Ablation, Ibrutinib & PSA testing (Curing Cancer)

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In a clinical setting; MRI Imaging is routinely used to identify tumour locations in preparation for treatments like microwave ablation (MWA) or high intensity focused ultrasound (HIFU)

Broadcaster: Channel 4

Year: 2014

Genre: Documentary

URL: http://bobnational.net/record/350267

Review by Ella Yabsley

The Curing Cancer documentary outlines in simple terms how cancer occurs. I do not recommend watching the entire hour-long episode from the Cutting Edge series as it only briefly covers certain areas and contains anecdotal sections which are irrelevant for educational purposes. This 14 minute clip (spliced together from shorter segments in the programme) could serve as a brief introduction to cancer cell biology.

If you already have a more advanced knowledge of cancer biology then I recommend skipping to the four specific cases below (rather than watching the longer clip). Each case describes and demonstrates a different cancer treatment in action; Ibrutinib, high intensity focused ultrasound (HIFU)  and microwave ablation (MWA). Case 2 describes the diagnosis techniques prostate-specific antigen (PSA) testing and biopsy extraction.

Watching the cases below could be valuable if you are taking a cancer biology module and want to demonstrate knowledge of emerging therapies. Additionally, please take a look at this post which highlights a recent BBC News item on immunotherapy techniques used for treating melanoma (skin cancer).

Case 1: Ibrutinib http://bobnational.net/record/350722 (4:41)

The first clip demonstrates MRI imaging on a patient with Lymphoma (the specific type of lymphoma is not identified in the documentary). At the time of filming, the drug Ibrutinib was still in clinical trials; however it is now licensed to treat Mantle Cell Lymphoma, Chronic Lymphocytic Leukemia (CLL) and also Waldenstrom’s Macrogloulinemia. The patient is shown being given the drug orally and responds rapidly to the drug after a few weeks.

Ibrutinib is a targeted treatment which works specifically by forming a covalent bond to a cysteine residue at position 481 (C481) in the BTK (Bruton’s tyrosine kinase) enzyme. This Cancer Cell article gives a concise description of Ibrutinib and its mechanism of action in the treatment of CLL. The paper includes a very nice diagram summarising where Ibrutinib binds and the specific pathways affected.

Case 2: PSA Testing http://bobnational.net/record/350726 (1:46)

The second clip shows a patient having a PSA test; this test is used by clinicians to check for prostate cancer. Rises of PSA (Prostate-Specific Antigen) protein levels in the blood can be an early indicator for prostate cancer. The PSA test is followed by extracting tissue biopsies from the patient for further testing. The clip also highlights some of the limitations when extracting tumour biopsies from living tissue.

Case 3 : High Intensity Focused Ultrasound(HIFU)  http://bobnational.net/record/350732 (3:35)

A patient who has already been diagnosed with prostate cancer talks with the doctor about the non-invasive HIFU process; a type of ablation treatment. The clip also shows the procedure in a clinical setting. Please see the Nature Review article linked below for more in depth information about HIFU.

Case 4 : Microwave Ablation (MWU) http://bobnational.net/record/350735 (4:54)

A patient with multiple lung metastases undergoes a microwave ablation procedure. An outline of microwave ablation is described in this video along with benefits to the approach (such as minimal invasion and lower costs than full surgery). Thermal ablation therapy can also be used in conjunction with other targeted treatments; delivering personalised medicine to individuals with cancer.

For a more thorough introduction to thermal ablation therapies (including both HIFU and MWA) see this 2014 Nature Reviews: Cancer article by Katrina Chu and Damian Dupuy (subscription required).

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