Glow Tumor Technology is Reimagining Cancer Surgery at Penn Medicine

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When facing surgery to remove cancers and tumors, a major concern — for patients and physicians alike — is ensuring that all of the cancerous cells are removed in order to inhibit recurrence. It is up to the surgeon to determine which tissue is healthy and which tissues are cancerous, but now, Penn Medicine’s Sunil Singhal, MD have utilized injectable dyes to make the diseased tissue glow to help with the identification of these cancerous cells. The benefit, of course, is that it allows surgeons to be more precise when determining which tissue is healthy vs. cancerous. Initially implemented in a clinical trial at the University of Pennsylvania’s School of Veterinary Medicine, the technology has gone on to show extraordinary promise in treating many other cancers and tumors.

Here, Dr. Singhal discusses the inspiration behind the technology, how it’s benefitted patients, and his future plans for this new technology.

In layman’s terms, can you explain exactly how the tumor glows?

Before the operation starts, the patients get an intravenous line through the vein in their arm — which they need anyway for the operation —and through that vein we give them an injection of a dye. The dyes have been specially engineered so that they are attracted to the tumor. They basically get soaked up by the tumor. It doesn’t make the tumor glow right away, but the moment you open up the body cavity and it gets exposed to light, [the dye] becomes activated and the tumor will start glowing. It’s actually a basic idea. It’s a dye that goes to tumors, gets to the tumor and starts glowing.

What is the benefit for a surgeon to make the tumor glow?

There are two main things you can imagine. The first thing is that by seeing where the tumor is you can make sure you get it all out. The technology is being used in other disease areas and the surgeons are reporting that they show improvement over the standard approach, have better margins and can be more precise. So, it makes it a lot easier and safer for the patient if [the surgeons] take out what they need to take out and don’t take out what they don’t need to take out. It makes the operation more precise than the standard approach.

The other advantage is for what I do as a lung cancer surgeon. And for me, it’s to find lymph nodes. The lymph nodes are really important because when the cancer goes there it tells us that you may need to give them more therapy or tells us that they are in a worse clinical stage. So, it’s important for us to know if the lymph nodes are positive. This technology allows us to identify which lymph nodes we should take out and which lymph nodes we should leave in.

What was the inspiration behind the technique?

I started getting interested in this in 2007, however the concept has been around. While we’ve made a lot of big contributions in our laboratory and here at Penn, the idea is not completely new although it had not been worked out to the point to where it has been used in people up until the last couple of years. My interest in this technology stemmed out of my own frustration of the high rate of patients that have been previously treated and then develop cancer again. So, that was the impetus for me to say that there’s got be a better way to do this and that’s when I got involved.

Which cancers can benefit from the technique?

We don’t know of tumor types that won’t benefit yet. We’ve been slowly increasing our range. We’ve been mainly using it for prostate cancer, kidney cancer, brain tumors and lung cancer. Our intention is to expand into other types of tumors in the near future. It’s a relatively new technology.

How do you think this technique will change cancer treatment going forward?

My hope is that the availability of these dyes and this technique will become more of a standard of care when surgically resecting cancers and ultimately decrease the cancer recurrence for many patients.

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