Automated active surveillance for prostate cancer?

In an article to be published in Biosensors and Bioelectronics, the authors describe the development of an implantable sensor device which, they claim, has the potential to offer continuous cancer monitoring.

In the abstract of their paper, Daniel et al. write (among other things) that, “we describe an implantable diagnostic device that senses the local in vivo environment. …  Short term applications for this device are numerous …. This may represent the first continuous monitoring device for soluble cancer biomarkers in vivo.”

Since prostate cancer is commonly treated in ways that would either remove the primary tumor (surgery) or destroy the device (radiation, etc.), the value of such a device in monitoring the results of the first-line treatment of prostate cancer may be limited. However, the very real potential of such a device in prostate cancer may be in its ability to continuously measure levels of PSA and other future markers post-implantation in men at unknown risk for future progression. This might allow a patient to be continuously “actively surveilled” with minimal need for additional invasive procedures such as biopsies and without monthly or even 3-monthly visits to the urologist for PSA tests — because all data could be obtained electronically.

Now we are clearly speculating here. To date the experimental biosensor has been tested on an experimental cancer in  a few mice, and we have no idea whether it could actually work to monitor biomarkers in prostate cancer if implanted in a man’s prostate — let alone for how long. But the potential represents a fascinating and revolutionary way to think about how men at risk for prostate cancer could be managed in the future.

A man with any of the significant known risk factors could be implanted with such a device at age 40 (or perhaps even younger) using a simple “biopsy-like” procedure and could then be monitored over time until treatment became necessary (if it ever did).

According to a report on the MIT News web site, “What this does is basically take the lab and put it in the patient,” said Michael Cima, MIT professor of materials science and engineering, who is the senior author of this paper.

cancer-det-2-enlargedThe MIT reports explains that the cylindrical, 5-mm implant contains magnetic nanoparticles coated with antibodies specific to the target molecules. Target molecules enter the implant through a semipermeable membrane, bind to the particles, and cause them to clump together. At present that clumping can be detected by magnetic resonance imaging (MRI), but The “New” Prostate Cancer InfoLink suspects that simpler means to detect specific types of target molecule will become fesible realitively quickly.

In this initial study, human tumors were transplanted into mice and the researchers sed the implants to track levels of human chorionic gonadotropin, a hormone produced by human tumor cells, over the course of a month.

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