[HN Gopher] Prostate cancer could be treated by destroying tumor...
       ___________________________________________________________________
        
       Prostate cancer could be treated by destroying tumors with electric
       currents
        
       Author : rmason
       Score  : 477 points
       Date   : 2023-03-17 05:06 UTC (17 hours ago)
        
 (HTM) web link (www.telegraph.co.uk)
 (TXT) w3m dump (www.telegraph.co.uk)
        
       | benevol wrote:
       | [flagged]
        
         | conjobn wrote:
         | No it wouldn't, it just adds to the repertoire of available
         | treatments.
        
       | bulbosaur123 wrote:
       | Only initial cancer or mets as well? When can this be
       | realistically tested on real humans? How long? I have a close
       | relative with potential biochemical recurrence. Could this save
       | him?
        
       | imutemyteam92 wrote:
       | [dead]
        
       | dybber wrote:
       | Seems like it comes with serious risk of complications. Here's a
       | news article in Danish about NanoKnife from 2019:
       | https://www.dr.dk/nyheder/penge/kontant/kraeftramte-thomas-b...
       | 
       | Google Translated: https://www-dr-
       | dk.translate.goog/nyheder/penge/kontant/kraef...
        
       | swader999 wrote:
       | Does this mean you need access to a MRI machine? "Guided by MRI
       | scanning, the short pulses can be targeted to the right area, and
       | surrounding healthy cells are left untouched and preserved,
       | experts said."
        
       | laminarflow wrote:
       | In a past life, I worked in prostate cancer ("PCa") clinical
       | research. To drive home the point about how large of an unmet
       | need this is:
       | 
       | A) In addition to 1/6 men being diagnosed with PCa, an ~equally
       | large percentage of men have undiagnosed cancer at the time of
       | death, it just wasn't severe enough yet to be the thing that
       | killed them. (1)
       | 
       | B) Because treatment carries a 50% risk of sexual and/or urinary
       | dysfunction side effects, the standard of care in the US for PCa
       | is literally to leave the cancer untreated and monitor it
       | closely, until it develops into an aggressive cancer. At that
       | point, we treat the entire prostate (the opposite of "focal"
       | therapy referenced in this article) and all bets are off re: side
       | effects. Also, often by that time, the cancer has spread outside
       | of the prostate and is much more difficult to treat.
       | 
       | (1)
       | https://www.sciencedirect.com/science/article/pii/S246829422...
        
         | fortran77 wrote:
         | My father died from metastasized prostate cancer. If/when I get
         | it I won't do "watchful waiting". I'm going to get the most
         | aggressive treatment possible.
        
           | laminarflow wrote:
           | My condolences. Hopefully you never get it, and better
           | treatments are available if you do.
        
         | Panzer04 wrote:
         | Most current cancer treatment methods we have are basically
         | sledgehammers with loads of collateral damage - it's not
         | surprising the preference is to leave it if it's benign.
        
       | ars wrote:
       | Is there anything about this that is specific to the prostate?
       | Wouldn't this exact same treatment work on other accessible
       | tumors, for example breast or skin?
        
         | dcminter wrote:
         | My father had Nanoknife for pancreatic cancer; it wasn't a
         | cure, but it reduced the tumour enough to buy him another
         | couple of years.
        
           | agumonkey wrote:
           | Was he having a good quality of life after the operation?
           | 
           | Also what stage was he at when they used this procedure?
        
           | z3c0 wrote:
           | Incredible. Arguably the most vicious form, so hearing that
           | it could buy so much time is awesome. Nonetheless, I'm sorry
           | for your loss.
        
         | haldujai wrote:
         | Irreversible electroporation isn't that new, it's being
         | actively used (i.e. not trials) for liver, lung, pancreas and
         | kidney cancers for a few years now.
         | 
         | We use it quite a bit in radiology. Usually faster / easier to
         | use thermal ablation (microwave or cryo these days, used to be
         | radiofrequency more often) but there are cases where it's not
         | feasible due to heat sinking or other reasons and IRE is an
         | alternative.
        
         | CommanderData wrote:
         | I read its effective at treating lung and liver cancers too.
         | 
         | Early diagnosis is key to survival.
        
           | einpoklum wrote:
           | Your second sentence merits millions of upvotes.
           | 
           | Many health care provision systems don't invest in screening
           | tests or other early-detection schemes, or they do make them
           | available, but don't invest in raising awareness of their
           | availability. I'm actually now at the age where I should
           | start thinking about "What new periodic tests/checkups should
           | you introduce within the next 5 years?" ... and at this point
           | I'm still clueless, except that I know that at around 50 I
           | should start getting my PSA checked.
        
         | iSnow wrote:
         | I'll take an uneducated guess here: this works best for small
         | and clearly defined tumors. You would have a hard time causing
         | electroporation of cell membranes farther away from the
         | electrodes without damaging too much healthy tissue.
        
       | dangwhy wrote:
       | This is only if cancer isn't metastatic. correct?
        
         | zwieback wrote:
         | Yes, from the sound of it. "Localized" usually means that the
         | cancer is inside the tough membrane surrounding the prostate.
        
       | sergiocampama wrote:
       | https://youtu.be/gAYL5H46QnQ?t=131
        
       | aquaphile wrote:
       | Electrical pulse ablation technology has been around a while,
       | with multiple studies performed and a large body of patents. The
       | promise and hope for the technology is that is causes cell
       | apoptosis, and early rat studies showed electrical ablation
       | shrinking tumors. The goal was/is to apply it to multiple cancer
       | types. Source: I helped with one of the pioneering companies in
       | the field.
       | 
       | A quick internet search for "electrical ablation cell apoptosis
       | cancer" yields a few research articles. For example
       | https://www.frontiersin.org/articles/10.3389/fonc.2020.01235...
        
         | kristopolous wrote:
         | I agree that this is old as the hills. I was reading a text
         | recently that cited medical claims of electricity curing
         | cancers in the 1870s.
         | 
         | I'd assume there's more nuance this time around. At least I'd
         | hope so.
         | 
         | The article points to
         | https://en.m.wikipedia.org/wiki/Irreversible_electroporation
         | 
         | You can do quite a bit with electrical signals, perhaps there's
         | some novel instruments and feedback loops being used
        
           | theGnuMe wrote:
           | There's something called tumor treating fields that uses
           | electric fields for treating glioblastoma. Fascinating stuff.
        
         | [deleted]
        
         | [deleted]
        
       | univr wrote:
       | The department I work with created PROST, a robot that can help
       | with biopsy for that type of cancer.
       | 
       | It's still a Proof of Concept, but I think it's an interesting
       | project to invest on.
       | https://metropolis.scienze.univr.it/project/prost/
        
         | haldujai wrote:
         | I actually perform image guided prostate biopsies, what is this
         | solving / what's the point?
         | 
         | We have great diagnostic accuracy with TRUS+MR fusion with
         | standard equipment.
         | 
         | This just looks much slower and more expensive.
        
       | afrcnc wrote:
       | business idea: anal beads that give you slight shocks every 10s
       | 
       | #winnin
        
         | ofchnofc wrote:
         | [dead]
        
       | the_third_wave wrote:
       | Oddly enough I've just been looking into a veterinary treatment
       | method for superficial tumours based around cytostatica in
       | combination with electric pulses - delivered by a pulse generator
       | controlled by a Raspberry Pi - which are supposed to increase the
       | efficacy of the cytostatica by 'electroporation' [1]. I'm mostly
       | looking into this because the glossy site and the presentation
       | given at my wife's vet clinic have a relatively high snake oil
       | coefficient although there is some science [2] behind the
       | process. It seems to come down to a combination of a TENS machine
       | [3] (which can be had for around PS40-60, L80 if you want it
       | remotely controlled through your phone) with needle probes except
       | for the fact that a 10-pack of 4-needle probes costs EUR2.500
       | while the machine itself - a Raspberry Pi with a keyboard, a
       | pulse generator and an LCD screen in a compact box - costs around
       | EUR25.000...
       | 
       | [1] http://vetiqure.se/our-products/
       | 
       | [2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5092241/
       | 
       | [3] https://www.boots.com/health-pharmacy/electrical-health-
       | diag...
        
       | 1970-01-01 wrote:
       | Much more info on how it works is available via FDA.gov:
       | 
       | https://www.accessdata.fda.gov/cdrh_docs/pdf18/K183385.pdf
        
       | chiefalchemist wrote:
       | I heard an interview on one of NPR shows last week and the guest
       | talked about using electricity for healing. For example, if I
       | remember correctly, a wound treated in someway with electricity
       | healed faster. It had something to do with stimulating the cells
       | in a particular way.
       | 
       | Side note: Does this give any credibility to the idea that
       | magnets can heal?
        
         | mrWiz wrote:
         | The mechanism used here is that high voltage causes cells to
         | open channels through the cell wall, letting good cell stuff
         | out and bad stuff in. Do it enough and the cell will die. I'm
         | no biologist but I don't know of a similar magnetic mechanism.
        
           | chiefalchemist wrote:
           | I was thinking that if high voltage power lines produce a
           | magnetic field, perhaps a magnetic field can influence energy
           | in cells? Again, it's an idea inspired by the interview I
           | heard.
           | 
           | https://www.epa.gov/radtown/electric-and-magnetic-fields-
           | pow...
        
         | Rychard wrote:
         | You may be referring to this[0], which was discussed on HN last
         | week.
         | 
         | [0]: https://news.ycombinator.com/item?id=35060657
        
           | chiefalchemist wrote:
           | I did see that, but I also heard an interview. In either
           | case, thanks.
        
         | LegitShady wrote:
         | the answer to your question is no, because the way you affect
         | cells with electricity is not through magnets.
         | 
         | Also, the mechanisms of this and that are not the same -
         | they're literally killing cells with electricity here, not
         | healing.
        
           | chiefalchemist wrote:
           | Yes. But I also reference how electric currents / fields are
           | being researched for healing / regenerative purposes. The
           | crux of that seems to be how to influence the energy
           | properties cells already have.
        
       | dnndev wrote:
       | Is this similar to rife machines that you can use at home?
       | Essentially frequency generators.
        
         | starkd wrote:
         | I would not try doing this at home.
        
           | tgv wrote:
           | My reply is totally against the guidelines, but the image of
           | some bio-curious hacker sticking needles in the perineum and
           | putting high voltages on them in a home lab is such an absurd
           | mixture of horror and embarassement that your sane reply had
           | me in stitches.
        
             | SketchySeaBeast wrote:
             | "Man, since that study came out 2nd degree taint burns are
             | up 75%."
        
       | teruakohatu wrote:
       | This seems like a game changer. According to the company website
       | they have treated 6,000 patients.
       | 
       | https://nanoknife.com
       | 
       | Further Googling showed it has been around since 2008 and machine
       | in 2010 the machines cost $300k. Maybe the novel application is
       | prostate cancer?
       | 
       | https://www.wsj.com/articles/SB10001424052748704029304575525...
        
         | rkagerer wrote:
         | Non-paywalled version of that WSJ article:
         | https://archive.is/bDRgi.
         | 
         | And a dumbed-down video primer on how it works:
         | https://nanoknife.com/technology/
         | 
         | Basically they insert somewhere between two and a handful 1mm
         | diameter needles, then pulse with high voltage to kill the
         | cells in between.
         | 
         | The article mentioned concerns from doctors that it hadn't been
         | through large clinical trials yet. 13 years later, does anyone
         | know of those trials have taken place?
        
           | amelius wrote:
           | > with high voltage
           | 
           | How high? Or is it the current that is controlled?
        
             | _Microft wrote:
             | I think you can find more information here:
             | 
             | https://en.wikipedia.org/wiki/Irreversible_electroporation
             | 
             | https://en.wikipedia.org/wiki/Electroporation#Physical_mech
             | a...
        
       | jojohohanon wrote:
       | Paywall
        
       | Antipodes456 wrote:
       | Sample size n=1, but my dad was on the research or clinical trial
       | of this exact treatment in Sydney, it worked for his prostate
       | cancer, he's still clear from PSA tests (and possibly had biopsy
       | also. No side effects.
       | 
       | Previously he'd had the radioactive beads treatment which failed,
       | the only other option was removal. Both these options have
       | potentially unpleasant side effects.
       | 
       | Happy to ask him questions if anyone wants to know more
        
         | glenstein wrote:
         | May I ask how this was discovered in your dad's case? I feel
         | like prostate cancer is the single most dangerous cancer for
         | men in the late 30s, 40s, and 50s. So it's a subject I'm trying
         | to pay attention to.
        
           | hlehmann wrote:
           | I was diagnosed with prostate cancer when I was about 57. I
           | had had somewhat regular "finger up the butt" exams prior to
           | that, since I was about 45, which were all negative. Then a
           | PSA blood test test came back positive and I then had a
           | biopsy done (no fun, trust me). Because I was still in my
           | 50's I needed to do something beyond just continuing to
           | monitor it. Between radiation treatment and a prostatectomy I
           | chose the latter. Eight years or so later my PSA tests are
           | still negative, knock on wood. Lesson learned, I think, is to
           | get a simple PSA blood test done regularly once you've
           | reached a certain age.
        
           | Antipodes456 wrote:
           | He had a change in PSA levels in his blood - it's a good idea
           | to get your bloods checked annually so you can pick up any
           | changes, as PSA levels vary a lot person to person.
           | 
           | Also gan get "the finger" to see if you have an enlarged
           | prostate.
           | 
           | I think as far as cancers go, prostate is one of the better
           | ones to get, not normally aggressive, you'll probably die
           | before it kills you.
           | 
           | Test often if you have family history.
        
         | markdown wrote:
         | Could you share the hospital or research facility where this
         | was done?
        
           | Antipodes456 wrote:
           | I believe it was Prof Stricker:
           | https://www.phillipstricker.com.au/prostate-cancer-
           | treatment....
        
             | markdown wrote:
             | Thank you
        
         | sebastianconcpt wrote:
         | Beautiful. Thanks for sharing this.
        
         | givemeethekeys wrote:
         | How does it go? Was he put to sleep? What was the prep like
         | leading up to it? What was the recovery like? Did he have to
         | take any drugs?
        
           | wil421 wrote:
           | My father had an aggressive form of prostate cancer that
           | required removal. He was put under at a hospital. The surgery
           | wasn't very long and the procedure wasn't too invasive.
           | 
           | Recovery wasn't so bad but you have a catheter for a bit.
           | Cancer drugs and all but no hair loss. IIRC, he was very low
           | energy. He's been cancer free for over a decade.
           | 
           | There's a chance you can lose the capability to get an
           | erection so you'll want a good surgeon (I did not discuss
           | this with my dad). Another person I knew had to wear a small
           | pad because he could have a small amount of urine dribble. He
           | said he could pee like a horse and it was much easier post
           | op.
        
           | Antipodes456 wrote:
           | https://www.phillipstricker.com.au/prostate-cancer-
           | treatment....
           | 
           | "After a full workup to ensure that our patients are suitable
           | for the program they then undergo a day surgery procedure
           | which takes between 40 and 60 minutes. Depending on the
           | extent of the cancer this may simply ablate the lesion, a
           | quarter of the prostate or a half of the prostate. No
           | prostate cancer cells are resistant to this treatment. Large
           | areas can be treated with minimal side effects.
           | 
           | After the treatment patients stay in the day surgery unit for
           | two to four hours and they are discharged home with a Foley
           | catheter in place. Postoperatively pain is minimal and
           | patients are discharged with tablets for mild pain, moderate
           | pain, bladder spasms and relaxation of the prostate and
           | antibiotics as required.
           | 
           | On day 2 a limited multiparametric MRI is performed. The
           | Foley catheter is left in for two to five days depending on
           | the extent of the treatment."
           | 
           | I'll ask him about prep / recovery
        
         | breck wrote:
         | Would you be interested in chatting more about the whole
         | experience? breck@cancerdb.com or 1-808-727-1111
         | 
         | I've been in Cancer Research for 5 years and am now starting my
         | own idea to help (utilizing my background in software
         | engineering and data science): CancerDB.com a public domain ad-
         | free knowledge graph. The idea is to get a core group of
         | researchers collating all the data into one place that's
         | accessible by both patients, families, caregivers, and
         | researchers.
        
       | CommanderData wrote:
       | Seems to good to be true, retreatment only needed in 10% of cases
       | with much less side effects too.
       | 
       | Is this still in clinical trials?
        
       | thr717272 wrote:
       | First time it really hits home how large the risk is.
       | 
       | 1/6 is a rather large risk.
        
         | lm28469 wrote:
         | The lifetime cancer risk is ~50% (all cancers)
         | 
         | Most of them are caused by lifestyle/environment:
         | https://www.ncbi.nlm.nih.gov/core/lw/2.0/html/tileshop_pmc/t...
         | 
         | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2515569/
        
           | Alex3917 wrote:
           | How credible is this paper? I see it's highly cited, but I
           | also see that it claims that fungi are cancer causing but not
           | also cancer preventing, which seems questionable.
        
             | lm28469 wrote:
             | Feel free to read other studies/sources:
             | https://en.wikipedia.org/wiki/Causes_of_cancer cites other
             | papers with similar stats, there are also many sub articles
             | listed
             | 
             | > Over one third of cancer deaths worldwide (and about
             | 75-80% in the United States) are potentially avoidable by
             | reducing exposure to known factors.
             | 
             | > Common environmental factors that contribute to cancer
             | death include exposure to different chemical and physical
             | agents (tobacco use accounts for 25-30% of cancer deaths),
             | environmental pollutants, diet and obesity (30-35%),
             | infections (15-20%), and radiation (both ionizing and non-
             | ionizing, up to 10%).
             | 
             | > less than 0.3% of the population are carriers of a
             | cancer-related genetic mutation and these make up less than
             | 3-10% of all cancer cases.
        
         | foepys wrote:
         | It's more likely that you die with prostate cancer than because
         | of prostate cancer.
         | 
         | Yes, cancer is never good but for most men prostate cancer
         | develops late and is usually growing very slowly and doesn't
         | spread.
        
           | melling wrote:
           | Currently, but as lifespans increase...
           | 
           | https://www.marketwatch.com/story/good-news-and-bad-news-
           | kid...
        
           | thaumasiotes wrote:
           | In medical school, one of my mother's classes had an exercise
           | one day which took this form:
           | 
           |  _Here are a bunch of slides of prostate samples. Find the
           | cancerous one._
           | 
           | This led to the teacher getting so many questions about
           | whether the slide someone was currently looking at was the
           | cancerous one that he was forced to interrupt the class to
           | make this more general announcement:
           | 
           |  _There 's a bit of cancer in_ everyone's _prostate. Find the
           | slide with obvious cancer._
        
             | copperx wrote:
             | Surely the slides were of men of an advanced age, right?
             | Otherwise that statement is false.
        
               | thaumasiotes wrote:
               | Why do you think that?
        
               | copperx wrote:
               | I don't believe every person of every age has observable
               | cancer that can be seen on a slide.
        
               | Dalewyn wrote:
               | I'm not a doctor, but my understanding has been that we
               | all have cancer cells at any given point in time.
               | Consider how many cells inside you are undergoing cell
               | division; errors in cell division are where cancer cells
               | come from.
               | 
               | The question is whether your body sees and kills the
               | cancer cells; most of the time it does, which is why most
               | of us can live pleasantly for most of our lives despite
               | errors cropping up silently. What we term cancer are the
               | cancer cells that slipped past our body's defences,
               | growing into masses that cause no end of grief.
               | 
               | To put it in computer terms, it's like error correction
               | in HDDs and SSDs and ethernet connections. Errors are
               | inevitably going to occur while data is in transit, but
               | they are of no concern so long as error correction and
               | other such mechanisms can correct and recover. The errors
               | do become a concern when they start slipping past such
               | mechanisms, however.
        
               | zkirill wrote:
               | This is my understanding as well and my favorite protein,
               | p53 [1], is responsible for hunting down cancerous cells.
               | From what I remember reading in Robins Basic Pathology,
               | it takes many steps for a cell to evolve into cancer and
               | our body has ways to reduce the probability at each step.
               | The most fascinating topic to me is how someone's
               | lifestyle and environment affect their body's natural
               | cancer defence mechanisms. We can do many things to stack
               | the odds in our favour, but sometimes the odds are still
               | not in our favour. Should we strive to minimize the
               | chance by adjusting our lifestyle and changing the
               | environment, or strive for some kind of balance?
               | 
               | [1] https://en.m.wikipedia.org/wiki/P53
        
               | Dalewyn wrote:
               | >Should we strive to minimize the chance by adjusting our
               | lifestyle and changing the environment, or strive for
               | some kind of balance?
               | 
               | That is as much a philosophical question as it is
               | biological, and one where the answer will vary by who is
               | asked.
               | 
               | Personally, I will say this: If you're miserable while
               | endeavouring to prevent cancer (or any other disease),
               | that's putting the cart before the horse. The goal is,
               | presumably after all, to live happily.
        
               | pfdietz wrote:
               | Elephants have 100x as many cells as a human does, live
               | about as long, but have about 1/2 the chance of dying of
               | cancer. Why? A big part is that each elephant cell has
               | ~40 copies of the p53 gene.
        
               | hawk_ wrote:
               | Before anyone thinks of increasing p53 in human bodies to
               | prevent cancer keep in mind that it can cause premature
               | aging.
        
               | pfdietz wrote:
               | I'm sure elephants have all sorts of compensatory
               | mutations so they can live with so many copies of the
               | gene.
        
               | copperx wrote:
               | That's my understanding too. But we're talking about
               | cancer that can be observed on a slide. At that point,
               | that's beyond the error correction mechanisms AFAIK.
        
           | barrenko wrote:
           | Yess, it's something along the lines that as a man - if you
           | live long enough you'll get prostate cancer.
        
           | canucker2016 wrote:
           | "watchful waiting" is the phrase used. see
           | https://www.telegraph.co.uk/news/2023/03/12/prostate-
           | cancer-...
           | 
           | The above link mentions "one in eight men" will be affected
           | by prostate cancer.
           | 
           | If you have the deadly fast-growing type of prostate cancer,
           | it'll be evident soon enough.
        
             | nickd2001 wrote:
             | Someone I knew had the slow-growing case for quite some
             | time. Then, it abruptly without warning turned into the
             | aggressive form and killed him. Makes it very difficult to
             | know what to expect. I guess frequent checks are necessary,
             | because once its evident, you're already in a world of
             | trouble...
        
           | wisty wrote:
           | The stats are still pretty bad. Prostate cancer kills more
           | people than breast cancer (though it's usually men in their
           | 80s, so the QALYS is not as bad). A prostate cancer diagnosis
           | is not terrible (since it's so damn common) and aggressive
           | treatment and overly-aggressive screening might be a bad idea
           | in most cases (since it's often best to not worry too much -
           | over-treatment and even over-testing has its costs) but
           | there's certainly a need for better treatment in cases where
           | it does get bad (which is a very sizable number of older
           | men).
           | 
           | Doctors don't try to do the test on every man over 55 without
           | a good reason.
        
             | e40 wrote:
             | But, curiously, they stop testing at 70 (or was it 72?).
             | That's what my urologist told me last year when I had my
             | exam. Ever since my father had prostate cancer, I've had a
             | yearly PSA and exam by a urologist (thinking that a
             | urologist will be better at detecting tumors than a
             | GP/PCP).
        
       | kornhole wrote:
       | I expect to soon see articles on HN with DIY instructions using a
       | modified taser. The videos will get many views.
        
         | bookofjoe wrote:
         | https://www.bookofjoe.com/2023/03/plasma-lighter-xr.html
        
         | the_third_wave wrote:
         | A TENS machine is cheaper and easier to come by:
         | 
         | https://www.boots.com/health-pharmacy/electrical-health-diag...
         | 
         | Replace the pads with some needles, insulate most of the needle
         | with lacquer leaving only the points free...
         | 
         | READY ... AIM ... FIRE!
        
       | zwieback wrote:
       | I had PC in my early 40s, over 15 years ago now. If that
       | treatment had been available then I might still opt for surgical
       | removal. The peace of mind of getting the thing out is huge and
       | the side effects for me were negligible, as I had a great surgeon
       | and recovery for younger patients is pretty good.
       | 
       | In my 60s I would definitely go for something like this although
       | I'm always a little leery of treatments that have cool sounding
       | brand names.
        
         | hawk_ wrote:
         | Early 40s sounds kind of young to have it. How did you/they
         | find out that you had it? Anyway good that it worked out well
         | for you.
        
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