will get passed on is the old-fashioned way.

Memetic/cultural evolution is also happening at the level of "memes", as we see here on slashdot all the time, and quite rapidly, much faster than genetic evolution. But ask yourself, which of the memes you carry around in your head (including the one you just propagated) are more beneficial to your body as well as the communities that body is part of, and which are more parasitic or cancerous? And what does it take to have a healthy mental immune system?