Detecting Cancer Earlier is Goal of Rutgers-Developed Medical Imaging Technology
A new medical imaging method being developed at Rutgers University could help physicians detect cancer and other diseases earlier than before, speeding treatment and reducing the need for invasive, time-consuming biopsies.
The potentially lifesaving technique uses nanotechnology to reveal small cancerous tumors and cardiovascular lesions deep inside the body. It is showing promise in early tests by Rutgers researchers in the schools of engineering and pharmacy.
The Rutgers scientists, who published initial results of their work in the July issue of the journal Nature Communications, were recently awarded a $2.2 million grant from the National Institute of Biomedical Imaging and Bioengineering, part of the National Institutes of Health, to advance their research.
“Our new mode of fluorescent imaging aims not only to reveal diseases earlier, but also to learn more about the diseases before performing surgery,” said Prabhas Moghe, the lead researcher on the project and distinguished professor of biomedical engineering and chemical and biochemical engineering. “I like to think of it as an optical biopsy.”
“This technique could eventually be used to accurately determine whether a newly detected cancer has spread to nearby lymph nodes, which should help a surgeon deal with the full extent of disease during a single surgery,” said Shridar Ganesan, associate director for Translational Science at Rutgers Cancer Institute of New Jersey and clinical advisor for the project. Currently a surgeon who can’t tell how far a cancer has spread may do lymph node biopsies and wait a day for results and then perform a second surgery if needed, with its attendant trauma, risks and costs.
How is cancer detected?
Screening can detect early signs of cancerCancer is easier to treat and cure if it is diagnosed early. So a huge amount of effort has gone into developing ways to detect early signs of the disease.
Imaging
Imaging techniques enable doctors to create detailed pictures of what’s going on in our bodies without having to open us up. Here are some of the techniques commonly used to diagnose cancer.
X-rays are a form of electromagnetic radiation that can be used to take photographs of the inside of your body. X-rays are absorbed by dense materials inside the body, such as cartilage and bone, but not by lighter substances like blood. Read more about X-rays on CancerHelp UK
CT scans (or CAT scans as they are sometimes called) take lots of different x-ray photos of your body from different angles. These are then put back together using a powerful computer to form a 3D image or a series of pictures of ‘slices’ through your body. This allows doctors to see exactly where a tumour is. Read more about CT scans on CancerHelp UK
MRI scans (Magnetic Resonance Imaging) use magnetism rather than x-rays to build up a picture of the inside of your body. They can be used like a CT scan to view ‘slices’ through the body, or can make 3D images of your organs. MRI scanning usually produces a more detailed view of the body than x-rays, so doctors often use it to examine the brain. Read more about MRI scans on CancerHelp UK
PET scans (Positron Emission Tomography) are relatively new technology, and is only available in a few hospitals in the UK at the moment. PET scans can be even more sensitive than MRI and x-rays, and they can show how a particular bit of your body is working, not just what it looks like. Cancer Research UK has been leading the way in developing PET scanning in Europe. Read more about PET scans on CancerHelp UK
Ultrasound scans use sound waves to build up a picture of the inside of your body. Read more about ultrasound on CancerHelp UK
The Rutgers technology, co-developed by Richard Riman, distinguished professor of Materials Science and Engineering, uses a different type of infrared light than is used for imaging today. Called shortwave infrared, it penetrates skin and other tissue more deeply than visible light or the near-infrared light used in current imaging methods. This light stimulates dyes made with nanocrystals of rare earth elements - a family of 17 similar metals that are not scarce but are difficult to mine. Rare earths are in growing demand for electronic products such as smart phones, video screens and electric car motors and batteries.
While scientists and physicians have long recognized the potential value of shortwave infrared light, fluorescent dyes that react to this light have either been too toxic to use safely or could not deliver sharp images. The dyes that Moghe and his team are developing encapsulate rare-earth nanocrystals in a shell of human serum albumin. They are well tolerated, distribute quickly through the body and accumulate at the disease sites.
The researchers can employ different types rare-earth elements, which glow under slightly different colors of shortwave infrared light, to create a family of probes that are sensitive to a variety of cancers. “In this way, we can get a precise picture of the makeup and stage of the disease,” he said.
The researchers have demonstrated positive results in laboratory mice, and have shown that the spread of cancer even on a very small scale can be detected earlier than with traditional techniques such as magnetic resonance imaging or near-infrared imaging. This may open up new avenues for early intervention.
Working with Moghe and Riman are engineering colleagues Charles Roth, Vidya Ganapathy and Mark Pierce along with Mei-Chee Tan, a professor at the Singapore University of Technology & Design. Also participating are graduate students Margot Zevon, Harini Kantamneni, and Laura Higgins.
How can cancer be detected early?
In many cases, the sooner cancer is diagnosed and treated, the better a person’s chance for a full recovery. If you develop cancer, you can improve the chance that it will be detected early if you have regular medical checkups and do certain self-exams. Often a doctor can find early cancer during a physical exam or with routine tests, even if a person has no symptoms. Some important medical exams, tests, and self-exams are discussed on the next pages. The doctor may suggest other exams for people who are at increased risk for cancer.
Ask your doctor about your cancer risk, problems to watch for, and a schedule of regular checkups. The doctor’s advice will be based on your age, medical history, family history, and other risk factors. The doctor also can help you learn about self-exams. (More information and free booklets about self-exams are available from the National Cancer Institute’s Cancer Information Service).
Many local health departments have information about cancer screening or early detection programs. The Cancer Information Service also can tell you about such programs.
Exams For Both Men And Women
Skin - The doctor should examine your skin during regular checkups for signs of skin cancer. You should also check regularly for new growths, sores that do not heal, changes in the size, shape, or color of any moles, or any other changes on the skin. Warning signs like these should be reported to the doctor right away.
Colon and Rectum - Beginning at age 50, you should have a yearly fecal occult blood test. This test is a check for hidden (occult) blood in the stool. A small amount of stool is placed on a plastic slide or on special paper. It may be tested in the doctor’s office or sent to a lab. This test is done because cancer of the colon and rectum can cause bleeding. However, noncancerous conditions can also cause bleeding, so having blood in the stool does not necessarily mean a person has cancer. If blood is found, the doctor orders more tests to help make a diagnosis.
To check for cancer of the rectum, the doctor inserts a gloved finger into the rectum and feels for any bumps or abnormal areas. A digital rectal exam should be done during regular checkups.
After age 50, you should have either a flexible sigmoidoscopy every five years, or a colonoscopy every 10 years. In this exam, the doctor uses a thin, flexible tube with a light to look inside the rectum and colon for abnormal areas.
Mouth - Your doctor and dentist should examine your mouth at regular visits. Also, by looking in a mirror, you can check inside your mouth for changes in the color of the lips, gums, tongue, or inner cheeks, and for scabs, cracks, sores, white patches, swelling, or bleeding. It is often possible to see or feel changes in the mouth that might be cancer or a condition that might lead to cancer. Any symptoms in your mouth should be checked by a doctor or dentist. Oral exams are especially important for people who use alcohol or tobacco products and for anyone over age 50.
Exams For Men
Prostate - Men over age 40 should have a yearly digital rectal exam to check the prostate gland for hard or lumpy areas. The doctor feels the prostate through the wall of the rectum.
Testicles - Testicular cancer occurs most often between ages 15 and 34. Most of these cancers are found by men themselves, often by doing a testicular self-exam. If you find a lump or notice another change, such as heaviness, swelling, unusual tenderness, or pain, you should see your doctor. Also, the doctor should examine the testicles as part of regular medical checkups.
Exams For Women
Breast - When breast cancer is found early, a woman has more treatment choices and a good chance of complete recovery. It is, therefore, important that breast cancer be detected as early as possible. The National Cancer Institute encourages women to take an active part in early detection. They should talk to their doctor about this disease, the symptoms to watch for, and an appropriate schedule of checkups. Women should ask their doctor about:
Mammograms (x-rays of the breast);
Breast exams by a doctor or nurse; and
Breast self-examination (BSE)
A mammogram can often show tumors or changes in the breast before they can be felt or cause symptoms. However, we know mammograms cannot find every abnormal area in the breast. This is especially true in the breasts of young women. Another important step in early detection is for women to have their breasts examined regularly by a doctor or a nurse.
Between visits to the doctor, women should examine their breasts every month. By doing BSE, women learn what looks and feels normal for their breasts, and they are more likely to find a change. Any changes should be reported to the doctor. Most breast lumps are not cancer, but only a doctor can make a diagnosis.
Cervix - Regular pelvic exams and Pap tests are important to detect early cancer of the cervix. In a pelvic exam, the doctor feels the uterus, vagina, ovaries, fallopian tubes, bladder, and rectum for any change in size or shape.
For the Pap test, a sample of cells is collected from the upper vagina and cervix with a small brush or a flat wooden stick. The sample is placed in a glass slide and checked under a microscope for cancer or other abnormal cells.
Women should start having a Pap test every year after they turn 18 or become sexually active. If the results are normal for 3 or more years in a row, a woman may have this test less often, based on her doctor’s advice.
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