From the Future: Innovative treatments for cancer
For many, the phrase “curing cancer” has devolved into a tongue-in-cheek expression to deride projects that are too ambitious or miraculous to be taken seriously. But in truth, progress is being made on cancer treatment, even if an outright cure hasn’t yet been found. The National Cancer Institute notes that from 2015-2019, “cancer death rates continued to fall among men, women, children and adolescents and young adults in every major racial and ethnic group in the United States.” Notre Dame is contributing to this progress with its Harper Cancer Research Institute in collaboration with Indiana University, South Bend. In this edition of From the Future, The Observer showcases three Notre Dame researchers exploring innovative ways of treating cancer and improving the lives of those afflicted by it.
Atmospheric pressure plasma jets: A compelling cancer treatment from the world of physics
Dr. Sylwia Ptasinska, Associate Professor, Department of Physics and Astronomy
Sylwia Ptasinska, associate professor of physics and astronomy, came to Notre Dame for opportunities like this.
A physicist by training, she was lured to South Bend 12 years ago with the promise of being able to do applied, interdisciplinary research.
“I always wanted to do physics, but not pure theoretical physics,” Ptasinska said. “I wanted to have some motivation behind [my work]. And in medical applications, I could see I can contribute.”
Today, Ptasinska’s interdisciplinary research group explores, among other topics, biomedical applications for atmospheric pressure plasma jets. In conjunction with the Harper Cancer Research Institute, Ptasinska and her colleagues are studying the use of plasma jets as a cancer treatment option.
Ptasinska’s team has created a device that emits a low-power artificial plasma jet capable of damaging biological tissues, including cancerous cells. This device presents numerous advantages to existing cancer treatment options.
For one, plasma jets are simple and cheap to construct. Ptasinska noted that you could potentially build such a device “even in your home … if you know a little bit about electricity and you’re careful with high voltage.”
This, of course, is not an invitation from Ptasinska to do so. Still, it emphasizes how accessible plasma jets can be, especially in comparison to something like the X-ray technology used in certain cancer treatments.
Plasma jets have also shown to be more accurate than most current cancer treatment options. Many methods have a side effect of killing healthy tissues as well as harmful ones, but early studies seem to indicate that plasma jets can kill cancerous cells in a targeted manner.
While plasma jets have clear advantages over existing options, there is still work to be done before this method can be deployed as a standalone or adjuvant treatment — which is exactly the objective of Ptasinska’s lab.
The primary obstacle at the moment is determining the appropriate dose of plasma radiation for the treatment. Ptasinska said that estimating radiation doses with plasma is more difficult than other types of matter, and this issue cannot necessarily be solved using a physics lens alone. So, her lab collaborates with people from chemistry and computer science backgrounds who can help address the plasma radiation problem in creative, interdisciplinary ways.
“We are trying to find methods like borrowing ideas from chemistry or from computational methodology to estimate the dose of plasma,” Ptasinska said.
Though hurdles remain, Ptasinska explained that plasma jets are already employed to treat cancer in countries like Germany and Japan, which have highly respected biomedical technology industries. Differing medical treatment protocols are slowing the process of implementation in the United States, but clinical trials are underway. Ptasinska thinks atmospheric pressure plasma jets will be approved in the US as a standalone or adjuvant cancer treatment very soon.
“I think it will be just a few years,” Ptasinska said.
Lighting up cancerous tissue
Dr. Bradley Smith, Emil T. Hofman Professor of Science, Department of Chemistry and Biochemistry
Bradley Smith, the Emil T. Hofman professor of science, works to improve current methods of cancer-removing surgeries by researching new fluorescence imaging methods and photothermal therapy techniques.
In his research, he utilizes either nanoparticle probes or dye molecules that accumulate in tumor cells that absorb a certain frequency of near-infrared light. When the particles are exposed to this frequency during high resolution body imaging techniques, the location of tumors can be identified. By using these images, the tumor can be removed in a process known as fluorescence-guided surgery, Smith said.
Smith, who began working at the University in 1991, began his research in this area due to his interest in imaging and sensing technology.
“I’m a chemistry professor who looks at a lot of fundamental chemistry things. And then in the last 20 years, I’ve gotten into imaging technologies and detection technologies,” Smith said. “We’ve looked at a number of diseases, and cancer is one of them.”
Although the cancer death rate has dropped in the last 20 years — and there is an increase in cancer treatments — improving surgical methods of removing cancer is still a “very sensible and common thing to do,” Smith said.
Locating a tumor is very important because surgeons must cut out a small portion of healthy tissue surrounding the tumor to ensure that all cancerous cells have been removed. This is known as a negative margin, Smith said.
“If they see a spot where there’s not that margin — that is called a positive margin — that has still got cancer cells in it, that is not good. You don’t want your surgeon doing that,” Smith said. “And that means they’ll have to go back and try to cut more of it out. And it is known that if you have positive margins, you’re more likely to get the cancer coming back.”
Surgeons are better equipped to determine a negative margin when conducting fluorescence-guided surgery, Smith said. The surgeons shine a light on the area with the cancer cells and a camera that is more sensitive than the human eye collects an image of the fluorescent cells.
In addition to locating the tumor, Smith said a similar technique could ultimately be used to kill cancerous cells.
“If I now just shined stronger light, then I could put a lot of energy and I could begin to heat it up. That would also kill cancer cells,” Smith said.
So far, Smith and his team successfully killed the cancerous cells from a mouse. They injected the mouse with a nanoparticle that accumulated into the tumor, shined a laser beam on the area and removed it.
Smith’s current work also aspires to improve two aspects of the nanoparticles and dyes: the part that targets the cancer cells, and the part that absorbs the light.
“Wherever the dye is, is where you’re going to get heat. So if our dye is selectively in the cancer, we’re golden, but it’s not 100 percent,” Smith said.
Because this treatment is still being researched and improved, it will only benefit patients of the future. But Smith hopes that people recognize the role their tax dollars will play in the current research in this area.
“Their taxes are going to things that in the long term may not benefit them, but their children and their children’s children and all of that sort of stuff,” Smith said. “So there’s sort of a public message in there that if you can’t directly do this research yourself, by paying your taxes, you are indirectly supporting that.”
The psychology of coping with cancer
Dr. Thomas Merluzzi, Professor, Department of Psychology
Thomas Merluzzi, a newly-retired professor of psychology, researches how the coping processes of those with cancer influences their quality of life.
Merluzzi began his psychology career studying the cognitive aspects of social anxiety. But after his first wife passed away of breast cancer, he delved into psycho-oncology, the study of the psychological aspects of cancer.
“So what I did was probably turn this tragedy into something that I hoped would benefit people, including myself,” Merluzzi said.
Although his own personal experiences inspired him to join the field, he used to not share this information. Merluzzi said he believed it was important to be respected for his work separate from his personal life.
His research is focused on the mindset of the patients themselves and how they view themselves in the context of their own cancer treatment.
“Within the bounds of the disease, I look at persons with cancer as agents, collaborators in their care,” Merluzzi said. “So, what they want for their life in terms of quality of life, the decisions they make, [we] try to encourage them to participate in that as an active agent of their care, rather than a passive recipient of care.”
There is evidence that those who feel more efficacious about coping with cancer will feel less depressed and feel their quality of life is better, Merluzzi said. This will help them adhere to treatments better and increase satisfaction with their care.
It is important to note that this form of research may not affect the longevity of life-after treatment, but it still has its benefits.
“If someone has a great attitude, is that going to mean they’re going to live longer? Well, no, but they’re gonna live better,” Merluzzi said.
The quality of social support that those going through cancer treatment receive also plays a role in improving their quality of life.
Social support, Merluzzi said, is tantamount to medicine. Just as patients are active in their coping, they must also be active in the pursuit of social connections.
Effective social support should also match the needs of the patient because not all social support is good, Merluzzi said.
“If somebody is doing something for you, and you don’t need the help, it’s debilitating. It will make you feel more like a patient,” Merluzzi said. “[There is] this matching of need and provision. So in other words, when that comes together, that means you’re getting the social support you need when you need it. And if you don’t need it, you’re doing stuff on your own, as you usually did.”
He is also currently working on a project that involves religious coping. His research has determined that the quality of life for patients who put the outcome of their treatment “in God’s hands” is better than that of patients who take on the responsibility of future outcomes, he said.
“The best possible thing you can do would be to be an empowered patient who takes responsibility, who’s self-efficacious, but also is not going to get all wrapped up in whether they’re going to live 30 years from now or whether their cancer is going to be cured,” Merluzzi said. “They’re going to let go of that, but they’re going to concentrate on the present.”
Merluzzi said he hopes to investigate a secular version of this mindset. Although Merluzzi retired on Dec. 31 of last year— after spending 48 years at the University — he plans to continue his research in this area with colleagues from around the globe.