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Novel endoscopy tool opens new doors for pancreatic cancer treatment

A significantly more effective, minimally invasive treatment for pancreatic tumours may be on the horizon, thanks to a new endoscopy tool created in the Penn State Department of Mechanical Engineering.

On average, only about 20% of pancreatic cancer patients are eligible for surgical removal of a tumour, which is currently the most effective treatment option.

The location of the pancreas in the abdomen and the difficulty to detect the disease make it one of the most difficult to treat.

To change that prognosis, Brad Hanks, a doctoral student studying mechanical engineering, created a new type of electrode to be used in endoscopic radiofrequency ablation (RFA) procedures and has been theorised to effectively neutralise 55% more of an abdominal tumour using these methods.

A minimally invasive procedure, RFA is conducted by inserting an electrode into the abdomen and administering high-frequency energy that heats the tumour and as a result, neutralises the cancer cells.

While the RFA treatment itself is well-established and effective, the current endoscopic tools that exist to perform this procedure are “one size fits all”, rather than customised to each person’s tumour.

A standard RFA electrode produces an elliptical ablation zone, which most tumours are approximately spherical.

Since the RFA treatment zone doesn’t usually match the shape of the tumour, the untreated remnants can continue the spread of the disease.

“It’s like trying to fit a square peg in a round hole,” Hanks said. “Without a surgical tool to match the shape of the tumour, the effectiveness of the treatment can be severely limited.”

However, by harnessing finite element analysis and evolutionary algorithms, he designed an electrode that deploys once it is within the abdomen, spreading electrode “fingers” that produce an ablation zone that is better matched to the specific tumour’s shape.

“Because each cancer patient is unique, I believe the tools we use to treat them should be as well,” he said.

Though the electrode itself may not able to completely eradicate the tumour, the method also provides additional benefits to a patients’ on-going treatment, an idea from Hank’s collaborator on the project, Matthew Moyer, a physician at the Penn State Hershey Medical Center.

Currently, gold beads called fiducials are often inserted in another procedure to provide guidance for radiation treatments.

Marking the edges of the tumour through X-rays, the fiducials provide a clearer outline for targeting and eradicating the tumour.

"The custom electrode, designed to detach and stay in the tumour, can provide a similar purpose.

With one less procedure, Hanks said, “Using my electrodes, which are able to do the same thing, it’s a simplified process to have this electrode guide the way for radiologists.”

In addition, with further exploration, Hanks hopes he can 3D print patient-specific electrodes to ensure an even more targeted and personalised treatment.

He said, “It adds another really interesting component to this work, it could lead to an even more custom treatment that is less expensive for the patient.”

While the initial focus of the project was on treating pancreatic cancer tumours due to the low rate of patients eligible for surgery and its status as the 4th most deadly cancer in the United States, the custom electrode treatment can be adapted for other abdominal cancers, including tumours found in the lungs and stomach.

He added, “The day we are able provide truly personalised care for these cancers is not so far away.”

Source: Penn State College of Engineering



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