Intraoperative, tumor-specific fluorescence imaging — will it work in prostate cancer?

A report just published on line in Nature Medicine describes the first use of intraoperative, tumor-specific fluorescence imaging to highlight the precise position of small groups of cancer cells in women with ovarian cancer, thereby allowing the surgeon to carefully excise such small groups of cells. This technique may also be appropriate as a method for identifying and removing small groups of prostate cancer cells.

van Dam et al. describe how they have used a folate receptor-α-targeted fluorescent agent to bind to and thus selectively visualize groups of epithelial ovarian cancer cells in women with ovarian cancer undergoing cytoreductive surgery. According to related media information, van Dam et al. have so far operated on some 20 Dutch women using this technique, and a video showing the actual removal of cancerous cells can be seen on the New Scientist web site.

According to the research team, “Tumor-specific intraoperative fluorescence imaging may improve staging and debulking efforts in cytoreductive surgery and thereby improve prognosis” in woemn with ovarian cancer. However, the ability to attach fluorescent dyes to cancer cells is potentially possible in all sorts of cancers. If this could be done in prostate cancer it could potentially help surgeons to:

  • Accurately identify whether the cavernous nerves needed to be removed or could be spared in men with extracapsular extension
  • Avoid leaving behind the cancerous tissue that is commonly associated with pathologically positive surgical margins
  • “Clean up” other small amounts of cancer in tissues adjacent to the actual prostate

As yet The “New” Prostate Cancer InfoLink is not aware of any specific fluorescent agent that can be targeted safely to prostate cancer cells in an analogous manner to that described by van Dam et al. However, many research teams have been working on comparable ways to highlight cancer cells using comparable forms of fluorescence technology, so there is good reason to believe in the potential of this technique

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