The nanonife will not cut off excess
Surgeons test point therapy for cancer
Alfiya Yenikeeva, RIA Novosti
The most common cancer among men, prostate cancer, which affects about a quarter of patients in urological hospitals, was treated surgically until recently – the organ was removed. The latest technology – nanonozhe – allows you to preserve the prostate gland, destroying only cancer cells. The correspondent of RIA Novosti visited the operation at the I. M. Sechenov Moscow State Medical University, where clinical trials of this method are being conducted.
"The feeling that we are participating in a historical event. We didn't just jump into a train running at full speed, we are riding in a locomotive," smiles Dmitry Enikeev, Deputy director of the Research Institute of Uronephrology at Sechenov University.
He had just removed a prostate tumor from a patient using a nanonife. This technology, which is part of the arsenal of focal therapy, a new concept for the treatment of prostate cancer, has not yet been included in the treatment protocol anywhere in the world, but is being actively tested in four major medical centers. In addition to Sechenov University, these are University College London (UK), University of Amsterdam (Netherlands) and Duke University (USA).
Before the operation, the patient undergoes a fusion biopsy procedure – ultrasound examination (ultrasound) and magnetic resonance imaging (MRI) of the prostate gland. MRI and ultrasound images are combined, and doctors clearly see the area of the prostate, presumably affected by cancer. From there, the tissue is taken for a biopsy. In addition, a control sampling of tissues from other areas of the prostate gland is carried out to make sure that there is no cancer there. This allows you to very accurately determine the place that should be operated on.
"Technically, everything is simple," the surgeon explains. – We know where the affected area is. We insert probes there with a diameter thinner than the rod of a ballpoint pen. We create an electric field between them, and the impulses kill cancer."
The nanonife operates on the basis of the principle of irreversible electroporation. When a current is passed through the probes, many non-fouling nanopores are formed in the cell membranes of tumor tissues. The homeostasis of cancer cells is disrupted, and the mechanism of their self-destruction is triggered.
This is one of the safest ways to treat cancer. Previously, prostate cancer patients had their gland completely or partially removed or the tumor destroyed by laser or radio frequency radiation, destroying both cancer and healthy cells.
"Such operations are effective, but they have a strong impact on the quality of life. The patient is highly likely to have impaired sexual function, there may be leakage or even urinary incontinence. Focal therapy completely preserves the quality of life. And the rehabilitation is very fast. Previously, after surgery, patients got up on their feet only after five to seven days, now they walk the next day, the drainage catheter is removed the next day - and that's it," says Yenikeev.
As part of the trials, ten patients will be operated on at the Sechenov University Urology Clinic. The main ideologist of the technique, professor of the University Clinic of Amsterdam Theo de Rijke has already performed 35 operations. By the way, he was in these days in Sechenov and advised Russian colleagues. In total, about a thousand such operations have been performed in the world.
"We will see the first real results in six months, when we take blood from the operated patients for cancer markers, do an MRI and a biopsy. So far, we represent everything only in theory. The research has not been completed. We conduct them ourselves here and now. Everyone in our team is confident that the new technology will make a real revolution in medicine," says Enikeev.
It is assumed that focal therapy will be included in the treatment protocols for prostate cancer in the next five years. The nanonife will also be able to treat pancreatic cancer and liver cancer.
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