{"id":2721,"date":"2024-04-02T16:49:46","date_gmt":"2024-04-02T16:49:46","guid":{"rendered":"https:\/\/horizon.peachpuff-wolverine-566518.hostingersite.com\/?p=2721"},"modified":"2024-04-02T16:49:46","modified_gmt":"2024-04-02T16:49:46","slug":"fighting-pancreatic-cancer-with-computers-and-lasers","status":"publish","type":"post","link":"https:\/\/scienceblog.com\/horizon\/2721\/fighting-pancreatic-cancer-with-computers-and-lasers\/","title":{"rendered":"Fighting pancreatic cancer with computers and lasers"},"content":{"rendered":"

Faster detection and less invasive surgery offer hopes of advances against a leading fatal disease in Europe.<\/p>\n

By<\/em><\/strong> \u00a0Anthony King<\/p>\n

When Dr John Hermans meets a patient with pancreatic cancer at his hospital, he has to steel himself.<\/p>\n

Patients with this type of tumour are often diagnosed too late to save them. On average, only 25% survive for a year and 12% are still alive after five years.<\/p>\n

Major killer<\/strong><\/p>\n

\u2018One difficulty with these patients is that you very seldom have good news,\u2019 said Hermans, a clinician at Radboud University Medical Center, also known as Radboud UMC, in the Netherlands.<\/p>\n

He is part of a project that received EU funding to harness artificial intelligence (AI) to improve the prospects for people with pancreatic cancer.<\/p>\n

Called PANCAIM<\/a>, the project relies on machine learning to scrutinise patient scans and tissue samples as well as DNA from the cancer. The four-year initiative is due to wrap up in December 2024.<\/p>\n

The pancreas is a pear-shaped gland \u2013 about 12 centimetres to 15 cm long \u2013 that lies close to the stomach and liver. It helps with digestion and with the regulation of blood-sugar levels.<\/p>\n

In 2020, pancreatic cancer killed more than 132 000 people in Europe, according to a study<\/a>. It said the risk of developing pancreatic cancer in Europe is 2.31 per 100 000 people.<\/p>\n

While little understood, the causes may include genetic inheritance, smoking, obesity and\/or age.<\/p>\n

Hidden signs<\/strong><\/p>\n

Because the disease has already spread too far when it is detected in about 80% of patients, life-saving surgery for them is impossible.<\/p>\n

\u2018The only option to cure the patient is to cut out the tumour, but that\u2019s only possible with about one out of five patients,\u2019 said Hermans.<\/p>\n

People with pancreatic cancer often receive intense chemotherapy, which is physically demanding. Even with chemo, the response rates are low and it only slows the disease.<\/p>\n

\u2018The issue with pancreatic cancer is late diagnosis, poor outcomes and no curative chemo,\u2019 Hermans said.<\/p>\n

Under PANCAIM, computer scientists and medical doctors have teamed up to collect thousands of patient scans and train AI to recognise the early signs of pancreatic cancer.<\/p>\n

The team says it has made progress with an AI programme that automatically examines the results of CT \u2013 or computer tomography \u2013 scans.<\/p>\n

\u2018This seems quite capable of helping to find pancreatic cancer earlier,\u2019 said Henkjan Huisman, a professor of medical imaging and AI at Radboud UMC who works closely with Hermans in PANCAIM.<\/p>\n

High-tech hope<\/strong><\/p>\n

Patients with cancer of the pancreas often have no symptoms for a long time. And even when signs do emerge, they can be as subtle as fatigue or indigestion.<\/p>\n

Furthermore, when a person goes for a hospital scan, the cancer is easily overlooked.<\/p>\n

\u2018The tumour can be visible on early CT scans but they are missed in about 40% of cases,\u2019 said Hermans.<\/p>\n

The project is gathering digital images of patient tissue, removed during surgery or by a needle biopsy.<\/p>\n

Such slides show millions of cells that a pathologist must carefully examine for signs of cancer. This is painstaking work and small abnormalities are easily overlooked.<\/p>\n

That\u2019s where AI can make a big difference.<\/p>\n

\u2018AI can do things humans can\u2019t such as spot a couple of cells among a billion or hone in on tiny structures,\u2019 said Huisman.<\/p>\n

It can also easily count cell types \u2013 something exceedingly difficult for a human to do.<\/p>\n

The project converts tissue slides from patient cancers into images and then searches for telltale footprints that could allow AI to spot the cancer earlier.<\/p>\n

Tumour terminator<\/strong><\/p>\n

The earlier the detection of a tumour, the greater the chances it can be eliminated with lasers rather than surgery.<\/p>\n

Lasers are the focus of Dr Francesco Di Matteo. He is an Italian clinician who has broken medical ground by guiding a thin fibre-optic cable towards patient tumours in the pancreas to destroy them with a tiny laser.<\/p>\n

Now the technique is being refined by Dr Paola Saccomandi, a biomedical engineer at the Polytechnic University of Milan in Italy, as part of another EU-funded research project.<\/p>\n

Called LASER OPTIMAL<\/a>, the project is due to wrap up in April 2024 after six years.<\/p>\n

\u2018The light from the laser hits the tumour cells and kills them,\u2019 said Saccomandi.<\/p>\n

Her research has used laboratory studies of animals and numerical calculations to gauge how much energy should be fired at a tumour of a given size and location.<\/p>\n

Precision treatment<\/strong><\/p>\n

In a continuing study with Di Matteo, eight pancreatic-cancer patients so far have had their tumours scanned using magnetic resonance imaging, or MRI. Calculations were then run for individual patients.<\/p>\n

This told the surgeon where and how much to direct at the patient\u2019s tumour. As part of a new monitoring approach, the tumour\u2019s temperature was tracked to achieve optimal temperature for destroying cancer cells.<\/p>\n

Equally importantly, the laser should avoid killing healthy tissue as much as possible.<\/p>\n

\u2018The pancreas has lots of important blood vessels,\u2019 said Saccomandi. \u2018We need to be sure that the laser light does not damage the blood vessels and cause bleeding.\u2019<\/p>\n

Her goal is to boost the laser\u2019s effectiveness as a therapy.<\/p>\n

The idea here is to insert into the cancer tissue tiny metal rods, which then heat up when hit by a laser and kill the tumour cells close to them.<\/p>\n

\u2018Since the nanoparticles are delivered only to the tumour, we can improve selectivity of the treatment,\u2019 said Saccomandi.<\/p>\n

That means less unwanted heat damage to healthy cells. This isn\u2019t yet ready for patients and remains a work in progress.<\/p>\n

The significance of what PANCAIM and LASER OPTIMAL are striving for \u2013 making it possible to detect pancreatic cancer earlier through AI and to treat such illnesses through lasering \u2013 is hard to overstate.<\/p>\n

\u2018That could save a lot of lives,\u2019 said Hermans of PANCAIM.<\/p>\n

Research in this article was funded by the EU\u2019s Horizon Programme including, in the case of LASER OPTIMAL, via the European Research Council (ERC). The views of the interviewees don\u2019t necessarily reflect those of the European Commission.<\/em><\/p>\n

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