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“Revolutionary” surgical knife could detect womb cancer within seconds, say experts

The device can identify the presence of endometrial cancer with nearly 90 per cent accuracy

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A surgical knife that “smells tumours” can diagnose womb cancer within seconds, researchers at Imperial College London have revealed.

Around 9,400 women are diagnosed with endometrial cancer, also known as uterine or womb cancer, in the UK each year. This makes it the country’s fourth most common cancer in women and the sixth most common globally.

However, only about 10 per cent of those with suspected symptoms who undergo a biopsy are found to have it.

Researchers have now found that the iKnife, a device that is already used to treat breast and brain cancers, can detect the presence of endometrial cancer with nearly 90 per cent accuracy.

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

According to Imperial College London, the iKnife is based on electrosurgery, a technique invented in the 1920s often used in surgery to control bleeding and to rapidly dissect soft tissue in surgery.

Electrosurgical knives use an electrical current to heat tissue, cutting through it while minimising blood loss. In doing so, they vaporise the tissue, creating smoke that is normally sucked away by extraction systems.

The iKnife’s inventor, Dr Zoltan Takats of Imperial College London, connected an electrosurgical knife to a mass spectrometer, an analytical instrument used to identify chemicals in a sample.

The device can tell the difference between cancerous and healthy tissue by analysing the smoke produced when tissue is vaporised.

The experts said its effectiveness was proved using biopsy tissue samples from 150 women with suspected womb cancer, and the results compared with current diagnosis methods.

Athena Lamnisos, chief executive of the Eve Appeal cancer charity which funded the research, told the Guardian: “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 per cent 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.”

Prof Sadaf Ghaem-Maghami, who led the research, told the newspaper the iKnife has the potential to completely revolutionise the way healthcare professionals 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 per cent and positive predictive value of 94 per cent, 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,” he added.

Hormonal health

Study links small bowel microbiome differences to women’s health

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Small bowel microbiome differences between women and men may help explain why some conditions are more common in women, a study suggests.

The small bowel microbiome is the community of microorganisms living in this part of the digestive tract, where they play vital roles in immune function, metabolism and hormonal regulation.

Researchers found differences between women and men in the composition and organisation of these microbial communities. One bacterial community containing Granulicatella was found only in women.

The study was conducted by investigators at Cedars-Sinai Health Sciences University.

Ruchi Mathur, director of clinical research and clinical operations for the Medically Associated Science and Technology (MAST) Program at Cedars-Sinai and corresponding author of the study, said: “One intriguing finding was a bacterial community containing Granulicatella, which we found only in women.

“Bacteria in this community appear at increased levels in women with polyendocrine metabolic ovarian syndrome, formerly known as polycystic ovary syndrome.”

The researchers also identified differences between women and men in how microbes in the small bowel produce fructans, complex carbohydrates known to trigger digestive symptoms in irritable bowel syndrome (IBS).

IBS is far more common in women than men.

Mathur, who is also a professor of medicine, said: “Our findings show that biological sex is a critical variable in the small bowel microbiome.

“We must consider it as we move toward more personalised approaches to understanding and treating disease.”

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Menopause

Cancer drug could tackle osteoporosis menopause weight gain

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An experimental cancer drug reduced bone loss and body fat in mice modelling post-menopausal changes, early research suggests.

The compound, CADD522, appeared to strengthen bones and help the animals stay leaner after surgery designed to mimic hormonal changes seen after menopause.

The treatment remains at an early experimental stage and has so far only been tested in animals.

The study, led by the University of East Anglia, investigated CADD522, which was originally developed to block a protein involved in the growth and spread of several cancers.

Mice treated with the compound for eight weeks showed significant improvements in bone health. Scans found increased bone volume and better preservation of the honeycomb-like structures inside bones that are crucial for strength and resilience.

Blood tests suggested the treatment stimulated new bone growth without interfering with the body’s normal process of breaking down and rebuilding bone.

Dr Darrell Green, lead researcher from UEA’s Norwich Medical School, said: “Osteoporosis affects around one in three women over the age of 50, leaving sufferers vulnerable to painful fractures that can seriously impact quality of life.

“Current treatments exist, but many are plagued by side effects, safety concerns or inconvenient dosing schedules that make long-term use difficult.”

The researchers also found that mice receiving CADD522 weighed less than untreated mice despite eating the same amount of food.

They had less body fat and fewer fat deposits in their bone marrow, a process commonly seen after menopause and linked to declining bone health.

The team also examined brain tissue and found that the drug appeared to reverse several menopause-related changes in fatty acids.

Levels of omega-3 fats including DHA remained largely intact, while several other lipid abnormalities shifted back towards healthier patterns.

Green said: “We didn’t directly test for memory or thinking ability, but our work raises questions about whether this drug could one day help address wider menopause-related health problems.”

Safety experiments in mice, rats and dogs found that CADD522 could be taken orally and was well tolerated.

The compound also appeared to be metabolised more slowly in human tissue than in rodents, potentially improving its performance in people.

“This is still in the early stages and has so far only been tested in animals but we hope that the benefits will translate to humans to ultimately reduce fracture rates,” added Green.

The research was led by UEA in collaboration with the University of Maryland, the Scintillon Research Institute in San Diego and the University of Stirling.

Safety testing was funded by The Sir William Coxen Trust as part of the development of CADD522 as a childhood cancer treatment.

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Fertility

Weight loss surgery improves menstrual health and PMOS symptoms, study finds

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Weight loss surgery was linked to more regular periods and fewer polyendocrine metabolic ovarian syndrome (PMOS) symptoms in women aged 18 to 45 living with obesity in a recent study.

The researchers recommend that women undergoing the procedure have access to preconception care and reproductive counselling to support their reproductive health.

Researchers at the University of Surrey analysed data over 24 months from 84 women who underwent bariatric surgery and 18 women living with obesity who did not have surgery.

Of those who underwent surgery, 49 had gastric bypass procedures and 35 had gastric sleeve surgery.

Women who underwent metabolic bariatric surgery lost more than 30kg on average at 12 and 24 months after the procedure.

Among women with polycystic ovaries, the condition persisted in only 10 per cent after 24 months.

Women also reported a resolution of clinical hirsutism, or excess body hair, by 12 months.

Women who had previously experienced irregular periods reported more regular menstrual cycles after surgery.

Professor Martin Whyte, co-author of the study and professor of metabolic medicine at the University of Surrey, said: “A large proportion of those undergoing bariatric surgery are women of reproductive age, who may be planning a pregnancy in the coming years.

“So much remains unknown about the impact of this type of surgery on women who are planning to have children.

“This raises the question of when the ideal time after surgery is to conceive.”

Women have a higher prevalence of obesity than men, with 57 per cent of women in the UK classified as overweight and 27 per cent living with obesity, which can affect fertility and the health of an unborn baby.

The researchers said 17 women had healthy pregnancies following surgery.

Although this was not specifically examined in the study, no difference in birth weight was observed between babies conceived within or after the first year.

Dr Kathryn Hart, co-author of the study and associate professor in nutrition and dietetics at the University of Surrey, said: “What we have found is that bariatric surgery positively affects the reproductive health of women living with obesity and can improve the likelihood of them having a healthy pregnancy after surgery.

“Dysregulated hormone levels, irregular periods and conditions such as polycystic ovaries are affected by obesity.

“By reducing this, what we have seen is that it can lead to improvements without the need for medication.

“We would suggest that clinicians consider medical intervention for obesity to treat irregularities in the menstrual cycle and issues with fertility.”

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