[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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