January 16, 2021

I, Science

The science magazine of Imperial College

In the first part of our new Diary of a Researcher series, PhD student Ilias Konstantinou talks to us about new brain cancer treatments.

The main idea behind brain surgeries, to put it simply, is the local removal of infected regions referred to as tumours. Looking at it historically, brain surgery has already been practised for centuries. But recently, some alternative treatments have also been in use, which involve a catheter that effectively infuses therapeutic drugs in the near-tumour region.

This catheter, unlike the image you may have in mind, is a needle-like tool that can reach far into the brain to the targeted area. For many years, the catheter’s design hindered surgeons performing accurate and precise movements in the brain. Catheters are fairly flexible and do not ‘listen’ to direction very well. As a consequence, surgeons were unable to get close enough to the area of interest.

Alternatives for surgeons
So how does this catheter work? Holding the needle at one end, the opposite end is then inserted in to the patient’s brain and any movement of that needle can be operated much like a joystick. Although brain surgeries require delicacy and concertation from the operator, they do sometimes remind us of surgeons playing video games.

Recent advances of targeted drug deliveries include the introduction of nanoparticles covered with gold. Although it might sound very ‘glamorous’, there are also some major issues behind this approach. Firstly, the nanoparticles need to be small enough to be able to pass through the protective membrane that our brain carries; the so called blood-brain-barrier (BBB). Secondly, covering the nanoparticles with gold helps to reduce their interaction with the BBB.

The BBB can be imagined as a protective wall having multiple small gates that control what is coming in and what stays out. By covering the drug particles in gold, these gates are effectively tricked into allowing these particles to pass through. In a sense, the drug particles are travelling undercover with good intentions for the brain.

Magnets and Tumours
An even more impressive technique involves magnetic nanoparticles of a therapeutic drug. The philosophy behind it is that these magnetic particles, once inserted into the blood, are driven by the use of external magnets to the targeted location of the patient’s body. This is in contrast to the common approach of orally administered medication, whereby pills are simply swallowed. As futuristic as it may sound, the technique of targeted drug delivery has been around for more than 30 years.

A huge amount of research underpins these options. For instance, a tremendous amount of research is undertaken in modelling the behaviour of the drug once it is introduced into the body. Whereas you might think that contribution to the medical field merely comes from people with medical backgrounds, this is not necessarily the case. Even someone with an engineering background might show interest in the biomedical sector. Engineers nowadays possess a range of interdisciplinary skills which are particularly useful when dealing with biomedical problems.

Making the treatment an experience
It is worth noting that Imperial College London is leading in the area of catheter design. An ambitious, yet novel and revolutionary design of a catheter is currently being developed. It has the ability to steer its way into the brain and come in very close proximity to the tumour. Ultimately, the catheter can infuse the therapeutic drug from different locations, angles and can even surround the tumour by multiple-spot infusion for better effectiveness.

Brain tumour treatment has certainly come a long way through a number of developments from centuries old techniques to cutting-edge methods. It should not be forgotten that a lot of these advances have been aided by technology and engineering. A successful operation lies in the surgeon’s hands of course, but one should not forget the noteworthy surgical tools which are essential. After all, where would medicine stand these days if it wasn’t for the technological breakthroughs and engineering advancements?

Ilias Konstantinou is a PhD student in Computational Fluid Dynamics of the Brain at the Department for Mechanical Engineering

Banner Image: 3D illustration of cancer cell, Jovan Vitanovski