Rapid new test transforms brain tumour diagnosis

Oliver Conway (0:00)

This is The Global News Podcast from the BBC World Service. Hello, I'm Oliver Conway. We're recording this at 14 Hours GMT on Friday the 25th of September. A new test for brain tumors can slash diagnosis time to just two hours. President Zelensky says the US will allow Ukraine to produce Patriot missiles despite a previous U-turn. And a Filipino maid who narrowly escaped execution in Indonesia has been pardoned.

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A new rapid test for brain tumours can slash diagnosis time to just two hours, meaning patients no longer have to wait weeks for news. It means surgeons can get results even while they're operating. Hospitals in the UK are trialling the test, as our medical editor, Fergus Walsh, reports.

Fergus Walsh (1:06)

Steve Palmer is being wheeled to the operating theatres at Queen's Medical Centre Nottingham in the heart of the UK.

The 55-year-old collapsed a few weeks ago and was diagnosed with a brain tumour. It is being prepped for surgery.

Steve Palmer (1:23)

Hopefully all of it removed and would be great. Then it can get on with recovery and whatever comes next and then it's getting back to hopefully some normality.

Stuart Smith (1:33)

So this is the scan of Stephen's head made by the computer system.

Fergus Walsh (1:36)

In theatre, neurosurgeon Stuart Smith is reviewing MRI scans.

Stuart Smith (1:42)

This is the right frontal lobe where the white area represents the tumour within his brain that we're going to be operating on today.

Fergus Walsh (1:48)

How big is that?

Stuart Smith (1:49)

So this tumour is about five or six centimetres across in total.

Fergus Walsh (1:53)

More than 12,000 people a year are diagnosed with a brain tumour in the UK alone. There are more than 150 different types, and a thorough genetic analysis means a definitive diagnosis can take six to eight weeks after surgery.

Not this time.

Once Steve's tumour is exposed, the surgeons carefully select tissue samples.

Simon Payne (2:18)

Damaged by any of the surgical techniques, this all looks viable. It doesn't look necrotic. And then top right.

Fergus Walsh (2:25)

These contain all the genetic information needed to grade and diagnose his tumour.

They're bagged up and taken to the pathology labs. The rapid genomic test was developed by scientists at the University of Nottingham in partnership with hospital clinicians.

Simon Payne (2:44)

And what we're hoping to have in 90 minutes or so will be a confident, comprehensive molecular classification.

Fergus Walsh (2:52)

The samples are fed into an ultra-rapid sequencing machine the size of a shoebox. Molecules of DNA pass through a nanopore or tiny hole, which reveals the tumour's unique genomic fingerprint.

Simon Payne (3:09)

The nanopore is running now. It's been running for about 20 minutes.

Fergus Walsh (3:12)

Dr Simon Payne, consultant neuropathologist at Nottingham University Hospitals, phones the operating theatre with the results.

Simon Payne (3:22)

Given the bigger picture and those copy number changes, I think this would be most in keeping with glioblastoma.

Fergus Walsh (3:27)

Neurosurgeon Stuart Smith has taken the call.

Stuart Smith (3:30)

Yeah, I think we've probably done as much as we can in terms of taking out the visible tumour. Yeah, great. Well, thank you very much. That's really helpful and that will help us finish up the operation.

Fergus Walsh (3:43)

A definitive diagnosis has taken just two hours, with Steve Palmer still on the operating table. Stuart Smith says it's an extraordinary medical advance.

Stuart Smith (3:55)

It seems almost magical that you can do things that quickly, but this adds a whole new level of information that will guide the surgeon and allow us to make more accurate decisions about how much surgery we do, how extensive that operation is. Hi Stephen, how are you?

Fergus Walsh (4:12)

Neurosurgeon Stuart Smith is able to feed back the results and a treatment plan to Steve within days rather than many weeks.

Stuart Smith (4:22)

I'm afraid it's not great news in terms of what type of tumour it is. It is one of these grade 4 tumours and the name for that type of tumour is glioblastoma.

Fergus Walsh (4:33)

But it does mean chemo and radiotherapy can start sooner.

Stuart Smith (4:38)

The other benefit of getting all the genetic diagnosis means that we have a full genetic profile of the tumour. And that hopefully will open the door to clinical trials for you. There's a national programme being...

Steve Palmer (4:51)

Obviously it wasn't what I wanted to hear. But for me, getting that quick diagnosis, let's get on to the next phase of treatment and recovery and get on to fighting whatever I've got to fight.