Anti-tumor therapy with endoscopic ultrasound may assist docs in fighting cancer

Investigational research on a therapeutic technique that could allow physicians to directly inject malignant tumors with cancer fighting agents from inside the body was presented at the 16th International Symposium of Endoscopic Ultrasonography (EUS2008) in San Francisco, held on Sept. 12-13.

The technique, which uses a flexible gastrointestinal endoscope with a miniature ultrasound transducer on the tip to guide a small needle directly into a tumor, could prove to be a safer and more effective approach to administering chemotherapy because it allows doctors to deliver therapy right to the tumor and avoid damaging normal surrounding tissues, according to the researchers. 

Investigators said that EUS combines endoscopy and ultrasound to obtain the most accurate, high-resolution images and information about the digestive tract and the surrounding tissue and organs. A more advanced form of EUS, called curvilinear EUS, allows doctors to operate within the lumen of the gut while at the same time detect, biopsy and treat lesions and tumors that lie outside the intestinal wall.

The researchers said that the technique could be particularly useful in patients with pancreatic, esophageal and rectal cancer.

"Curvilinear endosonography will likely become the dominant technology within the field of EUS," said co-chairman of EUS2008, Robert Hawes, MD, professor of medicine and chair for endoscopic innovation at the Medical University of South Carolina in Charleston. "The potential for accurate diagnosis using ultrasound-guided biopsy, precise staging with high resolution ultrasound images and then the enormous opportunity for new therapies with the curvilinear endoscope is why we are focusing this meeting on the use of this instrument alone."

Used in conjunction with real time imaging, the researchers reported that EUS can help physicians to detect blood flow in blood vessels in and around tumors, as well as detect and biopsy tumors and lymph nodes as small as 3-5 mm, allowing doctors to avoid puncturing blood vessels when sampling tissue and know exactly what stage a cancer is in for optimal therapy for treatment.

The technique could save cancer patients with late stage disease from going through unnecessary surgery, according to the presenters. They said that EUS also may play a role in the future of minimally invasive surgery.

Olympus supported the symposium through unrestricted educational grant.

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