As a laser analyst I’m always on the lookout for interesting new laser applications, especially if an application can make an important difference in some way. Seldom do I come across a laser application like this because this is a very high bar to meet. Yet recently I have come across such an application, while not entirely new, is moving toward commercialization quite nicely.
This application helps to solve a problem surgeons have when performing cancer surgery; how do you tell where the cancer ends and where the healthy tissue starts? According to the National Cancer Institute (NCI) 1.658 million people in the US will be diagnosed with cancer this year, and 589,430 will die from it. For many types of cancer, surgery is the main or only option. Surgeons can use diagnostic tests to determine approximately where the cancer is before operating, but once in surgery it is not always possible to see where the cancer is and isn’t. Often times biopsies are taken during surgery, but this can take 40 minutes to get the results, and the surgeon has to carefully note where each biopsy was taken from. Other times the biopsies are performed at a later time after surgery, but if the correct margins are not obtained, a second surgery is required.
But what if the surgeon could tell in real-time if an area is cancerous or not? While such “smart scalpels” have been talked about for more than 15 years, the technique is finally performed in larger trials for the first time. Charing Cross Hospital will be testing the technique on 30 to 40 brain cancer patients over the next year. An IR laser probe is used with Raman spectroscopy determining if cancer is present. In the future, more powerful lasers could be sent to the probe to actually perform the surgery.
Today, medical applications make up only 7.2% of total laser revenues, with cosmetic and ophthalmic procedures making up 77% of that revenue. Laser surgical revenue comes in at a distant third. This comes at a time when hospitals are under enormous pressure to better perform procedures and greatly increase outcomes. For the patient, knowing that the cancer is completely gone is also much more reassuring then having to wait for a callback when the biopsies are completed.
Non-invasive laser spectroscopy is starting to be used more often in surgery, but its use is still quite rare. Not only does it preserve potentially healthy tissue, but some recent studies has shown that Raman spectroscopy can be more accurate at detecting cancer during surgery than a biopsy. Still, there are many challenges including the price and availability of the equipment, training of the surgeons, and insurance reimbursement. Still, the trend in medical lasers is definitely headed in this direction.