Working Group 1 (WG1) – Cancer EMF interactions and applications
Leader: Gerard C. Van Rhoon, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
concerting the research on treatment and diagnosis of cancer using EMFs and/or EMF-based technologies.
– establish the scientific rationale of cancer treatments based on low level and high level EMFs;
– optimize the administration and control of EMF-based cancer treatment
– develop and/or improve EMF-based cancer diagnostic modalities
– develop the associated technology for clinical use
Treatment and diagnosis of cancer using low-level EMFs is an emerging methodology with a breakthrough potential, which so far lacks a sound scientific foundation, although clinical trials have shown promising results. Therefore, a wide range of interdisciplinary and multilevel studies are needed. Clinical evidence suggests that low-level EMFs having certain frequencies within the radiofrequency (RF) range of the spectrum may have anti-tumour effects without causing hyperthermia, for several types of cancer. It is important to emphasize that these interactions occur at the non-thermal level of applied EMFs, well under the ICNIRP limits for harmful exposure. However, there are evident gaps in knowledge that limit the applicability of this treatment. To improve the knowledge linked to cancer treatment and diagnosis based on EMFs, the modifications undergone by cells and tissues due to the interaction with low-levels EMFs will be investigated with the aim of evidencing the EMFs characteristics linked to morphological or other cells modifications. These data will be useful for developing the scientific rationale of treatments based on low level EMFs.
The discovered interactions of EMFs with tumour tissues and cells raise questions whether similar underlying mechanisms could be used for cancer diagnosis. One group of investigators reported a phenomenon of “tumour-specific frequency signature” identified in patients with primary malignancies from the same tissue of origin, and lacking in patients without malignancy. Other modalities for EMF-based cancer diagnosis include the use of impedance tomography and radar-like applications where backscattering is used to identify tumour locations. Other approaches use targeted (functionalized) nanoparticles (e.g., magnetic) that can be subsequently imaged using EMFs. Magnetoencephalography (MEG) is a non-invasive modality used to differentiate among neoplastic tissue types in the brain, with the potential to be used in combination with CT or MRI. A modality called TRIMprob has shown sensitivity and specificity in the diagnosis of prostate and rectal cancer by exploiting differences in tissue resonance between neoplastic and normal tissue. Thus, optimization of EMF diagnostic modalities to complement current screening methods may lead to improve diagnosis accuracy.
High-level EMF treatments can be based on: strong heating that directly leads to macroscopically apparent tissue changes (such as tumour coagulation); moderate heating that interferes with the immune system, perfusion and related oxygenation, genetic activity, protein expression, and DNA damage/repair; membrane permeabilization; the use of magnetic nanoparticles that translate applied EMF fields into deposited energy and temperature activated liposomes for targeted drug delivery. Particularly in the case of moderate heating treatment (e.g., hyperthermia), the mechanisms, expected outcomes, and optimal administration and control are poorly understood. Cancer treatment applications with high-level EMFs, as hyperthermia and radiofrequency (RF)/microwave (MW) thermal ablation, still present challenging aspects for the clinical practice. In particular, thermal ablation is a technique that has remarkably developed in the last years, showing many promising advantages for local treatment of soft-tissue pathologies as tumours, and offering the possibility of treating relative large tissue areas with minimally invasive applicators. The implementation of treatment planning procedures for the clinical practice requires the development of patient-specific simulation models, exploiting the availability of high-resolution digital models (e.g. from MR or CT scanners) and automated tools for the EM model generation. However there are several open issues to be investigated, with particular reference to the changes in the dielectric, thermal and morphologic properties of tissues due to the very high temperatures reached during an EMF-based ablation treatment. Deeper understanding of these phenomena could allow the development of optimised ablation antennas and of predictive tools for personalised treatment planning in clinical practice.