When you hear the word cancer, it conjures up sad feelings. Most patients think that if they have it, they have less chance to survive and it’s the start of a countdown to death. Most people only know of the most common treatments such as – chemotherapy, which uses drugs to kill cancer cells, radiation which is used to destroy cancer cells and damage cancer cell’s DNA to stop dividing and growing, and surgery which remove the cancer tissues. They imagine losing hair and being in the hospital for weeks or even, months. But what is cancer, really? Is there a cure? What’s the chance of survival?
According to Canadian Cancer Society, all types of cancer start in our cells. We have lots of cells, in fact, trillions of cells which grouped together to form tissues and organs such as muscles, bones, the lungs, liver and others. Inside each cell, our genes provide instructions to the cell on when to grow, work, divide and even die. Our cells follow these instructions to keep us healthy. However, when instructions get mixed up, our cells grow and divide out of control. When the abnormal cell grows and divides, they can form a lump called a tumor. Tumors can be classified as non-cancerous which stay in one place and don’t spread. Or as cancerous and grow into nearby tissues and spread to other parts of the body.
Cancer.ca researchers estimated that there would be 233,900 new cancer cases and 85,100 cancer deaths in Canada in 2022 Statistics Canada records the number of deaths across Canada — and the major diseases that Canadians are dying from. The leading causes of death include cancer (28.2%), heart disease (18.5%), and others (29.4%). Cancer.ca advise that, the earlier cancer is diagnosed and treated, the better the outcome. And so, early detection is crucial in managing and treating cancer.
Methods of early detection are also known as “cancer screening”. This means, finding cancerous cells or tissues even in the absence of any symptoms and methods may include annual mammograms, pap smears and colonoscopies which can potentially detect early form of breast, cervical and colon cancer. However, newer methods such as genetic testing, liquid biopsy test, improved imaging techniques and predictive analytics based on data and specific high populations are now available and gaining traction.
Even though the above mentioned technologies for early detection are good, I believe that it would be even better if we could detect cancer using simple and easy to use devices similar to glucose meters for monitoring the level of blood sugar. Patients could use the device at home, a doctor’s office or in the hospital. Because it is simple, it could also be cheap enough for everyone to use.
A group of university researchers in the US, developed a device that can isolate individual cancer cells from a patient’s blood sample using a new microfluidic chip that separates cancer cells from whole blood or minimally diluted blood. The researchers note that the current methods for detecting cancer cells circulating in the blood are expensive and are out of reach of many research laboratories or hospitals. According to them, the new microfluidic device is cheap and because it does not require much specimen preparations or dilution, it is fast and easy to use. Their device separates various cell types found in blood by their size. They report that Isolating circulating tumor cells from the blood is no easy task, since the cells are present in extremely small quantities. For many cancers, circulating cells are present at levels close to one per 1 billion blood cells.
The researchers used microfluidic technologies as an alternative to traditional methods of cell detection in fluids. These devices either use markers to capture targeted cells as they float by, or they take advantage of the physical properties of targeted cells — mainly size — to separate them from other cells present in fluids.
Their device can be applied not only for the isolation of Circulating Tumor cells (CTCs) but also for molecular diagnostics for RNA and DNA, study of tumor biology in microfluidic channels and for high throughput screenings such as cell array for drug screening, blood protein detection and single cell capture.
What are the microfluidic technologies currently are being used for cancer early detection and diagnostics? The following are the promising techniques cited in different studies.
- Isolation, capture and identification of Circulating Tumor Cells (CTC)
- DNA Micro array
- Cell patterning on microfluidic chips
- Detection of cancer cells by magnetic depositions analysis
- Cell sorting by optical force
- Capillary electrophoresis to detect cancer related mutations
- Cancer cell migration on chip- movement of cancer cells
- High throughput microfluidic cell-based assays
- On chip live cell assay
- Multiplex detection of cancer biomarkers
- Droplet microfluidics for single cell screenings
- Single cell arrays for drug screening
- Long term on-chip cell culture
- On chip study of cancer cell biology
To date, most cancer detection technologies using microfluidic chips are still in the research stage at universities and research institutions. A number of early stage companies have started to emerge and are prototyping. Others are in clinical testing. Even though there is huge potential for early cancer detection, there are some inherent challenges encountered during the product development. Hurdles to successful commercialization are the cost of development, technical issues in translating assays to microfluidic chips, repeatability of device produce, and issues in scale-up production.
On a positive note, these challenges can be overcome in a matter of time. In the near future, microfluidic devices for early cancer detection are a big win for humanity in fighting the disease along with the other treatment and therapies currently available.
Lorenzo Gutierrez is the StarFish Medical Microfluidics Manager. Lorenzo has extensive experience translating point of care assays to microfluidic cartridges. His microfluidics portfolio includes developing a polyvalence instrument for early infant diagnostics at Chipcare.