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26 February 2024

Knife that ‘smells tumours’ can detect womb cancer within seconds

By The Guardian

A revolutionary surgical knife that “smells tumours” can diagnose womb cancer within seconds, researchers have found in a breakthrough that could enable thousands of healthy women to get the all-clear quicker.

The disease is the fourth most common cancer in women and affects about 9,000 a year in the UK, but only about 10% of those with suspected symptoms who undergo a biopsy are found to have it.

Now experts at Imperial College London have discovered that the iKnife, a device that is already used to treat breast and brain cancers, can accurately detect the presence of endometrial cancer.

“The iKnife reliably diagnosed endometrial cancer in seconds, with a diagnostic accuracy of 89%, minimising the current delays for women whilst awaiting a histopathological diagnosis,” the team of researchers wrote in the journal Cancers. “The findings presented in this study can pave the way for new diagnostic pathways.”

The iKnife uses electrical currents to differentiate between cancerous and healthy tissue by analysing the smoke that is emitted when the biopsy tissue is vaporised, after it has been removed from the womb.

The researchers said its effectiveness was proved using biopsy tissue samples from 150 women with suspected womb cancer, and the results compared with current diagnosis methods. The team plans to launch a major clinical trial, which could lead to its use becoming widespread.

Athena Lamnisos, the chief executive of the Eve Appeal cancer charity, which funded the research, said: “Waiting for test results is stressful – especially if that test is to find out whether or not you have cancer. When you hear that the ‘c’ word is even a possibility, the days can’t pass quickly enough until a clinician gives you the all clear.

“Womb cancer has one ‘red flag’ symptom of postmenopausal bleeding that should always get checked out on a two-week referral from your GP. To wait a further two weeks for the results can be really hard for patients.

“There are many reasons for abnormal vaginal bleeding after the menopause – womb cancer is just one of them – the ability to provide a diagnostic test that rules cancer in or out immediately, and with accuracy, could make such a positive difference.

“This Eve-supported research has the potential to create a step change in faster diagnosis, and for the 90% of women with postmenopausal bleeding that isn’t cancer, a really effective way to put their minds at ease. We know how important this is for patients.”

Alison, a 57-year-old from west London who had symptoms of womb cancer earlier this year but eventually got the all-clear, said the iKnife would have made a huge difference to her experience.

“Thankfully, I was one of the people with postmenopausal bleeding lucky enough to find out it wasn’t caused by cancer. It was really frustrating waiting for the results, which was almost three weeks for me.

“I was asked to go in person to receive the results too, which to me was a clear indication that it was bad news and I did have womb cancer. It was terrifying.

“It would have made such a difference to know straight away that I didn’t have cancer and not have to wait three weeks.”

Prof Sadaf Ghaem-Maghami, who led the research at Imperial College London, said getting a diagnosis within seconds could enable women confirmed to have cancer to start treatment sooner, while those deemed healthy would avoid weeks of anxiety.

“The iKnife has the potential to completely revolutionise the way we manage people seen in the rapid-access clinics with significant abnormal vaginal bleeding who have been referred for potential diagnosis of endometrial cancer.

“With its high diagnostic accuracy of 89% and positive predictive value of 94%, one could immediately reassure the person of the very low likelihood of having cancer if the iKnife result is negative and expedite further tests and scans and treatment for people whose biopsies indicate presence of cancer. This could happen whilst awaiting confirmation from standard pathology, which can take up to two weeks.”