Preserving Malignant Tissue for Benign Purposes

For thousands of cancer patients who have undergone successful surgeries to remove malignant tumours, the fear that the insidious disease might strike again never really goes away.

One way that patients can better equip themselves to battle the disease the next time it appears is by knowing exactly what type of cancer they had. A molecular analysis of the cancer cells that are stored in a tissue bank can yield vital information about whether new medicines could treat a patient’s particular type of cancer.

New hope for cancer sufferers in Germany

So far cancer patients in Germany didn’t necessarily have that option. Unlike other countries, for instance in Scandinavia, doctors in Germany are not bound by law to indefinitely preserve cancerous tissues of their patients in such a manner that they could be used to test new diagnostic developments and therapies.

But a first-of-its-kind initiative called PA.T.H. or Patients’ Tumour Bank of Hope in Augsburg, in southern Germany, could change that.

Founded by medical journalist and breast-cancer sufferer Ursula Goldmann-Posch and other patients and researchers, PA.T.H. allows cancer patients the option to store tissues taken from their malignant tumours before they undergo surgery to remove the tumours.

Those patients who decide to store their tumours at PA.T.H are advised about the entire procedure by representatives from PA.T.H and the surgeons. Once the malignant tumour is removed, it is immediately transported in a special liquid to PA.T.H in Augsburg and frozen using a special tissue-freezing method called cryogenics.

For this purpose, PA.T.H works together with a firm in Hanover called "Lip-Nova", which specialises in freezing the tumour tissue according to the latest European standards. By testing the cancerous tumour tissue stored in PA.T.H, the firm also hopes to develop new medicines to fight cancer that are tailor-made for individual patients.

Existing procedure and laws in Germany redundant?

Usually pathologists in Germany examine the removed tumescent lump after a cancer operation to determine, among other things, whether the tumour has been fully removed. As part of the post-surgical procedure, the pathologist cuts paper-thin slices from the tumour tissue, prepares them in paraffin and examines them under a microscope.

What then happens to the intact tumour tissue lies entirely in the hands of the pathologists. Under German law, the thin treated slices of tissue must be preserved for ten years.

But Michael Untch, Head of the Breast Cancer Research Centre at the Munich University Clinic Grosshadern, told the daily "Berliner Zeitung" in an interview that no living cell material can be retrieved from such treated slices of tumour tissue.

"Only by analysing living cell material can new diagnostic procedures and therapies for cancer be developed", he said.

Therefore, the current procedure hardly provides the research benefits justifying the 10-year storage law. In a sense, the law becomes redundant, since the tissues are scientifically ineffective.

Big step forward for research

The central tissue bank has been largely welcomed by medical researchers and scientists in Germany, who see the bank as a one-stop place for scientists involved in cancer and molecular biological research.

But the founders of PA.T.H are clear to point out that the tissue bank is not open to all research because it isn’t always in the interest of their cancer patients.

Instead the bank – guided by an advisory board of experts such as the Brussels breast cancer researcher, Martine Piccart, and Director of the Max Planck Institute for Molecular Genetics, Hans Lehrach – will allow testing of their tissue samples only for certain research projects.

Founding PA.T.H member Goldmann-Posch told the "Berliner Zeitung" "it’s equally important for us that doctors and researchers recognise cancer patients as equal partners in research".

So far, some 40 cancer patients have submitted their tissue samples and disease data to PA.T.H. The freezing of one tumour costs 500 euro ($497), while yearly costs for preserving the tissue are 50 euro ($47).

Patients sign an agreement before their operation, where the terms for preservation, collection and usage of the tumour tissue are laid down. The privacy of donors is protected and the bank maintains a database of valuable follow-up information to contact donors if necessary.

An anonymous donor and cancer patient told the "Berliner Zeitung", "I’m convinced that every cancer patient would be ready to pay to preserve his tumour tissue, if through it he someday has the chance for a new therapy".