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20 Jun 2024

Glowing dye revolutionises how surgeons remove prostate cancer cells

Researchers from the University of Oxford have developed a glowing dye that sticks to prostate cancer cells and gives surgeons a “second pair of eyes” to remove them in real time and with better long-term outcomes. Experts say the breakthrough could reduce the risk of cancer coming back and prevent debilitating side-effects.

In a study led by the University of Oxford and supported by Cancer Research UK (CRUK) and the National Institute for Health and Care Research, scientists tested a special injection that enables prostate cancer cells to glow when shined with a special light, ultimately allowing specialists to better target cancerous cells and preserve healthy areas.

The technology is a combination of dye and a marker molecule — known as IR800-IAB2M — that attaches itself to the PSMA protein found on the surface of prostate cancer cells.

The study, published in the European Journal of Nuclear Medicine and Molecular Imaging in early June, saw twenty-three men with prostate cancer injected with the fluorescent dye before undergoing prostate removal surgery. The marker dye found areas of cancerous tissue not picked up by the naked eye or other clinical methods. This enabled surgeons to remove every last cancer cell while preserving healthy tissue.

Professor of Surgery at the University of Oxford and lead author of the study, Professor Freddie Hamdy, celebrated the results of the study: “We are giving the surgeon a second pair of eyes to see where the cancer cells are and if they have spread. It’s the first time we’ve managed to see such fine details of prostate cancer in real-time during surgery.”

“With this technique, we can strip all the cancer away, including the cells that have spread from the tumour which could give it the chance to come back later. It also allows us to preserve as much of the healthy structures around the prostate as we can, to reduce unnecessary life-changing side-effects like incontinence and erectile dysfunction.”

“Prostate surgery is life changing. We want patients to leave the operating theatre knowing that we have done everything possible to eradicate their cancer and give them the best quality of life afterwards. I believe this technique makes that possibility a reality.”

Further clinical trials are already underway to test the technique's efficacy in removing more prostate cancer while preserving more healthy pelvic tissue compared to existing surgical methods.

Although the marker dye is still in early-stage development, the University of Oxford highlights that it could become part of routine prostate cancer surgery practice in the future, and could even be adapted for use for other types of cancer by changing its protein base.

Executive Director of Research and Innovation at Cancer Research UK, Dr Iain Foulkes, said: “Surgery can effectively cure cancers when they are removed at an early stage. But, in those early stages, it’s near impossible to tell by eye which cancers have spread locally and which have not.”

“We need better tools to spot cancers which have started to spread further. The combined marker dye and imaging system that this research has developed could fundamentally transform how we treat prostate cancer in the future.”

“We hope that this new technique continues to show promise in future trials. It is exciting that we could soon have access to surgical tools which could reliably eradicate prostate and other cancers and give people longer, healthier lives free from the disease.”

David Butler (77), a retired sales development manager from Southmoor in Oxfordshire, was one of the 23 men who took part in the study. Before the surgery, scans had indicated that his prostate cancer had begun to spread.

“I had several biopsies and scans but one scan - the PSMA PET scan - revealed that the cancer was starting to spread from the prostate. It was in the lymph nodes, it was in loads of places near to the prostate. That information proved vital to the doctors to get the cancer treated quickly.”

David had his prostate removed, along with several lymph nodes and other cancerous tissues, using this revolutionary technique in January 2019. “I am a very lucky man to have had the life I’ve had. I’ve dealt with a lot health-wise but I’ve had excellent treatment too.”

“I retired early to make the most of life’s pleasures – gardening, playing bowls and walking. Taking part in the PROMOTE study has allowed me to have many more of those pleasures for years to come.”

The paper detailing the study, entitled 'First‑in‑man study of the PSMA Minibody IR800‑IAB2M for molecularly targeted intraoperative fluorescence guidance during radical prostatectomy' is published in the European Journal of Nuclear Medicine and Molecular Imaging.

Read the full paper

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