The spread of colon cancer cells from the primary site to distant locations in the body has been difficult to treat. Now, thanks to a fluorescent dye solution and minimally-invasive infrared ray laparoscopy surgery with a special camera, that has changed. Medical consultants across the world are impressed by this latest breakthrough at the VU University of Amsterdam.

If you’re in time, colon cancer is generally regarded as treatable. But once the cancerous cells spread to other sites, a process known as metastasis, it is difficult to locate the malignant cells. This is often because the so-called sentinel lymph node – the first lymph node which cancer cells are likely to spread to – is embedded in a layer of fatty tissue. This is especially the case in overweight people, who have more fat surrounding their organs.

Laparoscopy
Now a special camera has been developed which, together with a fluorescent non-toxic indocyanine green dye (ICG), can almost effortlessly locate the sentinel lymph node. The procedure is carried out using laparoscopy, or keyhole surgery, performed through a small incision – so the patient’s abdomen doesn’t need to be opened. The breakthrough is the work of surgeon Jeroen Meijerink and his doctoral student Martijn van der Pas at the Department of Surgery in Amsterdam’s VU University.
 
“An ICG solution, salt and albumin protein are injected into the patient at the site of the primary tumour,” explains Mr Van der Pas. “The solution then travels to the sentinel lymph node. The camera and surgical instruments enter the gland. The camera has a special filter that detects the fluorescence in the lymph node, which is removed to test for further cancerous cells.”
 
United States
Several patients have already been treated using this method in Amsterdam and the town of Haarlem and the results are “exceptionally good”, Mr van der Pas adds. The discovery has been met with enthusiasm in medical circles, both at home and abroad. Mr van der Pas has already presented the findings in the US, while Japan and some other countries are next on the agenda.
 
Martijn van der Pas expects that fluorescence will be used in diagnosing and treating other forms of cancer in the near future. “For example, cervical or stomach cancer. The idea is to attach a fluorescent solution to antibodies which can recognise tumours and cancer cells. The affected cells would then light up, so that we know exactly where they’re located in the body. But we’ll need something stronger than ICG; a US laboratory is currently conducting research on it.”
 
Facts and figures
In the Netherlands, 12,000 people are diagnosed with colon cancer each year. This form of cancer is treatable, but if the cancer spreads, it becomes much more complicated. In 20 to 30 percent of patients, metastasis occurs and the cancer returns.