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 21 June 2018

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News

Breakthrough in tracking the spread of esophageal cancer cells

Scientists funded by the Cancer Research Campaign at the University of Newcastle upon Tyne have developed a way of accurately predicting the spread of esophageal cancer - leading to hopes of life-saving improvements in surgery.

News image

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Using colored dye and a radioactive tracking device, the researchers can track the routes of renegade cancer cells as they break away from the main tumor and start to spread around the body.

The technique predicts with 95% accuracy the tissues which should be removed by surgery and which can be left alone.

This could allow doctors to individually tailor each patient's surgery to provide the best chance of cure.

By identifying the favored escape routes, the researchers hope to predict which lymph glands needed to be surgically removed to stop the cancer from spreading.

The researchers have already studied the lymph nodes of 40 people with esophageal cancer, and plan to examine 30 more.

Before having an operation to remove their tumor, each patient has blue dye and a harmless radioactive molecule called "Technetium99-labelled colloid" injected into the edges of the tumor, via a camera placed in the esophagus.

During surgery, a medical physicist monitors the flow of radioactivity through the lymphatic system using a hand-held probe.

Then, at the end of the operation, researchers measure the amounts of radiation and of blue dye within each lymph node. This tells them the precise lymphatic pathways that are draining the tumor.

The pathology research team then cuts open and examines the lymph nodes.

The technique predicts cancerous tissues to be removed with 95% accuracy.
The University of Newcastle upon Tyne
Both conventional techniques and immunohistochemistry are used to verify the presence of even single cancer cells. This process is very accurate, but time-consuming and laborious.

At the moment there are far too many lymph nodes (40 per patient) to test them all with immunohistochemistry. However, the new technique could allow doctors to narrow down the search for escaping cancer cells to less than 3 lymph nodes, which could then be examined in greater detail.

Team leader, Professor Michael Griffin says, "The type of esophageal cancer we're looking at is among the fastest increasing cancers in the UK. Unfortunately, at the time of diagnosis, most have already started to spread to the surrounding lymph glands.

"Our main hope of slowing the cancer's progress is to remove the affected lymph glands, but at present it is difficult to identify the glands that need to be removed for each patient.

"Hopefully, our research will predict the spread of cancer much more accurately, allowing us to remove the affected lymph glands while leaving those that are free of cancer alone."

Professor Gordon McVie, Director General of the Cancer Research Campaign, says, "Professor Griffin's work should provide valuable information about which lymph glands the esophageal cancer is likely to have reached. Hopefully, doctors will be able to design surgery for the individual patient, maximizing the chance of cure, while minimizing the severity of the operation."

The University of Newcastle upon Tyne
13 September 2001

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