WO2004030760A2 - Apparatus for treating a tumor by an electric field - Google Patents

Apparatus for treating a tumor by an electric field Download PDF

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Publication number
WO2004030760A2
WO2004030760A2 PCT/IB2003/004321 IB0304321W WO2004030760A2 WO 2004030760 A2 WO2004030760 A2 WO 2004030760A2 IB 0304321 W IB0304321 W IB 0304321W WO 2004030760 A2 WO2004030760 A2 WO 2004030760A2
Authority
WO
WIPO (PCT)
Prior art keywords
electric field
dividing cells
insulated
conductor
electrode
Prior art date
Application number
PCT/IB2003/004321
Other languages
French (fr)
Other versions
WO2004030760A3 (en
Inventor
Yoram Palti
Original Assignee
Standen Ltd.
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Priority claimed from US10/263,329 external-priority patent/US7136699B2/en
Priority claimed from US10/285,313 external-priority patent/US7089054B2/en
Priority to AU2003265066A priority Critical patent/AU2003265066A1/en
Priority to EP10012702.6A priority patent/EP2281602B1/en
Priority to JP2004541094A priority patent/JP4350042B2/en
Priority to EP19183539.6A priority patent/EP3572123B1/en
Priority to ES03799042T priority patent/ES2813059T3/en
Priority to EP10012706.7A priority patent/EP2281603B1/en
Application filed by Standen Ltd. filed Critical Standen Ltd.
Priority to EP19219623.6A priority patent/EP3656441B1/en
Priority to EP10012777.8A priority patent/EP2281605B1/en
Priority to DK03799042.1T priority patent/DK1545704T3/en
Priority to EP19219652.5A priority patent/EP3659671A1/en
Priority to CA2499845A priority patent/CA2499845C/en
Priority to EP10012716.6A priority patent/EP2281604B1/en
Priority to EP03799042.1A priority patent/EP1545704B1/en
Publication of WO2004030760A2 publication Critical patent/WO2004030760A2/en
Publication of WO2004030760A3 publication Critical patent/WO2004030760A3/en

Links

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00Electrotherapy; Circuits therefor
    • A61N1/18Applying electric currents by contact electrodes
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00Electrotherapy; Circuits therefor
    • A61N1/40Applying electric fields by inductive or capacitive coupling ; Applying radio-frequency signals
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14Probes or electrodes therefor
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00017Electrical control of surgical instruments
    • A61B2017/00022Sensing or detecting at the treatment site
    • A61B2017/00084Temperature

Definitions

  • This invention concerns selective destruction of rapidly dividing
  • microorganisms such as bacteria, mycoplasma, yeast, protozoa, and
  • organisms can be destroyed, or their proliferation controlled, by methods that are
  • centrioles (each cell contains 2) begin moving towards opposite poles
  • each chromosome is composed of duplicate
  • Microtubular spindles radiate from regions adjacent to the
  • centrioles which are closer to their poles.
  • the centrioles have reached the poles, and some spindle fibers extend to the center of the cell, while
  • the cell begins to elongate along
  • cytokinesis begins as the cleavage
  • cytokinesis is complete and the cell returns to interphase.
  • Bacteria also divide by chromosome replication, followed by cell
  • cancer treatments e.g., irradiation therapy and the use of various chemo ⁇
  • Such treatments are based on the fact that cells undergoing
  • Examples of the first type of application include the
  • cardiac defibrillators peripheral nerve and muscle stimulators, brain-derived neurotrophic stimulators
  • an electric wave such as an RF wave or a microwave source that is
  • the energy is transmitted to the body by radiation or induction. More
  • the electric energy generated by the source reaches the vicinity of the
  • the applied electrical current destroys substantially all cells
  • the electric fields are high frequency
  • alternating fields applied to the body by means of insulated electrodes are alternating fields applied to the body by means of insulated electrodes.
  • the first type of electric field is used, for example, to stimulate
  • This heating can be calculated by the power
  • stimulatory power on nerve, muscle, etc.
  • is an inverse function of the frequency
  • one negative effect is the changes in ionic concentration in the various
  • the dominant field effect is that due to dielectric losses and
  • the cells are selected on the basis of intrinsic or induced
  • threshold can depend upon a number of parameters, including the difference in
  • the apparatus can be incorporated into a number of different organisms.
  • the apparatus can be incorporated into a number of different organisms.
  • the apparatus is particularly capable of
  • the apparatus is configured to:
  • the apparatus can be any type of tumor condition.
  • the apparatus can be any type of tumor condition.
  • the apparatus can be any type of tumor condition.
  • the apparatus can be any type of tumor condition.
  • testicles a hand, leg, arm, neck, etc., for treating a localized tumor in one of these
  • type structure can be used to treat thyroid, parathyroid, laryngeal lesions, etc.
  • the apparatus (either completely or partially) is disposed within
  • the apparatus when it is in the form of an internal member (e.g., a probe or catheter) that is inserted into the body through a
  • a major use of the present apparatus is in the treatment of tumors
  • cell may also refer to a single-
  • present apparatus causes minimal damage, if any, to normal tissue and, thus,
  • destruction of dividing cells is based on distinguishable geometrical characteristics of cells undergoing division, in comparison to non-dividing cells,
  • cells in their non-dividing state may have different shapes, e.g., spherical,
  • This cleavage furrow is a slow cell membrane
  • a growing cleft e.g., a groove or notch
  • the cell structure is basically that of two sub-cells interconnected by
  • the electric current flow pattern for cells undergoing division is
  • Such cells including
  • first and second sub-cells namely an "original" cell and a newly formed cell
  • organelles and macromolecules are polarizable, they are all force towards the
  • neck portion in itself exerts strong forces on charges and natural dipoles and can
  • the membrane and disrupt other cell structures can be enhanced by applying a
  • pulsating alternating electric field that has a frequency from about 50KHz to
  • pulses are applied to the organelles numerous times per second,
  • apparatus includes a generator that generates an alternating voltage waveform at
  • the generator is
  • conductive leads which are connected at their other ends to insulated conductors/electrodes (also referred to as isolects) that are activated
  • the insulated electrodes consist of a conductor in
  • present apparatus can be applied in several different modes depending upon the
  • the electric fields are applied by
  • the generated by the insulated electrodes are directed at the tumors (lesions, etc.).
  • the apparatus is used in an
  • the insulated electrodes are in the form of a probe
  • the present apparatus utilizes electric fields that fall into a
  • electrodes are used, i.e., ion concentration changes in the cells and the formation
  • the selective destruction utilizing the present apparatus can be used in conjunction with any organism that proliferates division and multiplication, for
  • tissue cultures such as bacteria, mycoplasma,
  • bridge is formed between the two parts of the organism, similar to the bridge
  • Figs. 1A-1E are simplified, schematic, cross-sectional, illustrations
  • FIGS. 2 A and 2B are schematic illustrations of a non-dividing cell
  • Figs. 3 A, 3B and 3C are schematic illustrations of a dividing cell
  • Fig. 4 is a schematic illustration of a dividing cell at one stage
  • Fig. 5 is a schematic block diagram of an apparatus for applying
  • Fig. 6 is a simplified schematic diagram of an equivalent electric
  • Fig. 7 is a cross-sectional illustration of a skin patch incorporating
  • Fig. 8 is a cross-sectional illustration of the insulated electrodes
  • FIG. 9 is a cross-sectional illustration of the insulated electrodes
  • Figs. 10A-10D are cross-sectional illustrations of various components
  • Fig. 11 is a front elevational view in partial cross-section of two
  • insulated electrodes being arranged about a human torso for treatment of a tumor
  • a container within the body e.g., a tumor associated with lung cancer
  • Figs. 12A-12C are cross-sectional illustrations of various insulated
  • Fig. 13 is a schematic diagram of insulated electrodes that are
  • Fig. 14 is a cross-sectional view of insulated electrodes
  • Fig. 15 is a partial section of a hat according to an exemplary
  • Fig. 16 is a cross-sectional view of the hat of Fig. 15 placed on a
  • Fig. 17 is a cross-sectional top view of an article of clothing
  • Fig. 18 is a cross-sectional view of a section of the article of
  • Fig. 19 is a cross-sectional view of a probe according to one
  • Fig. 20 is an elevational view of an unwrapped collar according to
  • Fig. 21 is a cross-sectional view of two insulated electrodes with
  • Fig. 22 is a cross-sectional view of the arrangement of Fig. 21
  • Fig. 23 is a cross-sectional view of an arrangement of at least two
  • insulated electrodes with conductive gel members being arranged about a body
  • each conductive gel member has a
  • Fig. 24 is a cross-sectional view of another arrangement of at least
  • a conductive member is
  • Fig. 25 is a cross-sectional view of an arrangement of two
  • Fig. 26 is a cross-sectional view of an arrangement of at least two
  • insulated electrodes with conductive gel members being arranged about a body
  • each conductive gel member has a
  • FIG. 1A illustrates a cell 10 at its normal
  • Figs. IB- ID illustrate cell 10 during different stages of its division
  • sub-cells 14 and 16 which eventually evolve into new cells 18
  • non-dividing cell 10 being subjected to an electric field produced by applying an alternating electric potential, at a relatively low frequency and at a
  • Cell 10 includes intracellular organelles,
  • Electrodes 28 e.g., a nucleus 30. Alternating electric potential is applied across electrodes 28
  • volume conductor (hereinafter referred to as a "volume conductor") consisting mostly of electrolytic
  • FIG. 2B depicted generally in Fig. 2B.
  • intercellular (i.e., extracellular) fluid and the intracellular fluid each has a
  • the membrane capacitance can short the membrane resistance and, therefore, the
  • electrodes 28 and 32 are electrically insulated.
  • the displacement currents are induced in the tissue due to charging
  • intracellular organelles according to the present invention (as described below) is
  • insulated electrodes can be used efficiently. Several advantages of insulated electrodes
  • Electrodes are that they have lower power consumption and cause less heating of
  • the intercellular fluid is mostly an electrolyte with a specific
  • Fig. 2 schematically depicts the resulting field distribution in the
  • membrane is that of a resistor and capacitor in parallel, the impedance is a
  • TC fields alternating fields
  • bridge 22 also
  • neck 22 the current/field line density within neck 22 is
  • nuclei 24 and 26 are known in the art that all intracellular organelles, for example, nuclei 24 and 26
  • sub-cells 14 and 16 are polarizable and, thus, such intracellular
  • organelles are electrically forced in the direction of the bridge 22. Since the
  • organelles such as nuclei 24 and 26 are always in the direction of bridge 22.
  • bridge membrane 22 results in the breakage of cell membrane 11 at the vicinity
  • organelles 24 and 26 have a "hammering" effect, whereby pulsed forces beat on
  • a dividing cell 10 is illustrated, at an
  • fields e.g., alternating fields in the frequency range of about lOOKHz to about
  • the lines 120 are microtubules that are
  • tubules as well as other polar macromolecules and especially those that have a specific orientation within the cells or its surrounding, susceptible to electric
  • negative poles are at the center of the dividing cell and the other pair is at the
  • This structure forms sets of double dipoles and therefore they
  • Fig. 5 is a simple schematic diagram of the electronic apparatus
  • the electronic apparatus 200 illustrating the major components thereof.
  • the electronic apparatus 200
  • the apparatus 200 includes a generator 210 and a pair of
  • conductive leads 220 that are attached at one end thereof to the generator 210.
  • the opposite ends of the leads 220 are connected to insulated conductors 230 that
  • the insulated conductors are activated by the electric signals (e.g., waveforms).
  • the insulated conductors e.g., waveforms.
  • isolects 230 are also referred to hereinafter as isolects 230.
  • isolects 230 are also referred to hereinafter as isolects 230.
  • the apparatus 200 includes a temperature sensor
  • the generator 210 generates an alternating voltage waveform at
  • control box 250 When the control box 250 is included, it controls the output of the
  • control box 250 sets the output at the maximal value that does not cause
  • control box 250 issues a warning or the like when the
  • temperature (sensed by temperature sensor 240) exceeds a preset limit.
  • the leads 220 are standard isolated conductors with a flexible
  • metal shield preferably grounded so that it prevents the spread of the electric
  • the isolects 230 have specific shapes and
  • the apparatus 200 that behave differently are the insulators of the isolects 230 (see Figs. 7-9).
  • the isolects 200 consist of a conductor in contact with a dielectric
  • TC fields e.g., 50KHz to 500KHz
  • intermediate frequencies e.g., 50KHz to 500KHz
  • the impedance of the capacitance of the capacitors is dominant and determines
  • dielectric or use a dielectric with high dielectric constant.
  • the isolects 230 are
  • TC fields can be applied by external isolects and
  • the TC fields can be applied by internal isolects.
  • TC fields Electric fields that are applied by external isolects
  • the first type includes, for example,
  • Fig. 7 illustrates an exemplary embodiment where the isolects 230 are
  • the skin patch 300 can be a self-adhesive
  • the patch 300 includes
  • insulation 260 is applied to skin surface 301 that contains a tumor 303 either
  • Tissue is
  • the internal insulation 310 must have a relatively high capacity. This can be achieved by a large surface area; however,
  • the internal portion (e.g., an area larger than required to treat the tumor).
  • the internal portion (e.g., an area larger than required to treat the tumor).
  • insulation 310 can be made very thin and/or the internal insulation 310 can be of
  • the impedance if it is desired for the impedance to be about 10K Ohms or less, such
  • the capacity should be on the order of
  • the thickness of the insulating layer 310 should be about 50-100 microns.
  • insulation can be replaced by very high dielectric constant insulating materials
  • the dielectric constant can reach values of
  • lithium nibate LiNbO 3
  • ferroelectric crystal LiNbO 3
  • YIG yittrium iron garnet
  • optical isolator can be realized from this material; barium titanate (BaTiO )
  • KTaO a dielectric crystal (ferroelectric at low temperature) and has
  • LiTaO lithium tantalate
  • lithium niobate properties as lithium niobate and has utility in electro-optical, pyroelectric and
  • the isolects 230 can be
  • the shaping can be any shape that can be added to the structure.
  • the shaping can be any shape that can be added to the structure.
  • the gel can be contained
  • hydrogels can be made of hydrogels, gelatins, agar, etc., and can have salts dissolved in it to
  • FIGs. 10A-10C illustrate various exemplary
  • the thickness of the gel is
  • dielectric coating of each should be very thin, for example from between 1-50
  • the isolect' s structure so as to provide desired protection from such damage.
  • the isolect 230 can be coated, for example, with a relatively loose net
  • the loose net 340 can be formed of a
  • 340 is formed of nylon, polyester, cotton, etc. Alternatively, a very thin
  • conductive coating 350 can be applied to the dielectric portion (insulating layer)
  • One exemplary conductive coating is formed of a metal and
  • the thickness of the coating 350 depends upon the
  • the coating has a thickness from about 0.1
  • rim illustrated in Fig. 10 can also
  • dielectric strength of the internal insulation 310 determines at what field intensity
  • insulators such as plastics, have dielectric strength values of about
  • the internal insulator 310 a combination of a high dielectric constant and a high
  • dielectric strength gives a significant advantage. This can be achieved by using a
  • insulating layer 310 should be eliminated as by rounding the corners, etc., as
  • FIGs. 8 and 9 illustrate a second type of treatment using the
  • isolects 230 namely electric field generation by internal isolects 230.
  • the isolects 230 can have
  • isolects 230 can be large. The pairs can even by positioned opposite sides of a
  • the electric fields (TC fields)
  • the isolects insulating material should be any material and field parameters. The isolects insulating material.
  • Fig. 13 illustrates such an
  • Example is not limiting and does not limit the scope of the present invention in
  • TC fields alternating electric fields
  • the generator 210 and the control system thereof can be any suitable generator.
  • the control system thereof can be any suitable generator.
  • article of clothing 500 is in the form of a hat or cap or other type of clothing
  • a head designed for placement on a head of a person.
  • a head For purposes of illustration, a head
  • An intra-cranial tumor or the like 510 is shown as being
  • the hat 500 is formed within the head 502 underneath the skin surface 504 thereof.
  • insulated electrodes 230 are arranged in a more or less planar arrangement since
  • the insulated electrodes 230 in this embodiment are specifically contoured and
  • lesions or the like typically requires a treatment that is of a relatively long
  • the hat 500 is specifically designed to provide
  • the hat 500 includes a
  • the tumor 510 is positioned within these lines of force 520. As will be described
  • the insulated electrodes 230 are positioned within the insulated electrodes 230 .
  • insulated electrodes 230 are placed in contact with the skin surface 504 of the
  • hair on the head 502 is shaved in selected areas to permit better contact
  • the hat 500 preferably includes a mechanism 530 that applies or
  • the mechanism 530 can be of a biasing type that
  • the insulated electrodes 230 are
  • the mechanism 530 pressed against the skin surface 504 by the mechanism 530.
  • the mechanism 530 is pressed against the skin surface 504 by the mechanism 530.
  • the mechanism 530 is a
  • the insulated electrodes 230 are
  • the generator 210 can be any generator 210 that can be coupled to the generator 210 by means of conductors 220.
  • the generator 210 can be any generator 210.
  • independent system or the generator 210 can be disposed external to
  • hat 500 located in any number of different locations, some of which are in close proximity to the hat 500 itself, while others can be further away from the hat 500.
  • the generator 210 can be disposed within a carrying bag or the like
  • generator 210 can also be disposed in a protective case that is secured to or
  • the protective case can be inserted into a pocket of a sweater, etc.
  • a first exemplary embodiment in one exemplary embodiment, a
  • insulated electrodes 230 along with the mechanism 530 are preferably
  • the patient can easily insert and/or remove the units 540 from
  • the hat 500 when they may need cleaning, servicing and/or replacement.
  • the hat 500 is constructed to include select
  • each area 550 is in the form of an opening
  • the unit 540 has a body 542 and
  • the mechanism 530 includes the mechanism 530 and one or more insulated electrodes 230.
  • mechanism 530 is arranged within the unit 540 so that a portion thereof (e.g., one
  • each insulated electrode 230 is in contact with a face of each insulated electrode 230 such that the
  • mechanism 530 applies a biasing force against the face of the insulated electrode
  • the hat 500 is a of an adhesive material or by using mechanical means.
  • the hat 500 is a hat 500
  • pivotable clip members that pivot between an open position in which
  • the opening 550 is free and a closed position in which the pivotable clip members
  • portions e.g., peripheral edges
  • the insulated electrodes 230 are retained within
  • an adhesive element 560 which in one embodiment is a two
  • adhesive rim 560 is removed and it is applied around the periphery of the exposed face of the insulated electrode 230, thereby securely attaching the
  • one side of the adhesive rim 560 is in contact with and secured to the skin surface
  • rim 560 can be placed flushly against the skin surface 540.
  • the adhesive rim 560 is designed to securely attach the unit 540
  • the opening 550 in a manner that permits the unit 540 to be easily removed from
  • the hat 500 when necessary and then replaced with another unit 540 or with the
  • the unit 540 includes the biasing
  • the unit 540 can be constructed so that side
  • a support surface formed of a rigid
  • biasing mechanism 530 e.g., a spring
  • the biasing mechanism 530 e.g., spring
  • the biasing mechanism 530 preferably has a contour corresponding
  • the insulated electrode 230 thereto to permit the insulated electrode 230 to have a contour complementary to
  • mechanism 530 can be a spring, there are a number of other
  • 530 can be in the form of an elastic material, such as a foam rubber, a foam
  • the unit 540 has an electric connector 570 that can be hooked up
  • a corresponding electric connector such as a conductor 220, that is disposed
  • the conductor 220 connects at one end to the unit 540 and at
  • the generator 210 can be any generator 210.
  • the generator 210 can be any generator 210.
  • the generator 210 can be positioned directly into the hat 500 or the generator 210 can be positioned
  • a coupling agent such as a conductive
  • the coupling agent is disposed on the insulated electrode 230 and
  • a uniform layer of the agent is provided along the surface of the
  • the patient after a predetermined time period or after a number of uses, the patient
  • Figs. 17 and 18 illustrate another article of clothing which has the
  • insulated electrodes 230 incorporated as part thereof. More specifically, a bra or
  • the like 700 is illustrated and includes a body that is formed of a traditional bra
  • the bra 700 also includes a fabric support layer 710 on one side thereof.
  • the support layer 710 is preferably formed of a suitable fabric material that is
  • bra 700 constructed to provide necessary and desired support to the bra 700.
  • the bra 700 includes one or
  • the one or more insulated electrodes are disposed along an inner surface of the bra 700
  • the insulated electrodes 230 in this embodiment are identical to the insulated electrodes 230 in this embodiment.
  • a lining 720 is disposed across the insulated electrodes 230 so as
  • the lining 720 can be
  • the lining 720 is formed of a fabric
  • the bra 700 also preferably includes a biasing mechanism 800 as
  • the biasing mechanism 800 is disposed
  • electrode 230 remains in contact with the skin surface as opposed to lifting away
  • mechanism 800 can be in the form of a spring arrangement or it can be an elastic
  • the biasing mechanism 800 applies a force against the insulated electrodes 230
  • biasing mechanism 800 is in the form of springs that are disposed within the bra
  • a conductive gel 810 can be provided on the insulated electrode
  • the conductive gel layer 810 is
  • An electric connector 820 is provided as part of the insulated
  • the conductor 220 runs within the bra
  • conductor 220 extends through this opening and is routed to the generator 210,
  • the generator 210 can be disposed within the bra 700
  • the bra 700 can have a compartment
  • the compartment can be
  • a releasable strap that can open and close to permit the generator
  • the strap can be formed of the
  • bra 700 same material that is used to construct the bra 700 or it can be formed of some
  • the strap can be releasably attached to the surrounding
  • bra body by fastening means, such as a hook and loop material, thereby
  • loop elements to gain access to the compartment for either inserting or removing
  • the generator 210 also has a connector 211 for electrical
  • the insulated electrodes 230 are
  • TC fields electric field
  • 230 within the bra 700 will vary depending upon the location of the tumor.
  • insulated electrodes 230 can likewise vary. For example, if the insulated
  • Electrodes 230 are placed on the bottom section of the bra 700 as opposed to a
  • the insulated electrodes 230 will have different shapes
  • FIG. 19 illustrates yet another embodiment in which the insulated
  • electrodes 230 are in the form of internal electrodes that are incorporated into in
  • a probe or catheter 600 that is configured to enter the body through a
  • the natural pathway such as the urethra, vagina, etc.
  • the urethra such as the urethra, vagina, etc.
  • insulated electrodes 230 are disposed on an outer surface of the probe 600 and
  • the conductors 220 are electrically connected to the
  • Electrodes 230 and run within the body of the probe 600 to the generator 210
  • the probe 600 can be configured to penetrate the
  • the probe 600 can penetrate the skin surface and then be positioned
  • the probe 600 is inserted through the
  • Electrodes 230 are disposed near the target area (i.e., the tumor).
  • probe 600 is merely exemplary in nature and
  • probe 600 can have other shapes and configurations so long as they can

Abstract

An apparatus is provided for selectively destroying dividing cells in living tissue formed of dividing cells and non-dividing cells. The dividing cells contain polarizable intracellular members and during late anaphase or telophase, the dividing cells are connected to one another by a cleavage furrow. The apparatus includes insulated electrodes to be coupled to a generator for subjecting the living tissue to electric field conditions sufficient to cause movement of the polarizable intracellular members toward the cleavage furrow in response to a non-homogeneous electric field being induced in the dividing cells. The movement of the polarizable intracellular intracellular members towards the cleavage furrow causes the breakdown thereof which adversely impacts the multiplication of the dividing cells. Preferably, an intervening member is disposed between each insulated electrode and the skin surface and each intervening member includes a conductive 'floating' plate that protects against the effects on the patient from a breakdown in the insulation of the electrode.

Description

APPARATUS FOR TREATING A TUMOR OR THE LIKE AND ARTICLES INCORPORATING THE APPARATUS
FOR TREATMENT OF THE TUMOR
Cross-Reference Related Applications
This application claims the benefit of U.S. patent application No.
10/315,576, filed December 10, 2002, which is a continuation-in-part application
of U.S. patent application serial No. 10/285,313, filed October 31, 2002, which is
a continuation-in-part application of U.S. patent application serial No. 10/263,329,
filed October 2, 2002, which are hereby incorporated by reference in their
entirety.
Technical Field
This invention concerns selective destruction of rapidly dividing
cells in a localized area, and more particularly, to an apparatus and method for
selectively destroying dividing cells by applying an electric field having certain prescribed characteristics using an apparatus that is configured to be
complimentary to a specific body part.
Background
All living organisms proliferate by cell division, including cell
cultures, microorganisms (such as bacteria, mycoplasma, yeast, protozoa, and
other single-celled organisms), fungi, algae, plant cells, etc. Dividing cells of
organisms can be destroyed, or their proliferation controlled, by methods that are
based on the sensitivity of the dividing cells of these organisms to certain agents.
For example, certain antibiotics stop the multiplication process of bacteria.
The process of eukaryotic cell division is called "mitosis", which
involves nice distinct phases (see Darnell et al, Molecular Cell Biology, New
York: Scientific American Books, 1986, p. 149). During interphase, the cell
replicates chromosomal DNA, which begins condensing in early prophase. At
this point, centrioles (each cell contains 2) begin moving towards opposite poles
of the cell. In middle prophase, each chromosome is composed of duplicate
chromatids. Microtubular spindles radiate from regions adjacent to the
centrioles, which are closer to their poles. By late prophase, the centrioles have reached the poles, and some spindle fibers extend to the center of the cell, while
others extend from the poles to the chromatids. The cells then move into
metaphase, when the chromosomes move toward the equator of the cell and align
in the equatorial plane. Next is early anaphase, during which time daughter
chromatids separate from each other at the equator by moving along the spindle
fibers toward a centromere at opposite poles. The cell begins to elongate along
the axis of the pole; the pole-to-pole spindles also elongate. Late anaphase
occurs when the daughter chromosomes (as they are not called) each reach their
respective opposite poles. At this point, cytokinesis begins as the cleavage
furrow begins to form at the equator of the cell. In other words, late anaphase is
the point at which pinching the cell membrane begins. During telophase,
cytokinesis is nearly complete and spindles disappear. Only a relatively narrow
membrane connection joins the two cytoplasms. Finally, the membranes separate
fully, cytokinesis is complete and the cell returns to interphase.
In meisosis, the cell undergoes a second division, involving
separation of sister chromosomes to opposite poles of the cell along spindle
fibers, followed by formation of a cleavage furrow and cell division. However,
this division is not preceded by chromosome replication, yielding a haploid germ
cell. Bacteria also divide by chromosome replication, followed by cell
separation. However, since the daughter chromosomes separate by attachment to
membrane components; there is no visible apparatus that contributes to cell
division as in eukaryotic cells.
It is well known that tumors, particularly malignant or cancerous
tumors, grow uncontrollably compared to normal tissue. Such expedited growth
enables tumors to occupy an ever-increasing space and to damage or destroy
tissue adjacent thereto. Furthermore, certain cancers are characterized by an
ability to transmit cancerous "seeds", including single cells or small cell clusters
(metastasises), to new locations where the messastatic cancer cells grow into
additional tumors.
The rapid growth of tumors, in general, and malignant tumors in
particular, as described above, is the result of relatively frequent cell division or
multiplication of these cells compared to normal tissue cells. The distinguishably
frequent cell division of cancer cells is the basis for the effectiveness of existing
cancer treatments, e.g., irradiation therapy and the use of various chemo¬
therapeutic agents. Such treatments are based on the fact that cells undergoing
division are more sensitive to radiation and chemo-therapeutic agents than non- dividing cells. Because tumors cells divide much more frequently than normal
cells, it is possible, to a certain extent, to selectively damage or destroy tumor
cells by radiation therapy and/or chemotherapy. The actual sensitivity of cells to
radiation, therapeutic agents, etc., is also dependent on specific characteristics of
different types of normal or malignant cell types. Thus, unfortunately, the
sensitivity of tumor cells is not sufficiently higher than that many types of normal
tissues. This diminishes the ability to distinguish between tumor cells and
normal cells, and therefore, existing cancer treatments typically cause significant
damage to normal tissues, thus limiting the therapeutic effectiveness of such
treatments. Furthermore, the inevitable damage to other tissue renders treatments
very traumatic to the patients and, often, patients are unable to recover from a
seemingly successful treatment. Also, certain types of tumors are not sensitive at
all to existing methods of treatment.
There are also other methods for destroying cells that do not rely
on radiation therapy or chemotherapy alone. For example, ultrasonic and
electrical methods for destroying tumor cells can be used in addition to or instead
of conventional treatments. Electric fields and currents have been used for
medical purposes for many years. The most common is the generation of electric
currents in a human or animal body by application of an electric field by means of a pair of conductive electrodes between which a potential difference is
maintained. These electric currents are used either to exert their specific effects,
i.e., to stimulate excitable tissue, or to generate heat by flowing in the body since
it acts as a resistor. Examples of the first type of application include the
following: cardiac defibrillators, peripheral nerve and muscle stimulators, brain
stimulators, etc. Currents are used for heating, for example, in devices for tumor
ablation, ablation of malfunctioning cardiac or brain tissue, cauterization,
relaxation of muscle rheumatic pain and other pain, etc.
Another use of electric fields for medical purposes involves the
utilization of high frequency oscillating fields transmitted from a source that
emits an electric wave, such as an RF wave or a microwave source that is
directed at the part of the body that is of interest (i.e., target). In these instances,
there is no electric energy conduction between the source and the body; but
rather, the energy is transmitted to the body by radiation or induction. More
specifically, the electric energy generated by the source reaches the vicinity of the
body via a conductor and is transmitted from it through air or some other electric
insulating material to the human body. In a conventional electrical method, electrical current is delivered
to a region of the target tissue using electrodes that are placed in contact with the
body of the patient. The applied electrical current destroys substantially all cells
in the vicinity of the target tissue. Thus, this type of electrical method does not
discriminate between different types of cells within the target tissue and results in
the destruction of both tumor cells and normal cells.
Electric fields that can be used in medical applications can thus be
separated generally into two different modes. In the first mode, the electric fields
are applied to the body or tissues by means of conducting electrodes. These
electric fields can be separated into two types, namely (1) steady fields or fields
that change at relatively slow rates, and alternating fields of low frequencies that
induce corresponding electric currents in the body or tissues, and (2) high
frequency alternating fields (above 1MHz) applied to the body by means of the
conducting electrodes. In the second mode, the electric fields are high frequency
alternating fields applied to the body by means of insulated electrodes.
The first type of electric field is used, for example, to stimulate
nerves and muscles, pace the heart, etc. In fact, such fields are used in nature to
propagate signals in nerve and muscle fibers, central nervous system (CNS), heart, etc. The recording of such natural fields is the basis for the ECG, EEG,
EMG, ERG, etc. The field strength in these applications, assuming a medium of
homogenous electric properties, is simply the voltage applied to the
stimulating/recording electrodes divided by the distance between them. These
currents can be calculated by Ohm's law and can have dangerous stimulatory
effects on the heart and CNS and can result in potentially harmful ion
concentration changes. Also, if the currents are strong enough, they can cause
excessive heating in the tissues. This heating can be calculated by the power
dissipated in the tissue (the product of the voltage and the current).
When such electric fields and currents are alternating, their
stimulatory power, on nerve, muscle, etc., is an inverse function of the frequency.
At frequencies above 1-10 KHz, the stimulation power of the fields approaches
zero. This limitation is due to the fact that excitation induced by electric
stimulation is normally mediated by membrane potential changes, the rate of
which is limited by the RC properties (time constants on the order of 1 ms) of the
membrane.
Regardless of the frequency, when such current inducing fields are
applied, they are associated with harmful side effects caused by currents. For example, one negative effect is the changes in ionic concentration in the various
"compartments" within the system, and the harmful products of the electrolysis
taking place at the electrodes, or the medium in which the tissues are imbedded.
The changes in ion concentrations occur whenever the system includes two or
more compartments between which the organism maintains ion concentration
differences. For example, for most tissues, [Ca++] in the extracellular fluid is
about 2 x 10"3 M, while in the cytoplasm of typical cells its concentration can be
as low as 10"7 M. A current induced in such a system by a pair of electrodes,
flows in part from the extracellular fluid into the cells and out again into the
extracellular medium. About 2% of the current flowing into the cells is carried
by the Ca++ ions. In contrast, because the concentration of intracellular Ca++ is
much smaller, only a negligible fraction of the currents that exits the cells is
carried by these ions. Thus, Ca++ ions accumulate in the cells such that their
concentrations in the cells increases, while the concentration in the extracellular
compartment may decrease. These effects are observed for both DC and
alternating currents (AC). The rate of accumulation of the ions depends on the
current intensity ion mobilities, membrane ion conductance, etc. An increase in
[Ca++] is harmful to most cells and if sufficiently high will lead to the destruction
of the cells. Similar considerations apply to other ions. In view of the above observations, long term current application to living organisms or tissues can
result in significant damage. Another major problem that is associated with such
electric fields, is due to the electrolysis process that takes place at the electrode
surfaces. Here charges are transferred between the metal (electrons) and the
electrolytic solution (ions) such that charged active radicals are formed. These
can cause significant damage to organic molecules, especially macromolecules
and thus damage the living cells and tissues.
In contrast, when high frequency electric fields, above 1 MHz and
usually in practice in the range of GHz, are induced in tissues by means of
insulated electrodes, the situation is quite different. These type of fields generate
only capacitive or displacement currents, rather than the conventional charge
conducting currents. Under the effect of this type of field, living tissues behave
mostly according to their dielectric properties rather than their electric conductive
properties. Therefore, the dominant field effect is that due to dielectric losses and
heating. Thus, it is widely accepted that in practice, the meaningful effects of
such fields on living organisms, are only those due to their heating effects, i.e.,
due to dielectric losses. In U.S. Patent No. 6,043,066 ('066) to Mangano, a method and
device are presented which enable discrete objects having a conducting inner
core, surrounded by a dielectric membrane to be selectively inactivated by
electric fields via irreversible breakdown of their dielectric membrane. One
potential application for this is in the selection and purging of certain biological
cells in a suspension. According to the '066 patent, an electric field is applied for
targeting selected cells to cause breakdown of the dielectric membranes of these
tumor cells, while purportedly not adversely affecting other desired
subpopulations of cells. The cells are selected on the basis of intrinsic or induced
differences in a characteristic electroporation threshold. The differences in this
threshold can depend upon a number of parameters, including the difference in
cell size.
The method of the '066 patent is therefore based on the
assumption that the electroporation threshold of tumor cells is sufficiently
distinguishable from that of normal cells because of differences in cell size and
differences in the dielectric properties of the cell membranes. Based upon this
assumption, the larger size of many types of tumor cells makes these cells more
susceptible to electroporation and thus, it may be possible to selectively damage
only the larger tumor cell membranes by applying an appropriate electric field. One disadvantage of this method is that the ability to discriminate is highly
dependent upon cell type, for example, the size difference between normal cells
and tumor cells is significant only in certain types of cells. Another drawback of
this method is that the voltages which are applied can damage some of the normal
cells and may not damage all of the tumor cells because the differences in size
and membrane dielectric properties are largely statistical and the actual cell
geometries and dielectric properties can vary significantly.
What is needed in the art and has heretofore not been available is
an apparatus for destroying dividing cells, wherein the apparatus better
discriminates between dividing cells, including single-celled organisms, and non-
dividing cells and is capable of selectively destroying the dividing cells or
organisms with substantially no affect on the non-dividing cells or organisms and
which can be configured to applied to a specific body part, such as an extremity
and thus lends itself to being incorporated into an article of clothing.
Summary
An apparatus for use in a number of different applications for
selectively destroying cells undergoing growth and division is provided. This includes, cell, particularly tumor cells, in living tissue and single-celled
organisms. The apparatus can be incorporated into a number of different
configurations that are specifically designed to be effective for specific body
parts so that the apparatus distinctly targets a localized area to eliminate or
control the growth of such living tissue or organisms. For example and as will be
described in greater detail hereinafter, the apparatus is particularly capable of
being incorporated into a piece of clothing that is worn over the tumor area. One
of the configurations of the apparatus is in the form of a hat, cap or other type of
structure to be fitted over a person's head for treating intra-cranial tumors,
external scalp lesions or other lesions. In another configuration, the apparatus is
in the form of a modified bra or the like to be fitted over breasts for treating
breast cancer or other type of tumor condition. In addition, the apparatus can be
incorporated into clothing that is to be worn over other body parts, such as
testicles, a hand, leg, arm, neck, etc., for treating a localized tumor in one of these
locations (body parts). For example, a high standing collar member or necklace
type structure can be used to treat thyroid, parathyroid, laryngeal lesions, etc. In
this embodiment, the apparatus (either completely or partially) is disposed within
clothing that is fit around the neck for treating these conditions. In another aspect,
localized treatment is provided by the apparatus when it is in the form of an internal member (e.g., a probe or catheter) that is inserted into the body through a
natural pathway, such as the urethra, vagina, etc., or the member can penetrate
the skin to and other tissues to reach an internal target.
A major use of the present apparatus is in the treatment of tumors
by selective destruction of tumor cells with substantially no affect on normal
tissue cells, and thus, the exemplary apparatus is described below in the context
of selective destruction of tumor cells. It should be appreciated however, that for
purpose of the following description, the term "cell" may also refer to a single-
celled organism (eubacteria, bacteria, yeast, protozoa), multi-celled organisms
(fungi, algae, mold), and plants as or parts thereof that are not normally classified
as "cells". The exemplary apparatus enables selective destruction of cells
undergoing division in a way that is more effective and more accurate (e.g., more
adaptable to be aimed at specific targets) than existing methods. Further, the
present apparatus causes minimal damage, if any, to normal tissue and, thus,
reduces or eliminates many side-effects associated with existing selective
destruction methods, such as radiation therapy and chemotherapy. The selective
destruction of dividing cells using the present apparatus does not depend on the
sensitivity of the cells to chemical agents or radiation. Instead, the selective
destruction of dividing cells is based on distinguishable geometrical characteristics of cells undergoing division, in comparison to non-dividing cells,
regardless of the cell geometry of the type of cells being treated.
According to one exemplary embodiment, cell geometry-
dependent selective destruction of living tissue is performed by inducing a non-
homogenous electric field in the cells using an electronic apparatus.
It has been observed by the present inventor that, while different
cells in their non-dividing state may have different shapes, e.g., spherical,
ellipsoidal, cylindrical, "pancake-like", etc., the division process of practically all
cells is characterized by development of a "cleavage furrow" in late anaphase and
telophase. This cleavage furrow is a slow
Figure imgf000016_0001
cell membrane
(between the two sets of daughter chromosomes) which appears microscopically
as a growing cleft (e.g., a groove or notch) that gradually separates the cell into
two new cells. During the division process, there is a transient period (telophase)
during which the cell structure is basically that of two sub-cells interconnected by
a narrow "bridge" formed of the cell material. The division process is completed
when the "bridge" between the two sub-cells is broken. The selective destruction
of tumor cells using the present electronic apparatus utilizes this unique
geometrical feature of dividing cells. When a cell or a group of cells are under natural conditions or
environment, i.e., part of a living tissue, they are disposed surrounded by a
conductive environment consisting mostly of an electrolytic inter-cellular fluid
and other cells that are composed mostly of an electrolytic intra-cellular liquid.
When an electric field is induced in the living tissue, by applying an electric
potential across the tissue, an electric field is formed in the tissue and the specific
distribution and configuration of the electric field lines defines the direction of
charge displacement, or paths of electric currents in the tissue, if currents are in
fact induced in the tissue. The distribution and configuration of the electric field
is dependent on various parameters of the tissue, including the geometry and the
electric properties of the different tissue components, and the relative
conductivities, capacities and dielectric constants (that may be frequency
dependent) of the tissue components.
The electric current flow pattern for cells undergoing division is
very different and unique as compared to non-dividing cells. Such cells including
first and second sub-cells, namely an "original" cell and a newly formed cell, that
are connected by a cytoplasm "bridge" or "neck". The currents penetrate the first
sub-cell through part of the membrane ("the current source pole"); however, they
do not exit the first sub-cell through a portion of its membrane closer to the opposite pole ("the current sink pole"). Instead, the lines of current flow
converge at the neck or cytoplasm bridge, whereby the density of the current flow
lines is greatly increased. A corresponding, "mirror image", process that takes
place in the second sub-cell, whereby the current flow lines diverge to a lower
density configuration as they depart from the bridge, and finally exit the second
sub-cell from a part of its membrane closes to the current sink.
When a polarizable object is placed in a non-uniform converging
or diverging field, electric forces act on it and pull it towards the higher density
electric field lines. In the case of dividing cell, electric forces are exerted in the
direction of the cytoplasm bridge between the two cells. Since all intercellular
organelles and macromolecules are polarizable, they are all force towards the
bridge between the two cells. The field polarity is irrelevant to the direction of
the force and, therefore, an alternating electric having specific properties can be
used to produce substantially the same effect. It will also be appreciated that the
concentrated and inhomogeneous electric field present in or near the bridge or
neck portion in itself exerts strong forces on charges and natural dipoles and can
lead to the disruption of structures associated with these members.
The movement of the cellular organelles towards the bridge
disrupts the cell structure and results in increased pressure in the vicinity of the connecting bridge membrane. This pressure of the organelles on the bridge
membrane is expected to break the bridge membrane and, thus, it is expected that
the dividing cell will "explode" in response to this pressure. The ability to break
the membrane and disrupt other cell structures can be enhanced by applying a
pulsating alternating electric field that has a frequency from about 50KHz to
about 500KHz. When this type of electric field is applied to the tissue, the forces
exerted on the intercellular organelles have a "hammering" effect, whereby force
pulses (or beats) are applied to the organelles numerous times per second,
enhancing the movement of organelles of different sizes and masses towards the
bridge (or neck) portion from both of the sub-cells, thereby increasing the
probability of breaking the cell membrane at the bridge portion. The forces
exerted on the intracellular organelles also affect the organelles themselves and
may collapse or break the organelles.
According to one exemplary embodiment, the apparatus for
applying the electric field is an electronic apparatus that generates the desired
electric signals in the shape of waveforms or trains of pulses. The electronic
apparatus includes a generator that generates an alternating voltage waveform at
frequencies in the range from about 50KHz to about 500KHz. The generator is
operatively connected to conductive leads which are connected at their other ends to insulated conductors/electrodes (also referred to as isolects) that are activated
by the generated waveforms. The insulated electrodes consist of a conductor in
contact with a dielectric (insulating layer) that is in contact with the conductive
tissue, thus forming a capacitor. The electric fields that are generated by the
present apparatus can be applied in several different modes depending upon the
precise treatment application.
In one exemplary embodiment, the electric fields are applied by
external insulated electrodes which are incorporated into an article of clothing
and which are constructed so that the applied electric fields are of a local type
that target a specific, localized area of tissue (e.g., a tumor). This embodiment is
designed to treat tumors and lesions that are at or below the skin surface by
wearing the article of clothing over the target tissue so that the electric fields
generated by the insulated electrodes are directed at the tumors (lesions, etc.).
According to another embodiment, the apparatus is used in an
internal type application in that the insulated electrodes are in the form of a probe
or catheter etc., that enter the body through natural pathways, such as the urethra
or vagina, or are configured to penetrate living tissue, until the insulated
electrodes are positioned near the internal target area (e.g., an internal tumor). Thus, the present apparatus utilizes electric fields that fall into a
special intermediate category relative to previous high and low frequency
applications in that the present electric fields are bio-effective fields that have no
meaningful stimulatory effects and no thermal effects. Advantageously, when
non-dividing cells are subjected to these electric fields, there is no effect on the
cells; however, the situation is much different when dividing cells are subjected
to the present electric fields. Thus, the present electronic apparatus and the
generated electric fields target dividing cells, such as tumors or the like, and do
not target non-dividing cells that is found around in healthy tissue surrounding
the target area. Furthermore, since the present apparatus utilizes insulated
electrodes, the above mentioned negative effects, obtained when conductive
electrodes are used, i.e., ion concentration changes in the cells and the formation
of harmful agents by electrolysis, do not occur with the present apparatus. This is
because, in general, no actual transfer of charges takes place between the
electrodes and the medium, and there is no charge flow in the medium where the
currents are capacitive.
It should be appreciated that the present electronic apparatus can
also be used in applications other than treatment of tumors in the living body. In
fact, the selective destruction utilizing the present apparatus can be used in conjunction with any organism that proliferates division and multiplication, for
example, tissue cultures, microorganisms, such as bacteria, mycoplasma,
protozoa, fungi, algae, plant cells, etc. Such organisms divide by the formation
of a groove or cleft as described above. As the groove or cleft deepens, a narrow
bridge is formed between the two parts of the organism, similar to the bridge
formed between the sub-cells of dividing animal cells. Since such organisms are
covered by a membrane having a relatively low electric conductivity, similar to
an animal cell membrane described above, the electric field lines in a dividing
organism converge at the bridge connecting the two parts of the dividing
organism. The converging field lines result in electric forces that displace
polarizable elements and charges within the dividing organism.
The above, and other objects, features and advantages of the
present apparatus will become apparent from the following description read in
conjunction with the accompanying drawings, in which like reference numerals
designate the same elements.
Brief Description of the Drawing Figures
Figs. 1A-1E are simplified, schematic, cross-sectional, illustrations
of various stages of a cell division process; Figs. 2 A and 2B are schematic illustrations of a non-dividing cell
being subjected to an electric field;
Figs. 3 A, 3B and 3C are schematic illustrations of a dividing cell
being subjected to an electric field according to one exemplary embodiment,
resulting in destruction of the cell (Fig. 3C) in accordance with one exemplary
embodiment;
Fig. 4 is a schematic illustration of a dividing cell at one stage
being subject to an electric field;
Fig. 5 is a schematic block diagram of an apparatus for applying
an electric according to one exemplary embodiment for selectively destroying
cells;
Fig. 6 is a simplified schematic diagram of an equivalent electric
circuit of insulated electrodes of the apparatus of Fig. 5;
Fig. 7 is a cross-sectional illustration of a skin patch incorporating
the apparatus of Fig. 5 and for placement on a skin surface for treating a tumor or
the like;
Fig. 8 is a cross-sectional illustration of the insulated electrodes
implanted within the body for treating a tumor or the like; Fig. 9 is a cross-sectional illustration of the insulated electrodes
implanted within the body for treating a tumor or the like;
Figs. 10A-10D are cross-sectional illustrations of various
constructions of the insulated electrodes of the apparatus of Fig. 5;
Fig. 11 is a front elevational view in partial cross-section of two
insulated electrodes being arranged about a human torso for treatment of a tumor
container within the body, e.g., a tumor associated with lung cancer;
Figs. 12A-12C are cross-sectional illustrations of various insulated
electrodes with and without protective members formed as a part of the
construction thereof;
Fig. 13 is a schematic diagram of insulated electrodes that are
arranged for focusing the electric field at a desired target while leaving other
areas in low field density (i.e., protected areas);
Fig. 14 is a cross-sectional view of insulated electrodes
incorporated into a hat according to a first embodiment for placement on a head
for treating an intra-cranial tumor or the like;
Fig. 15 is a partial section of a hat according to an exemplary
embodiment having a recessed section for receiving one or more insulated
electrodes; Fig. 16 is a cross-sectional view of the hat of Fig. 15 placed on a
head and illustrating a biasing mechanism for applying a force to the insulated
electrode to ensure the insulated electrode remains in contact against the head;
Fig. 17 is a cross-sectional top view of an article of clothing
having the insulated electrodes incorporated therein for treating a tumor or the
like;
Fig. 18 is a cross-sectional view of a section of the article of
clothing of Fig. 17 illustrating a biasing mechanism for biasing the insulated
electrode in direction to ensure the insulated electrode is placed proximate to a
skin surface where treatment is desired;
Fig. 19 is a cross-sectional view of a probe according to one
embodiment for being disposed internally within the body for treating a tumor or
the like;
Fig. 20 is an elevational view of an unwrapped collar according to
one exemplary embodiment for placement around a neck for treating a tumor or
the like in this area when the collar is wrapped around the neck;
Fig. 21 is a cross-sectional view of two insulated electrodes with
conductive gel members being arranged about a body, with the electric field lines
being shown; Fig. 22 is a cross-sectional view of the arrangement of Fig. 21
illustrating a point of insulation breakdown in one insulated electrode;
Fig. 23 is a cross-sectional view of an arrangement of at least two
insulated electrodes with conductive gel members being arranged about a body
for treatment of a tumor or the like, wherein each conductive gel member has a
feature for minimizing the effects of an insulation breakdown in the insulated
electrode;
Fig. 24 is a cross-sectional view of another arrangement of at least
two insulated electrodes with conductive gel members being arranged about a
body for treatment of a tumor or the like, wherein a conductive member is
disposed within the body near the tumor to create a region of increased field
density;
Fig. 25 is a cross-sectional view of an arrangement of two
insulated electrodes of varying sizes disposed relative to a body; and
Fig. 26 is a cross-sectional view of an arrangement of at least two
insulated electrodes with conductive gel members being arranged about a body
for treatment of a tumor or the like, wherein each conductive gel member has a
feature for minimizing the effects of an insulation breakdown in the insulated
electrode. Detailed Description of Preferred Embodiments
Reference is made to Figs. 1 A- IE which schematically illustrate
various stages of a cell division process. Fig. 1A illustrates a cell 10 at its normal
geometry, which can be generally spherical (as illustrated in the drawings),
ellipsoidal, cylindrical, "pancake-like" or any other cell geometry, as is known in
the art. Figs. IB- ID illustrate cell 10 during different stages of its division
process, which results in the formation of two new cells 18 and 20, shown in Fig.
IE.
As shown in Figs. IB-ID, the division process of cell 10 is
characterized by a slowly growing cleft 12 which gradually separates cell 10 into
two units, namely sub-cells 14 and 16, which eventually evolve into new cells 18
and 20 (Fig. IE). A shown specifically in Fig. ID, the division process is
characterized by a transient period during which the structure of cell 10 is
basically that of the two sub-cells 14 and 16 interconnected by a narrow "bridge"
22 containing cell material (cytoplasm surrounded by cell membrane).
Reference is now made to Figs. 2 A and 2B, which schematically
illustrate non-dividing cell 10 being subjected to an electric field produced by applying an alternating electric potential, at a relatively low frequency and at a
relatively high frequency, respectively. Cell 10 includes intracellular organelles,
e.g., a nucleus 30. Alternating electric potential is applied across electrodes 28
and 32 that can be attached externally to a patient at a predetermined region, e.g.,
in the vicinity of the tumor being treated. When cell 10 is under natural
conditions, i.e., part of a living tissue, it is disposed in a conductive environment
(hereinafter referred to as a "volume conductor") consisting mostly of electrolytic
inter-cellular liquid. When an electric potential is applied across electrodes 28
and 32, some of the field lines of the resultant electric field (or the current
induced in the tissue in response to the electric field) penetrate the cell 10, while
the rest of the field lines (or induced current) flow in the surrounding medium.
The specific distribution of the electric field lines, which is substantially
consistent with the direction of current flow in this instance, depends on the
geometry and the electric properties of the system components, e.g., the relative
conductivities and dielectric constants of the system components, that can be
frequency dependent. For low frequencies, e.g., frequencies lower than lOKHz,
the conductance properties of the components completely dominate the current
flow and the field distribution, and the field distribution is generally as depicted
in Fig. 2A. At higher frequencies, e.g., at frequencies of between lOKHz and 1MHz, the dielectric properties of the components becomes more significant and
eventually dominate the field distribution, resulting in field distribution lines as
depicted generally in Fig. 2B.
For constant (i.e., DC) electric fields or relatively low frequency
alternating electric fields, for example, frequencies under lOKHz, the dielectric
properties of the various components are not significant in determining and
computing the field distribution. Therefore, as a first approximation, with regard
to the electric field distribution, the system can be reasonably represented by the
relative impedances of its various components. Using this approximation, the
intercellular (i.e., extracellular) fluid and the intracellular fluid each has a
relatively low impedance, while the cell membrane 11 has a relatively high
impedance. Thus, under low frequency conditions, only a fraction of the electric
field lines (or currents induced by the electric field) penetrate membrane 11 of the
cell 10. At relatively high frequencies (e.g., lOKHz - 1MHz), in contrast, the
impedance of membrane 11 relative to the intercellular and intracellular fluids
decreases, and thus, the fraction of currents penetrating the cells increases
significantly. It should be noted that at very high frequencies, i.e., above 1MHz,
the membrane capacitance can short the membrane resistance and, therefore, the
total membrane resistance can become negligible. In any of the embodiments described above, the electric field lines
(or induced currents) penetrate cell 10 from a portion of the membrane 11 closest
to one of the electrodes generating the current, e.g., closest to positive electrode
28 (also referred to herein as "source"). The current flow pattern across cell 10 is
generally uniform because, under the above approximation, the field induced
inside the cell is substantially homogeneous. The currents exit cell 10 through a
portion of membrane 11 closest to the opposite electrode, e.g., negative electrode
32 (also referred to herein as "sink").
The distinction between field lines and current flow can depend on
a number of factors, for example, on the frequency of the applied electric
potential and on whether electrodes 28 and 32 are electrically insulated. For
insulated electrodes applying a DC or low frequency alternating voltage, there is
practically no current flow along the lines of the electric field. At higher
frequencies, the displacement currents are induced in the tissue due to charging
and discharging of the electrode insulation and the cell membranes (which act as
capacitors to a certain extent), and such currents follow the lines of the electric
field. Fields generated by non-insulated electrodes, in contrast, always generate
some form of current flow, specifically, DC or low frequency alternating fields
generate conductive current flow along the field lines, and high frequency alternating fields generate both conduction and displacement currents along the
field lines. It should be appreciated, however, that movement of polarizable
intracellular organelles according to the present invention (as described below) is
not dependent on actual flow of current and, therefore, both insulated and non-
insulated electrodes can be used efficiently. Several advantages of insulated
electrodes are that they have lower power consumption and cause less heating of
the treated regions.
According to one exemplary embodiment of the present invention,
the electric fields that are used are alternating fields having frequencies that are in
the range from about 50KHz to about 500KHz, and preferably from about
lOOKHz to about 300KHz. For ease of discussion, these type of electric fields
are also referred to below as "TC fields", which is an abbreviation of "Tumor
Curing electric fields", since these electric fields fall into an intermediate
category (between high and low frequency ranges) that have bio-effective field
properties while having no meaningful stimulatory and thermal effects. These
frequencies are sufficiently low so that the system behavior is determined by the
system's Ohmic (conductive) properties but sufficiently high enough not to have
any stimulation effect on excitable tissues. Such a system consists of two types
of elements, namely, the intercellular, or extracellular fluid, or medium and the individual cells. The intercellular fluid is mostly an electrolyte with a specific
resistance of about 40-100 Ohm*cm. As mentioned above, the cells are
characterized by three elements, namely (1) a thin, highly electric resistive
membrane that coats the cell; (2) internal cytoplasm that is mostly an electrolyte
that contains numerous macromolecules and micro-organelles, including the
nucleus; and (3) membranes, similar in their electric properties to the cell
membrane, cover the micro-organelles.
When this type of system is subjected to the present TC fields
(e.g., alternating electric fields in the frequency range of lOOKHz - 300KHz)
most of the lines of the electric field and currents tend away from the cells
because of the high resistive cell membrane and therefore the lines remain in the
extracellular conductive medium. In the above recited frequency range, the
actual fraction of electric field or currents that penetrates the cells is a strong
function of the frequency.
Fig. 2 schematically depicts the resulting field distribution in the
system. As illustrated, the lines of force, which also depict the lines of potential
current flow across the cell volume mostly in parallel with the undistorted lines of
force (the main direction of the electric field). In other words, the field inside the cells is mostly homogeneous. In practice, the fraction of the field or current that
penetrates the cells is determined by the cell membrane impedance value relative
to that of the extracellular fluid. Since the equivalent electric circuit of the cell
membrane is that of a resistor and capacitor in parallel, the impedance is a
function of the frequency. The higher the frequency, the lower the impedance,
the larger the fraction of penetrating current and the smaller the field distortion
(Rotshenker S. & Y. Palti, Changes in fraction of current penetrating an axon as a
function of duration of stimulating pulse, J. Theor. Biol. 41; 401-407 (1973).
As previously mentioned, when cells are subjected to relatively
weak electric fields and currents that alternate at high frequencies, such as the
present TC fields having a frequency in the range of 50KHz - 500KHz, they have
no effect on the non-dividing cells. While the present TC fields have no
detectable effect on such systems, the situation becomes different in the presence
of dividing cells.
Reference is now made to Figs. 3A-3C which schematically
illustrate the electric current flow pattern in cell 10 during its division process,
under the influence of alternating fields (TC fields) in the frequency range from
about lOOKHz to about 300KHz in accordance with one exemplary embodiment. The field lines or induced currents penetrate cell 10 through a part of the
membrane of sub-cell 16 closer to electrode 28. However, they do not exit
through the cytoplasm bridge 22 that connects sub-cell 16 with the newly formed
yet still attached sub-cell 14, or through a part of the membrane in the vicinity of
the bridge 22. Instead, the electric field or current flow lines —that are relatively
widely separated in sub-cell 16— converge as they approach bridge 22 (also
referred to as "neck" 22) and, thus, the current/field line density within neck 22 is
increased dramatically. A "mirror image" process takes place in sub-cell 14,
whereby the converging field lines in bridge 22 diverge as they approach the exit
region of sub-cell 14.
It should be appreciated by persons skilled in the art that
homogeneous electric fields do not exert a force on electrically neutral objects,
i.e., objects having substantially zero net charge, although such objects can
become polarized. However, under a non-uniform, converging electric field, as
shown in Figs. 3A-3C, electric forces are exerted on polarized objects, moving
them in the direction of the higher density electric field lines. It will be
appreciated that the concentrated electric field that is present in the neck or
bridge area in itself exerts strong forces on charges and natural dipoles and can
disrupt structures that are associated therewith. One will understand that similar net forces act on charges in an alternating field, again in the direction of the field
of higher intensity.
In the configuration of Figs. 3 A and 3B, the direction of
movement of polarized and charged objects is towards the higher density electric
field lines, i.e., towards the cytoplasm bridge 22 between sub-cells 14 and 16. It
is known in the art that all intracellular organelles, for example, nuclei 24 and 26
of sub-cells 14 and 16, respectively, are polarizable and, thus, such intracellular
organelles are electrically forced in the direction of the bridge 22. Since the
movement is always from lower density currents to the higher density currents,
regardless of the field polarity, the forces applied by the alternating electric field
to organelles, such as nuclei 24 and 26, are always in the direction of bridge 22.
A comprehensive description of such forces and the resulting movement of
macromolecules of intracellular organelles, a phenomenon referred to as
"dielectrophoresis" is described extensively in literature, e.g., in C.L. Asbury &
G. van den Engh, Biophys. J. 74, 1024-1030, 1998, the disclosure of which is
hereby incorporated by reference in its entirety.
The movement of the organelles 24 and 26 towards the bridge 22
disrupts the structure of the dividing cell, change the concentration of the various cell constituents and, eventually, the pressure of the converging organelles on
bridge membrane 22 results in the breakage of cell membrane 11 at the vicinity
of the bridge 22, as shown schematically in Fig. 3C. The ability to break
membrane 11 at bridge 22 and to otherwise disrupt the cell structure and
organization can be enhanced by applying a pulsating AC electric field, rather
than a steady AC field. When a pulsating field is applied, the forces acting on
organelles 24 and 26 have a "hammering" effect, whereby pulsed forces beat on
the intracellular organelles towards the neck 22 from both sub-cells 14 and 16,
thereby increasing the probability of breaking cell membrane 11 in the vicinity of
neck 22.
A very important element, which is very susceptible to the special
fields that develop within the dividing cells is the microtubule spindle that plays a
major role in the division process. In Fig. 4, a dividing cell 10 is illustrated, at an
earlier stage as compared to Figs. 3 A and 3B, under the influence of external TC
fields (e.g., alternating fields in the frequency range of about lOOKHz to about
300KHz), generally indicated as lines 100, with a corresponding spindle
mechanism generally indicated at 120. The lines 120 are microtubules that are
known to have a very strong dipole moment. This strong polarization makes the
tubules, as well as other polar macromolecules and especially those that have a specific orientation within the cells or its surrounding, susceptible to electric
fields. Their positive charges are located at the two centrioles while two sets of
negative poles are at the center of the dividing cell and the other pair is at the
points of attachment of the microtubules to the cell membrane, generally
indicated at 130. This structure forms sets of double dipoles and therefore they
are susceptible to fields of different directions. It will be understood that the
effect of the TC fields on the dipoles does not depend on the formation of the
bridge (neck) and thus, the dipoles are influenced by the TC fields prior to the
formation of the bridge (neck).
Since the present apparatus (as will be described in greater detail
below) utilizes insulated electrodes, the above-mentioned negative effects
obtained when conductive electrodes are used, i.e., ion concentration changes in
the cells and the formation of harmful agents by electrolysis, do not occur when
the present apparatus is used. This is because, in general, no actual transfer of
charges takes place between the electrodes and the medium and there is no charge
flow in the medium where the currents are capacitive, i.e., are expressed only as
rotation of charges, etc. Turning now to Fig. 5, the TC fields described above that have
been found to advantageously destroy tumor cells are generated by an electronic
apparatus 200. Fig. 5 is a simple schematic diagram of the electronic apparatus
200 illustrating the major components thereof. The electronic apparatus 200
generates the desired electric signals (TC signals) in the shape of waveforms or
trains of pulses. The apparatus 200 includes a generator 210 and a pair of
conductive leads 220 that are attached at one end thereof to the generator 210.
The opposite ends of the leads 220 are connected to insulated conductors 230 that
are activated by the electric signals (e.g., waveforms). The insulated conductors
230 are also referred to hereinafter as isolects 230. Optionally and according to
another exemplary embodiment, the apparatus 200 includes a temperature sensor
240 and a control box 250 which are both added to control the amplitude of the
electric field generated so as not to generate excessive heating in the area that is
treated.
The generator 210 generates an alternating voltage waveform at
frequencies in the range from about 50KHz to about 500KHz (preferably from
about lOOKHz to about 300KHz) (i.e., the TC fields). The required voltages are
such that the electric field intensity in the tissue to be treated is in the range of
about 0.1 V/cm to about 10 V/cm. To achieve this field, the actual potential difference between the two conductors in the isolects 230 is determined by the
relative impedances of the system components, as described below.
When the control box 250 is included, it controls the output of the
generator 210 so that it will remain constant at the value preset by the user or the
control box 250 sets the output at the maximal value that does not cause
excessive heating, or the control box 250 issues a warning or the like when the
temperature (sensed by temperature sensor 240) exceeds a preset limit.
The leads 220 are standard isolated conductors with a flexible
metal shield, preferably grounded so that it prevents the spread of the electric
field generated by the leads 220. The isolects 230 have specific shapes and
positioning so as to generate an electric field of the desired configuration,
direction and intensity at the target volume and only there so as to focus the
treatment.
The specifications of the apparatus 200 as a whole and its
individual components are largely influenced by the fact that at the frequency of
the present TC fields (50KHz - 500KHz), living systems behave according to
their "Ohmic", rather than their dielectric properties. The only elements in the
apparatus 200 that behave differently are the insulators of the isolects 230 (see Figs. 7-9). The isolects 200 consist of a conductor in contact with a dielectric
that is in contact with the conductive tissue thus forming a capacitor.
The details of the construction of the isolects 230 is based on their
electric behavior that can be understood from their simplified electric circuit
when in contact with tissue as generally illustrated in Fig. 6. In the illustrated
arrangement, the potential drop or the electric field distribution between the
different components is determined by their relative electric impedance, i.e., the
fraction of the field on each component is given by the value of its impedance
divided by the total circuit impedance. For example, the potential drop on
element Δ VΛ = A/(A+B+C+D+E). Thus, for DC or low frequency AC,
practically all the potential drop is on the capacitor (that acts as an insulator). For
relatively very high frequencies, the capacitor practically is a short and therefore,
practically all the field is distributed in the tissues. At the frequencies of the
present TC fields (e.g., 50KHz to 500KHz), which are intermediate frequencies,
the impedance of the capacitance of the capacitors is dominant and determines
the field distribution. Therefore, in order to increase the effective voltage drop
across the tissues (field intensity), the impedance of the capacitors is to be
decreased (i.e., increase their capacitance). This can be achieved by increasing the effective area of the "plates" of the capacitor, decrease the thickness of the
dielectric or use a dielectric with high dielectric constant.
In order to optimize the field distribution, the isolects 230 are
configured differently depending upon the application in which the isolects 230
are to be used. There are two principle modes for applying the present electric
fields (TC fields). First, the TC fields can be applied by external isolects and
second, the TC fields can be applied by internal isolects.
Electric fields (TC fields) that are applied by external isolects can
be of a local type or widely distributed type. The first type includes, for example,
the treatment of skin tumors and treatment of lesions close to the skin surface.
Fig. 7 illustrates an exemplary embodiment where the isolects 230 are
incorporated in a skin patch 300. The skin patch 300 can be a self-adhesive
flexible patch with one or more pairs of isolects 230. The patch 300 includes
internal insulation 310 (formed of a dielectric material) and the external
insulation 260 and is applied to skin surface 301 that contains a tumor 303 either
on the skin surface 301 or slightly below the skin surface 301. Tissue is
generally indicated at 305. To prevent the potential drop across the internal
insulation 310 to dominate the system, the internal insulation 310 must have a relatively high capacity. This can be achieved by a large surface area; however,
this may not be desired as it will result in the spread of the field over a large area
(e.g., an area larger than required to treat the tumor). Alternatively, the internal
insulation 310 can be made very thin and/or the internal insulation 310 can be of
a high dielectric constant. As the skin resistance between the electrodes (labeled
as A and E in Fig. 6) is normally significantly higher than that of the tissue
(labeled as C in Fig. 6) underneath it (1-10 KΩ vs. 0.1-1KΩ ), most of the
potential drop beyond the isolects occurs there. To accommodate for these
impedances (Z), the characteristics of the internal insulation 310 (labeled as B
and D in Fig. 6) should be such that they have impedance preferably under
100KΩ at the frequencies of the present TC fields (e.g., 50KHz to 500KHz). For
example, if it is desired for the impedance to be about 10K Ohms or less, such
that over 1% of the applied voltage falls on the tissues, for isolects with a surface
area of 10 mm , at frequencies of 200KHz, the capacity should be on the order of
10"10 F, which means that using standard insulations with a dielectric constant of
2-3, the thickness of the insulating layer 310 should be about 50-100 microns.
An internal field 10 times stronger would be obtained with insulators with a
dielectric constant of about 20-50. Since the thin insulating layer can be very vulnerable, etc., the
insulation can be replaced by very high dielectric constant insulating materials,
such as titanium dioxide (e.g., rutil), the dielectric constant can reach values of
about 200. There a number of different materials that are suitable for use in the
intended application and have high dielectric constants. For example, some
materials include: lithium nibate (LiNbO3), which is a ferroelectric crystal and
has a number of applications in optical, pyroelectric and piezoelectric devices;
yittrium iron garnet (YIG) is a femmagnetic crystal and magneto-optical devices,
e.g., optical isolator can be realized from this material; barium titanate (BaTiO )
is a ferromagnetic crystal with a large electro-optic effect; potassium tantalate
(KTaO ) which is a dielectric crystal (ferroelectric at low temperature) and has
very low microwave loss and tunability of dielectric constant at low temperature;
and lithium tantalate (LiTaO ) which is a ferroelectric crystal with similar
properties as lithium niobate and has utility in electro-optical, pyroelectric and
piezoelectric devices. It will be understood that the aforementioned exemplary
materials can be used in combination with the present device where it is desired
to use a material having a high dielectric constant.
One must also consider another factor that effects the effective
capacity of the isolects 230, namely the presence of air between the isolects 230 and the skin. Such presence, which is not easy to prevent, introduces a layer of
an insulator with a dielectric constant of 1.0, a factor that significantly lowers the
effective capacity of the isolects 230 and neutralizes the advantages of the
titanium dioxide (routil), etc. To overcome this problem, the isolects 230 can be
shaped so as to conform with the body structure and/or (2) an intervening filler
270 (as illustrated in Fig. 10C), such as a gel, that has high conductance and a
high effective dielectric constant, can be added to the structure. The shaping can
be pre- structured (see Fig. 10A) or the system can be made sufficiently flexible
so that shaping of the isolects 230 is readily achievable. The gel can be contained
in place by having an elevated rim as depicted in Figs. 10C and IOC. The gel
can be made of hydrogels, gelatins, agar, etc., and can have salts dissolved in it to
increase its conductivity. Figs. 10A-10C illustrate various exemplary
configurations for the isolects 230. The exact thickness of the gel is not
important so long as it is of sufficient thickness that the gel layer does not dry out
during the treatment. In one exemplary embodiment, the thickness of the gel is
about 0.5 mm to about 2 mm.
In order to achieve the desirable features of the isolects 230, the
dielectric coating of each should be very thin, for example from between 1-50
microns. Since the coating is so thin, the isolects 230 can easily be damaged mechanically. This problem can be overcome by adding a protective feature to
the isolect' s structure so as to provide desired protection from such damage. For
example, the isolect 230 can be coated, for example, with a relatively loose net
340 that prevents access to the surface but has only a minor effect on the effective
surface area of the isolect 230 (i.e., the capacity of the isolects 230 (cross section
presented in Fig. 12B). The loose net 340 does not effect the capacity and
ensures good contact with the skin, etc. The loose net 340 can be formed of a
number of different materials; however, in one exemplary embodiment, the net
340 is formed of nylon, polyester, cotton, etc. Alternatively, a very thin
conductive coating 350 can be applied to the dielectric portion (insulating layer)
of the isolect 230. One exemplary conductive coating is formed of a metal and
more particularly of gold. The thickness of the coating 350 depends upon the
particular application and also on the type of material used to form the coating
350; however, when gold is used, the coating has a thickness from about 0.1
micron to about 0.1 mm. Furthermore, the rim illustrated in Fig. 10 can also
provide some mechanical protection.
However, the capacity is not the only factor to be considered. The
following two factors also influence how the isolects 230 are constructed. The
dielectric strength of the internal insulating layer 310 and the dielectric losses that occur when it is subjected to the TC field, i.e., the amount of heat generated. The
dielectric strength of the internal insulation 310 determines at what field intensity
the insulation will be "shorted" and cease to act as an intact insulation.
Typically, insulators, such as plastics, have dielectric strength values of about
100V per micron or more. As a high dielectric constant reduces the field within
the internal insulator 310, a combination of a high dielectric constant and a high
dielectric strength gives a significant advantage. This can be achieved by using a
single material that has the desired properties or it can be achieved by a double
layer with the correct parameters and thickness. In addition, to further decreasing
the possibility that the insulating layer 310 will fail, all sharp edges of the
insulating layer 310 should be eliminated as by rounding the corners, etc., as
illustrated in Fig. 10D using conventional techniques.
Figs. 8 and 9 illustrate a second type of treatment using the
isolects 230, namely electric field generation by internal isolects 230. A body to
which the isolects 230 are implanted is generally indicated at 311 and includes a
skin surface 313 and a tumor 315. In this embodiment, the isolects 230 can have
the shape of plates, wires or other shapes that can be inserted subcutaneously or a
deeper location within the body 311 so as to generate an appropriate field at the
target area (tumor 315). It will also be appreciated that the mode of isolects application is
not restricted to the above descriptions. In the case of tumors in internal organs,
for example, liver, lung, etc., the distance between each member of the pair of
isolects 230 can be large. The pairs can even by positioned opposite sides of a
torso 410, as illustrated in Fig. 11. The arrangement of the isolects 230 in Fig. 11
is particularly useful for treating a tumor 415 associated with lung cancer or
gastro-intestinal tumors. In this embodiment, the electric fields (TC fields)
spread in a wide fraction of the body.
In order to avoid overheating of the treated tissues, a selection of
materials and field parameters is needed. The isolects insulating material should
have minimal dielectric losses at the frequency ranges to be used during the
treatment process. This factor can be taken into consideration when choosing the
particular frequencies for the treatment. The direct heating of the tissues will
most likely be dominated by the heating due to current flow (given by the I*R
product). In addition, the isolect (insulated electrode) 230 and its surroundings
should be made of materials that facilitate heat losses and its general structure
should also facilitate head losses, i.e., minimal structures that block heat
dissipation to the surroundings (air) as well as high heat conductivity. The effectiveness of the treatment can be enhanced by an
arrangement of isolects 230 that focuses the field at the desired target while
leaving other sensitive areas in low field density (i.e., protected areas). The
proper placement of the isolects 230 over the body can be maintained using any
number of different techniques, including using a suitable piece of clothing that
keeps the isolects at the appropriate positions. Fig. 13 illustrates such an
arrangement in which an area labeled as "P" represents a protected area. The
lines of field force do not penetrate this protected area and the field there is much
smaller than near the isolects 230 where target areas can be located and treated
well. In contrast, the field intensity near the four poles is very high.
The following Example serves to illustrate an exemplary
application of the present apparatus and application of TC fields; however, this
Example is not limiting and does not limit the scope of the present invention in
any way.
Example
To demonstrate the effectiveness of electric fields having the
above described properties (e.g., frequencies between 50KHz and 500KHz) in
destroying tumor cells, the electric fields were applied to treat mice with malignant melanoma tumors. Two pairs of isolects 230 were positioned over a
corresponding pair of malignant melanomas. Only one pair was connected to the
generator 210 and 200KHz alternating electric fields (TC fields) were applied to
the tumor for a period of 6 days. One melanoma tumor was not treated so as to
permit a comparison between the treated tumor and the non-treated tumor. After
treatment for 6 days, the pigmented melanoma tumor remained clearly visible in
the non-treated side of the mouse, while, in contrast, no tumor is seen on the
treated side of the mouse. The only areas that were visible discemable on the
skin were the marks that represented the points of insertion of the isolects 230.
The fact that the tumor was eliminated at the treated side was further
demonstrated by cutting and inversing the skin so that its inside face was
exposed. Such a procedure indicated that the tumor has been substantially, if not
completely, eliminated on the treated side of the mouse. The success of the
treatment was also further verified by pathhistological examination.
The present inventor has thus uncovered that electric fields having
particular properties can be used to destroy dividing cells or tumors when the
electric fields are applied to using an electronic device. More specifically, these
electric fields fall into a special intermediate category, namely bio-effective fields
that have no meaningful stimulatory and no thermal effects, and therefore overcome the disadvantages that were associated with the application of
conventional electric fields to a body. It will also be appreciated that the present
apparatus can further include a device for rotating the TC field relative to the
living tissue. For example and according to one embodiment, the alternating
electric potential applies to the tissue being treated is rotated relative to the tissue
using conventional devices, such as a mechanical device that upon activation,
rotates various components of the present system.
Moreover and according to yet another embodiment, the TC fields
are applied to different pairs of the insulated electrodes 230 in a consecutive
manner. In other words, the generator 210 and the control system thereof can be
arranged so that signals are sent at periodic intervals to select pairs of insulated
electrodes 230, thereby causing the generation of the TC fields of different
directions by these insulated electrodes 230. Because the signals are sent at
select times from the generator to the insulated electrodes 230, the TC fields of
changing directions are generated consecutively by different insulated electrodes
230. This arrangement has a number of advantages and is provided in view of
the fact that the TC fields have maximal effect when they are parallel to the axis
of cell division. Since the orientation of cell division is in most cases random,
only a fraction of the dividing cells are affected by any given field. Thus, using fields of two or more orientations increases the effectiveness since it increases the
chances that more dividing cells are affected by a given TC field.
Turning now to Fig. 14 in which an article of clothing 500
according to one exemplary embodiment is illustrated. More specifically, the
article of clothing 500 is in the form of a hat or cap or other type of clothing
designed for placement on a head of a person. For purposes of illustration, a head
502 is shown with the hat 500 being placed thereon and against a skin surface
504 of the head 502. An intra-cranial tumor or the like 510 is shown as being
formed within the head 502 underneath the skin surface 504 thereof. The hat 500
is therefore intended for placement on the head 502 of a person who has a tumor
510 or the like.
Unlike the various embodiments illustrated in Figs. 1-13 where the
insulated electrodes 230 are arranged in a more or less planar arrangement since
they are placed either on a skin surface or embedded within the body underneath
it, the insulated electrodes 230 in this embodiment are specifically contoured and
arranged for a specific application. The treatment of intra-cranial tumors or other
lesions or the like typically requires a treatment that is of a relatively long
duration, e.g., days to weeks, and therefore, it is desirable to provide as much comfort as possible to the patient. The hat 500 is specifically designed to provide
comfort during the lengthy treatment process while not jeopardizing the
effectiveness of the treatment.
According to one exemplary embodiment, the hat 500 includes a
predetermined number of insulated electrodes 230 that are preferably positioned
so as to produce the optimal TC fields at the location of the tumor 510. The lines
of force of the TC field are generally indicated at 520. As can be seen in Fig. 14,
the tumor 510 is positioned within these lines of force 520. As will be described
in greater detail hereinafter, the insulated electrodes 230 are positioned within the
hat 500 such that a portion or surface thereof is free to contact the skin surface
504 of the head 502. In other words, when the patient wears the hat 500, the
insulated electrodes 230 are placed in contact with the skin surface 504 of the
head 502 in positions that are selected so that the TC fields generated thereby are
focused at the tumor 510 while leaving surrounding areas in low density.
Typically, hair on the head 502 is shaved in selected areas to permit better contact
between the insulated electrodes 230 and the skin surface 504; however, this is
not critical. The hat 500 preferably includes a mechanism 530 that applies or
force to the insulated electrodes 230 so that they are pressed against the skin
surface 502. For example, the mechanism 530 can be of a biasing type that
applies a biasing force to the insulated electrodes 230 to cause the insulated
electrodes 230 to be directed outwardly away from the hat 500. Thus, when the
patient places the hat 500 on his/her head 502, the insulated electrodes 230 are
pressed against the skin surface 504 by the mechanism 530. The mechanism 530
can slightly recoil to provide a comfortable fit between the insulated electrodes
230 and the head 502. In one exemplary embodiment, the mechanism 530 is a
spring based device that is disposed within the hat 500 and has one section that is
coupled to and applies a force against the insulated electrodes 230.
As with the prior embodiments, the insulated electrodes 230 are
coupled to the generator 210 by means of conductors 220. The generator 210 can
be either disposed within the hat 500 itself so as to provide a compact, self-
sufficient, independent system or the generator 210 can be disposed external to
the hat 500 with the conductors 220 exiting the hat 500 through openings or the
like and then running to the generator 210. When the generator 210 is disposed
external to the hat 500, it will be appreciated that the generator 210 can be
located in any number of different locations, some of which are in close proximity to the hat 500 itself, while others can be further away from the hat 500.
For example, the generator 210 can be disposed within a carrying bag or the like
(e.g., a bag that extends around the patient's waist) which is worn by the patient
or it can be strapped to an extremity or around the torso of the patient. The
generator 210 can also be disposed in a protective case that is secured to or
carried by another article of clothing that is worn by the patient. For example,
the protective case can be inserted into a pocket of a sweater, etc. Fig. 14
illustrates an embodiment where the generator 210 is incorporated directly into
the hat 500.
Turning now to Figs. 15 and 16, in one exemplary embodiment, a
number of insulated electrodes 230 along with the mechanism 530 are preferably
formed as an independent unit, generally indicated at 540, that can be inserted
into the hat 500 and electrically connected to the generator (not shown) via the
conductors (not shown). By providing these members in the form of an
independent unit, the patient can easily insert and/or remove the units 540 from
the hat 500 when they may need cleaning, servicing and/or replacement.
In this embodiment, the hat 500 is constructed to include select
areas 550 that are formed in the hat 500 to receive and hold the units 540. For example and as illustrated in Fig. 15, each area 550 is in the form of an opening
(pore) that is formed within the hat 500. The unit 540 has a body 542 and
includes the mechanism 530 and one or more insulated electrodes 230. The
mechanism 530 is arranged within the unit 540 so that a portion thereof (e.g., one
end thereof) is in contact with a face of each insulated electrode 230 such that the
mechanism 530 applies a biasing force against the face of the insulated electrode
230. Once the unit 540 is received within the opening 550, it can be securely
retained therein using any number of conventional techniques, including the use
of an adhesive material or by using mechanical means. For example, the hat 500
can include pivotable clip members that pivot between an open position in which
the opening 550 is free and a closed position in which the pivotable clip members
engage portions (e.g., peripheral edges) of the insulated electrodes to retain and
hold the insulated electrodes 230 in place. To remove the insulated electrodes
230, the pivotable clip members are moved to the open position. In the
embodiment illustrated in Fig. 16, the insulated electrodes 230 are retained within
the openings 550 by an adhesive element 560 which in one embodiment is a two
sided self-adhesive rim member that extends around the periphery of the
insulated electrode 230. In other words, a protective cover of one side of the
adhesive rim 560 is removed and it is applied around the periphery of the exposed face of the insulated electrode 230, thereby securely attaching the
adhesive rim 560 to the hat 500 and then the other side of the adhesive rim 560 is
removed for application to the skin surface 504 in desired locations for
positioning and securing the insulated electrode 230 to the head 502 with the
tumor being positioned relative thereto for optimization of the TC fields. Since
one side of the adhesive rim 560 is in contact with and secured to the skin surface
540, this is why it is desirable for the head 502 to be shaved so that the adhesive
rim 560 can be placed flushly against the skin surface 540.
The adhesive rim 560 is designed to securely attach the unit 540
within
the opening 550 in a manner that permits the unit 540 to be easily removed from
the hat 500 when necessary and then replaced with another unit 540 or with the
same unit 540. As previously mentioned, the unit 540 includes the biasing
mechanism 530 for pressing the insulated electrode 230 against the skin surface
504 when the hat 500 is worn. The unit 540 can be constructed so that side
opposite the insulated electrode 230 is a support surface formed of a rigid
material, such as plastic, so that the biasing mechanism 530 (e.g., a spring) can be
compressed therewith under the application of force and when the spring 530 is in a relaxed state, the spring 530 remains in contact with the support surface and
the applies a biasing force at its other end against the insulated electrode 230.
The biasing mechanism 530 (e.g., spring) preferably has a contour corresponding
to the skin surface 504 so that the insulated electrode 230 has a force applied
thereto to permit the insulated electrode 230 to have a contour complementary to
the skin surface 504, thereby permitting the two to seat flushly against one
another. While the mechanism 530 can be a spring, there are a number of other
embodiments that can be used instead of a spring. For example, the mechanism
530 can be in the form of an elastic material, such as a foam rubber, a foam
plastic, or a layer containing air bubbles, etc.
The unit 540 has an electric connector 570 that can be hooked up
to a corresponding electric connector, such as a conductor 220, that is disposed
within the hat 500. The conductor 220 connects at one end to the unit 540 and at
the other end is connected to the generator 210. The generator 210 can be
incorporated directly into the hat 500 or the generator 210 can be positioned
separately (remotely) on the patient or on a bedside support, etc.
As previously discussed, a coupling agent, such as a conductive
gel, is preferably used to ensure that an effective conductive environment is provided between the insulated electrode 230 and the skin surface 504. Suitable
gel materials have been disclosed hereinbefore in the discussion of earlier
embodiments. The coupling agent is disposed on the insulated electrode 230 and
preferably, a uniform layer of the agent is provided along the surface of the
electrode 230. One of the reasons that the units 540 need replacement at periodic
times is that the coupling agent needs to be replaced and/or replenished. In other
words, after a predetermined time period or after a number of uses, the patient
removes the units 540 so that the coupling agent can be applied again to the
electrode 230.
Figs. 17 and 18 illustrate another article of clothing which has the
insulated electrodes 230 incorporated as part thereof. More specifically, a bra or
the like 700 is illustrated and includes a body that is formed of a traditional bra
material, generally indicated at 705, to provide shape, support and comfort to the
wearer. The bra 700 also includes a fabric support layer 710 on one side thereof.
The support layer 710 is preferably formed of a suitable fabric material that is
constructed to provide necessary and desired support to the bra 700.
Similar to the other embodiments, the bra 700 includes one or
more insulated electrodes 230 disposed within the bra material 705. The one or more insulated electrodes are disposed along an inner surface of the bra 700
opposite the support 710 and are intended to be placed proximate to a tumor or
the like that is located within one breast or in the immediately surrounding area.
As with the previous embodiment, the insulated electrodes 230 in this
embodiment are specifically constructed and configured for application to a
breast or the immediate area. Thus, the insulated electrodes 230 used in this
application do not have a planar surface construction but rather have an arcuate
shape that is complementary to the general curvature found in a typical breast.
A lining 720 is disposed across the insulated electrodes 230 so as
to assist in retaining the insulated electrodes in their desired locations along the
inner surface for placement against the breast itself. The lining 720 can be
formed of any number of thin materials that are comfortable to wear against one's
skin and in one exemplary embodiment, the lining 720 is formed of a fabric
material.
The bra 700 also preferably includes a biasing mechanism 800 as
in some of the earlier embodiments. The biasing mechanism 800 is disposed
within the bra material 705 and extends from the support 710 to the insulated
electrode 230 and applies a biasing force to the insulated electrode 230 so that the electrode 230 is pressed against the breast. This ensures that the insulated
electrode 230 remains in contact with the skin surface as opposed to lifting away
from the skin surface, thereby creating a gap that results in a less effective
treatment since the gap diminishes the efficiency of the TC fields. The biasing
mechanism 800 can be in the form of a spring arrangement or it can be an elastic
material that applies the desired biasing force to the insulated electrodes 230 so
as to press the insulated electrodes 230 into the breast. In the relaxed position,
the biasing mechanism 800 applies a force against the insulated electrodes 230
and when the patient places the bra 700 on their body, the insulated electrodes
230 are placed against the breast which itself applies a force that counters the
biasing force, thereby resulting in the insulated electrodes 230 being pressed
against the patient's breast. In the exemplary embodiment that is illustrated, the
biasing mechanism 800 is in the form of springs that are disposed within the bra
material 705.
A conductive gel 810 can be provided on the insulated electrode
230 between the electrode and the lining 720. The conductive gel layer 810 is
formed of materials that have been previously described herein for performing
the functions described above. An electric connector 820 is provided as part of the insulated
electrode 230 and electrically connects to the conductor 220 at one end thereof,
with the other end of the conductor 220 being electrically connected to the
generator 210. In this embodiment, the conductor 220 runs within the bra
material 705 to a location where an opening is formed in the bra 700. The
conductor 220 extends through this opening and is routed to the generator 210,
which in this embodiment is disposed in a location remote from the bra 700. It
will also be appreciated that the generator 210 can be disposed within the bra 700
itself in another embodiment. For example, the bra 700 can have a compartment
formed therein which is configured to receive and hold the generator 210 in place
as the patient wears the bra 700. In this arrangement, the compartment can be
covered with a releasable strap that can open and close to permit the generator
210 to be inserted therein or removed therefrom. The strap can be formed of the
same material that is used to construct the bra 700 or it can be formed of some
other type of material. The strap can be releasably attached to the surrounding
bra body by fastening means, such as a hook and loop material, thereby
permitting the patient to easily open the compartment by separating the hook and
loop elements to gain access to the compartment for either inserting or removing
the generator 210. The generator 210 also has a connector 211 for electrical
connection to the conductor 220 and this permits the generator 210 to be
electrically connected to the insulated electrodes 230.
As with the other embodiments, the insulated electrodes 230 are
arranged in the bra 700 to focus the electric field (TC fields) on the desired target
(e.g., a tumor). It will be appreciated that the location of the insulated electrodes
230 within the bra 700 will vary depending upon the location of the tumor. In
other words, after the tumor has been located, the physician will then devise an
arrangement of insulated electrodes 230 and the bra 700 is constructed in view of
this arrangement so as to optimize the effects of the TC fields on the target area
(tumor). The number and position of the insulated electrodes 230 will therefore
depend upon the precise location of the tumor or other target area that is being
treated. Because the location of the insulated electrodes 230 on the bra 700 can
vary depending upon the precise application, the exact size and shape of the
insulated electrodes 230 can likewise vary. For example, if the insulated
electrodes 230 are placed on the bottom section of the bra 700 as opposed to a
more central location, the insulated electrodes 230 will have different shapes
since the shape of the breast (as well as the bra) differs in these areas. Fig. 19 illustrates yet another embodiment in which the insulated
electrodes 230 are in the form of internal electrodes that are incorporated into in
the form of a probe or catheter 600 that is configured to enter the body through a
natural pathway, such as the urethra, vagina, etc. In this embodiment, the
insulated electrodes 230 are disposed on an outer surface of the probe 600 and
along a length thereof. The conductors 220 are electrically connected to the
electrodes 230 and run within the body of the probe 600 to the generator 210
which can be disposed within the probe body or the generator 210 can be
disposed independent of the probe 600 in a remote location, such as on the patient
or at some other location close to the patient.
Alternatively, the probe 600 can be configured to penetrate the
skin surface or other tissue to reach an internal target that lies within the body.
For example, the probe 600 can penetrate the skin surface and then be positioned
adjacent to or proximate to a tumor that is located within the body.
In these embodiments, the probe 600 is inserted through the
natural pathway and then is positioned in a desired location so that the insulated
electrodes 230 are disposed near the target area (i.e., the tumor). The generator
210 is then activated to cause the insulated electrodes 230 to generate the TC fields which are applied to the tumor for a predetermined length of time. It will
be appreciated that the illustrated probe 600 is merely exemplary in nature and
that the probe 600 can have other shapes and configurations so long as they can
perform the intended function. Preferably, the conductors (e.g., wires) leading
from the insulated electrodes 230 to the generator 210 are twisted or shielded so
as not to generate a field along the shaft.
It will further be appreciated that the probes can contain only one
insulated electrode while the other can be positioned on the body surface. This
external electrode should be larger or consist of numerous electrodes so as to
result in low lines of force -current density so as not to affect the untreated areas.
In fact, the placing of electrodes should be designed to minimize the field at
potentially sensitive areas.
Fig. 20 illustrates yet another embodiment in which a high
standing collar member 900 (or necklace type structure) can be used to treat
thyroid, parathyroid, laryngeal lesions, etc. Fig. 20 illustrates the collar member
900 in an unwrapped, substantially flat condition. In this embodiment, the
insulated electrodes 230 are incorporated into a body 910 of the collar member
900 and are configured for placement against a neck area of the wearer. The insulated electrodes 230 are coupled to the generator 210 according to any of the
manner described hereinbefore and it will be appreciated that the generator 210
can be disposed within the body 910 or it can be disposed in a location external to
the body 910. The collar body 910 can be formed of any number of materials
that are traditionally used to form collars 900 that are disposed around a person's
neck. As such, the collar 900 preferably includes a means 920 for adjusting the
collar 900 relative to the neck. For example, complementary fasteners (hook and
loop fasteners, buttons, etc.) can be disposed on ends of the collar 900 to permit
adjustment of the collar diameter.
Thus, the construction of the present devices are particularly well
suited for applications where the devices are incorporated into articles of clothing
to permit the patient to easily wear a traditional article of clothing while at the
same time the patient undergoes treatment. In other words, an extra level of
comfort can be provided to the patient and the effectiveness of the treatment can
be increased by incorporating some or all of the device components into the
article of clothing. The precise article of clothing that the components are
incorporated into will obviously vary depending upon the target area of the living
tissue where tumor, lesion or the like exists. For example, if the target area is in
the testicle area of a male patient, then an article of clothing in the form of a sock-like structure or wrap can be provided and is configured to be worn around
the testicle area of the patient in such a manner that the insulated electrodes
thereof are positioned relative to the tumor such that the TC fields are directed at
the target tissue. The precise nature or form of the article of clothing can vary
greatly since the device components can be incorporated into most types of
articles of clothing and therefore, can be used to treat any number of different
areas of the patient's body where a condition may be present.
Now turning to Figs. 21-22 in which another aspect of the present
device is shown. In Fig. 21, a body 1000, such as any number of parts of a
human or animal body, is illustrated. As in the previous embodiments, two or
more insulated electrodes 230 are disposed in proximity to the body 1000 for
treatment of a tumor or the like (not shown) using TC fields, as has been
previously described in great detail in the above discussion of other
embodiments. The insulated electrode 230 has a conductive component and has
external insulation 260 that surrounds the conductive component thereof. Each
insulated electrode 230 is preferably connected to a generator (not shown) by the
lead 220. Between each insulated electrode 220 and the body 1000, a conductive
filler material (e.g., conductive gel member 270) is disposed. The insulated
electrodes 230 are spaced apart from one another and when the generator is actuated, the insulated electrodes 230 generate the TC fields that have been
previously described in great detail. The lines of the electric field (TC field) are
generally illustrated at 1010. As shown, the electric field lines 1010 extend
between the insulated electrodes 230 and through the conductive gel member
270.
Over time or as a result of some type of event, the external
insulation 260 of the insulated electrode 230 can begin to breakdown at any given
location thereof. For purpose of illustration only, Fig. 22 illustrates that the
external insulation 260 of one of the insulated electrodes 230 has experienced a
breakdown 1020 at a face thereof which is adjacent the conductive gel member
270. It will be appreciated that the breakdown 1020 of the external insulation
260 results in the formation of a strong current flow-current density at this point
(i.e., at the breakdown 1020). The increased current density is depicted by the
increased number of electric field lines 1010 and the relative positioning and
distance between adjacent electric field lines 1010. One of the side effects of the
occurrence of breakdown 1020 is that current exists at this point which will
generate heat and may burn the tissues/skin which have a resistance. In Fig. 22,
an overheated area 1030 is illustrated and is a region or area of the tissues/skin
where an increased current density exits due to the breakdown 1020 in the external insulation 260. A patient can experience discomfort and pain in this area
1030 due to the strong current that exists in the area and the increased heat and
possible burning sensation that exist in area 1030.
Fig. 23 illustrates yet another embodiment in which a further
application of the insulated electrodes 230 is shown. In this embodiment, the
conductive gel member 270 that is disposed between the insulated electrode 230
and the body 1000 includes a conductor 1100 that is floating in that the gel
material forming the member 270 completely surrounds the conductor 1100. In
one exemplary embodiment, the conductor 1100 is a thin metal sheet plate that is
disposed within the conductor 1100. As will be appreciated, if a conductor, such
as the plate 1100, is placed in a homogeneous electric field, normal to the lines of
the electric field, the conductor 1100 practically has no effect on the field (except
that the two opposing faces of the conductor 1100 are equipotential and the
corresponding equipotentials are slightly shifted). Conversely, if the conductor
1100 is disposed parallel to the electric field, there is a significant distortion of
the electric field. The area in the immediate proximity of the conductor 1100 is
not equipotential, in contrast to the situation where there is no conductor 1100
present. When the conductor 1100 is disposed within the gel member 270, the
conductor 1100 will typically not effect the electric field (TC field) for the reasons discussed above, namely that the conductor 1100 is normal to the lines of
the electric field.
If there is a breakdown of the external insulation 260 of the
insulated electrode 230, there is a strong current flow-current density at the point
of breakdown as previously discussed; however, the presence of the conductor
1100 causes the current to spread throughout the conductor 1100 and then exit
from the whole surface of the conductor 1100 so that the current reaches the body
1000 with a current density that is neither high nor low. Thus, the current that
reaches the skin will not cause discomfort to the patient even when there has been
a breakdown in the insulation 260 of the insulated electrode 230. It is important
that the conductor 1100 is not grounded as this would cause it to abolish the
electric field beyond it. Thus, the conductor 1100 is "floating" within the gel
member 270.
If the conductor 1100 is introduced into the body tissues 1000 and
is not disposed parallel to the electric field, the conductor 1100 will cause
distortion of the electric field. The distortion can cause spreading of the lines of
force (low field density-intensity) or concentration of the lines of field (higher
density) of the electric field, according to the particular geometries of the insert and its surroundings, and thus, the conductor 1100 can exhibit, for example, a
screening effect. Thus, for example, if the conductor 1100 completely encircles
an organ 1101, the electric field in the organ itself will be zero since this type of
arrangement is a Faraday cage. However, because it is impractical for a
conductor to be disposed completely around an organ, a conductive net or similar
structure can be used to cover, completely or partially, the organ, thereby
resulting in the electric field in the organ itself being zero or about zero. For
example, a net can be made of a number of conductive wires that are arranged
relative to one another to form the net or a set of wires can be arranged to
substantially encircle or otherwise cover the organ 1101. Conversely, an organ
1103 to be treated (the target organ) is not covered with a member having a
Faraday cage effect but rather is disposed in the electric field 1010 (TC fields).
Fig. 24 illustrates an embodiment where the conductor 1100 is
disposed within the body (i.e., under the skin) and it is located near a target (e.g.,
a target organ). By placing the conductor 1100 near the target, high field density
(of the TC fields) is realized at the target. At the same time, another nearby
organ can be protected by disposing the above described protective conductive
net or the like around this nearby organ so as to protect this organ from the fields.
By positioning the conductor 1100 in close proximity to the target, a high field density condition can be provided near or at the target. In other words, the
conductor 1100 permits the TC fields to be focused at a particular area (i.e., a
target).
It will also be appreciated that in the embodiment of Fig. 24, the
gel members 260 can each include a conductor as described with reference to Fig.
23. In such an arrangement, the conductor in the gel member 260 protects the
skin surface (tissues) from any side effects that may be realized if a breakdown in
the insulation of the insulated electrode 230 occurs. At the same time, the
conductor 1100 creates a high field density near the target.
There are a number of different ways to tailor the field density of
the electric field by constructing the electrodes differently and/or by strategically
placing the electrodes relative to one another. For example, in Fig. 25, a first
insulated electrode 1200 and a second insulated electrode 1210 are provided and
are disposed about a body 1300. Each insulated electrode includes a conductor
that is preferably surrounded by an insulating material, thus the term "insulated
electrode". Between each of the first and second electrodes 1200, 1210 and the
body 1300, the conductive gel member 270 is provided. Electric field lines are
generally indicated at 1220 for this type of arrangement. In this embodiment, the first insulated electrode 1200 has dimensions that are significantly greater than
the dimensions of the second insulated electrode 1210 (the conductive gel
member for the second insulated electrode 1210 will likewise be smaller).
By varying the dimensions of the insulated electrodes, the pattern
of the electric field lines 1220 is varied. More specifically, the electric field
tapers inwardly toward the second insulated electrode 1210 due to the smaller
dimensions of the second insulated electrode 1210. An area of high field density,
generally indicated at 1230, forms near the interface between the gel member 270
associated with the second insulated electrode 1210 and the skin surface. The
various components of the system are manipulated so that the tumor within the
skin or on the skin is within this high field density so that the area to be treated
(the target) is exposed to electric field lines of a higher field density.
Fig. 26 also illustrates a tapering TC field when a conductor 1400
(e.g., a conductive plate) is disposed in each of the conductive gel members 270.
In this embodiment, the size of the gel members 270 and the size of the
conductors
1400 are the same or about the same despite the differences in the sizes of the
insulated electrodes 1200, 1210. The conductors 1400 again can be characterized as "floating plates" since each conductor 1400 is surrounded by the material that
forms the gel member 270. As shown in Fig. 26, the placement of one conductor
1400 near the insulated electrode 1210 that is smaller than the other insulated
electrode 1200 and is also smaller than the conductor 1400 itself and the other
insulated electrode 1200 is disposed at a distance therefrom, the one conductor
1400 causes a decrease in the field density in the tissues disposed between the
one conductor 1400 and the other insulated electrode 1200. The decrease in the
field density is generally indicated at 1410. At the same time, a very
inhomogeneous tapering field, generally indicated at 1420, changing from very
low density to very high density is formed between the one conductor 1400 and
the insulated electrode 1210. One benefit of this exemplary configuration is that
it permits the size of the insulated electrode to be reduced without causing an
increase in the nearby field density. This can be important since electrodes that
having very high dielectric constant insulation can be very expensive. For
example, one insulated electrode can cost $500.00 or more and further, the price
is sensitive to the particular area of treatment. Thus, a reduction in the size of the
insulated electrodes directly leads to a reduction in cost.
While the invention has been particularly shown and described
with reference to preferred embodiments thereof, it will be understood by those skilled in the art that various changes in form and details can be made without
departing from the spirit and scope of the invention.

Claims

WHAT IS CLAIMED IS:
1. An apparatus for selectively destroying dividing cells in
living tissue, the dividing cells having polarizable or polar intracellular members,
the apparatus comprising:
a first insulated electrode having a first conductor;
a second insulated electrode having a second conductor; and
an electric field source for applying an alternating electric
potential
across the first and second conductors, wherein passage of the electric field
through the dividing cells in late anaphase or telophase transforms the electric
field into a non-homogenous electric field that produces an increased density
electric field in a region of a cleavage furrow of the dividing cells, the non-
homogeneous electric field produced within the dividing cells being of sufficient
intensity to move the polarizable intracellular members toward the cleavage.
2. The apparatus of claim 1, wherein the electric field is of
sufficient frequency so that the non-homogeneous electric field produced in the
dividing cells defines electric field lines which generally converge at a region of
the cleavage furrow, thereby defining the increased density electric field, resulting in destruction of the dividing cells as a result of the polarizable
intracellular members movement toward the furrow.
3. The apparatus of claim 1, further including:
a first conductive lead operatively connecting the first electrode to
the electric field source; and
a second conductive lead operatively connecting the second
electrode to the electric field source.
4. The apparatus of claim 1, wherein the first electrode
includes a first dielectric member that is in contact with the first conductor, the
first dielectric member for placement against the living tissue to form a capacitor,
wherein the second electrode includes a second dielectric member that is in
contact with the second conductor, the second dielectric member for placement
against the living tissue to form a capacitor.
5. The apparatus of claim 4, wherein each of the first and
second dielectric members is formed of a layer of titanium dioxide.
6. The apparatus of claim 4, wherein each of the first and
second dielectric members comprises a dielectric coating having a thickness
between about 5 microns to about 50 microns.
7. The apparatus of claim 6, further including: a loose net disposed around the dielectric coating for restricting
access to a surface of the dielectric coating while only having a minimal effect on
a surface area of the dielectric coating.
8. The apparatus of claim 6, further including:
a thin conducting coating disposed on the dielectric coating for
contacting the tissue.
9. The apparatus of claim 8, wherein the conducting coating
is formed of gold.
10. The apparatus of claim 1, wherein the alternating electric
potential has a frequency of between about lOOKHz to about 300KHz.
11. The apparatus of claim 1, wherein the electric field source
comprises a generator that generates an alternating voltage waveform at
frequencies between about 50KHz to about 500KHz.
12. The apparatus of claim 11, wherein the voltage waveform
is selected so that an electric field intensity in tissue to be treated is between
about 0.1 V/cm to about 10.0 V/cm.
13. The apparatus of claim 4, wherein at least one of the first
and second electrodes includes an intervening filler disposed on the respective dielectric member thereof, the intervening filler being formed of a material that
has high conductance and a high dielectric constant.
14. The apparatus of claim 13, wherein the intervening filler
comprises a gel formed of at least one material selected from the group consisting
of gelatins and agar.
15. The apparatus of claim 13, wherein the intervening filler is
contained within the dielectric member by a rim formed as part of the dielectric
member.
16. A skin patch for selectively destroying dividing cells that
are in a localized area of living tissue, the dividing cells having polarizable or
polar intracellular members, the skin patch including:
a skin patch body for placement on the living tissue over the
localized area of dividing cells, the skin patch body comprising:
a first insulated electrode having a first conductor;
a second insulated electrode having a second conductor;
and
an electric field source for applying an alternating electric
potential across the first and second conductors, wherein passage of the electric field
through the dividing cells in late anaphase or telophase transforms the electric
field into a non-homogenous electric field that produces an increased density
electric field in a region of a cleavage furrow of the dividing cells, the non-
homogeneous electric field produced within the dividing cells being of sufficient
intensity to move the polarizable intracellular members toward the cleavage
furrow.
17. The skin patch of claim 16, wherein the electric field is of
sufficient frequency so that the non-homogeneous electric field produced in the
dividing cells defines electric field lines which generally converge at a region of
the cleavage furrow, thereby defining the increased density electric field ,
resulting in destruction of the dividing cells as a result of the polarizable
intracellular members movement toward the furrow.
18. The skin patch of claim 16, wherein the alternating electric
potential has a frequency of between about lOOKHz to about 300KHz.
19. An article of clothing having a feature for selectively
destroying dividing cells in a target area of living tissue, the dividing cells having
polarizable or polar or charged intracellular members, the article of clothing
being constructed to be worn over the target area and comprising: a first insulated electrode having a first conductor;
a second insulated electrode having a second conductor; and
an electric field source connected to the first and second insulated
electrodes for applying an alternating electric potential difference across the first
and second conductors, wherein passage of the electric field through the dividing
cells in late anaphase or telophase transforms the electric field into a non-
homogenous electric field that produces an increased density electric field in a
region of a cleavage furrow of the dividing cells, the non-homogeneous electric
field produced within the dividing cells being of sufficient intensity to move the
polarizable or charged intracellular members toward the cleavage furrow.
20. The article of clothing of claim 19, wherein the article
comprises a hat to be worn over a head for treatment of one of an intra-cranial
tumor and a scalp tumor.
21. The article of clothing of claim 20, wherein the first and
second insulated electrodes have an arcuate shape for placement against the head.
22. The article of clothing of claim 19, wherein the electric
field is of sufficient frequency so that the non-homogeneous electric field
produced in the dividing cells defines electric field lines which generally
converge at a region of the cleavage furrow, thereby defining the increased density electric field , resulting in destruction of the dividing cells as a result of
the polarizable intracellular members movement toward the cleavage furrow.
23. The article of clothing of claim 19, further including:
a first conductive lead operatively connecting the first electrode to
the electric field source; and
a second conductive lead operatively connecting the second
electrode to the electric field source.
24. The article of clothing of claim 19, wherein the first
electrode includes a first dielectric member that is in contact with the first
conductor, the first dielectric member for placement against the living tissue to
form a capacitor and wherein the second electrode includes a second dielectric
member that is in contact with the second conductor, the second dielectric
member for placement against the living tissue to form a capacitor.
25. The article of clothing of claim 19, wherein the alternating
electric potential has a frequency of between about 50KHz to about 500KHz.
26. The article of clothing of claim 19, wherein the alternating
electric potential has a frequency of between about lOOKHz to about 300KHz.
27. The article of clothing of claim 19, wherein the electric
field source comprises a generator that generates an alternating voltage waveform
at frequencies between about 50KHz to about 500KHz.
28. The article of clothing of claim 27, wherein the generator is
disposed within the article of clothing.
29. The article of clothing of claim 19, further including:
a biasing mechanism for biasing each of the first and second
electrodes in a direction toward the living tissue when the article of clothing is
worn to ensure that the first and second electrodes seat against the living tissue.
30. The article of clothing of claim 29, wherein the biasing
mechanism includes a spring that applies a biasing force against one of the first
and second electrodes in the direction toward the living tissue.
31. The article of clothing of claim 29, wherein the biasing
mechanism comprises a body formed of an elastic material that is disposed within
the article of clothing in close proximity to or in contact with one of the insulated
electrodes.
32. The article of clothing of claim 31, wherein the body is
formed of a material that has undergone a foaming process.
33. The article of clothing of claim 19, wherein each insulated
electrode includes a conductor and a dielectric member in contact therewith and
for placement against the living tissue to form a capacitor.
34. The article of clothing of claim 33, wherein the insulated
electrode includes an intervening filler disposed on the respective dielectric
member thereof, the intervening filler being formed of a material that has high
conductance and a high dielectric constant.
35. The article of clothing of claim 34, wherein the intervening
filler comprises a gel formed of at least one material selected from the group
consisting of hydrogels, gelatins and agar.
36. The article of clothing of claim 19, wherein the clothing is
in the form of a bra.
37. A hat for treatment of an intra-cranial tumor or lesion by
selectively destroying dividing cells of the tumor, the dividing cells having
polarizable or polar or charged intracellular members, the hat comprising:
a hat body to be worn over a head and including a predetermined
number of openings formed therein;
at least one insulated electrode unit for placement in one of the
openings of the hat, each unit being a member having an insulated electrode disposed at one face thereof and a biasing mechanism for applying a biasing force
against the insulated electrode in a direction away from the hat body, the
insulated electrode being disposed at one face of the hat body when the unit is
inserted and securely held within the opening; and
an electric field source for applying an alternating electric
potential across at least two insulated electrodes to create a condition in the
dividing cells that results in the destruction thereof.
38. The hat of claim 37, wherein the unit is securely retained
within the opening by an adhesive member that has an adhesive layer formed on
at least one side thereof, the adhesive member being disposed around a peripheral
edge of the insulated electrode and over a peripheral edge of the hat body around
the opening for securely positioning and retaining the unit within the opening
with the insulated electrode being positioned at one face of the hat body.
39. The hat of claim 37, wherein the electric field source
comprises a generator that generates an alternating voltage waveform at
frequencies between about 50KHz to about 500KHz that activate each insulated
electrode.
40. The hat of claim 39, wherein the generator is disposed
within the hat body.
41. The hat of claim 37, wherein the biasing mechanism
includes a spring that applies a biasing force against one of the first and second
electrodes in the direction toward the living tissue.
42. The hat of claim 41 , wherein the biasing mechanism is
contained within a unit that is detachably coupled to the hat to permit removal
and replacement thereof.
43. The hat of claim 37, wherein the biasing mechanism
comprises a body formed of an elastic material that is disposed within the article
of clothing in close proximity to or in contact with one of the insulated electrodes.
44. The hat of claim 37, wherein each insulated electrode
includes a conductor and a dielectric member in contact therewith and for
placement against the head to form a capacitor.
45. The hat of claim 44, wherein the insulated electrode
includes an intervening filler disposed on the respective dielectric member
thereof, the intervening filler being formed of a material that has high
conductance and a high dielectric constant.
46. A probe for treatment of a section of living tissue by
selectively destroying dividing cells of a target section of tissue, the dividing
cells having polarizable or polar intracellular members, the probe comprising: a probe body for insertion into a body;
at least two insulated electrodes disposed on an outer surface of
the probe body; and
an electric field source for applying an alternating electric
potential across the at least two insulated electrodes to create a condition in the
dividing cells that encourages the destruction thereof.
47. The probe of claim 46, wherein the probe body is
configured to be inserted into and pass through a natural pathway of the body to
position the insulated electrodes relative to the target section.
48. The probe of claim 46, wherein the probe body is
configured to penetrate the living tissue and be positioned so that the electrodes
are disposed proximate the target section.
49. The probe of claim 46, wherein the first and second
insulated electrodes have an arcuate shape.
50. The probe of claim 46, wherein the electric field source
comprises a generator that generates an alternating voltage waveform at
frequencies between about 50KHz to about 500KHz that activate each insulated
electrode.
51. An apparatus for selectively destroying dividing cells in a
target area of living tissue, the dividing cells having polarizable or polar or
charged intracellular members, the apparatus comprising:
a first insulated electrode having a first conductor;
a second insulated electrode having a second conductor;
an electric field source connected to the first and second insulated
electrodes for applying an alternating electric potential difference across the first
and second conductors to create a condition in the dividing cells that encourages
the destruction thereof;
an intervening member formed of a filler material disposed
between one of the first and second insulated electrodes and a skin surface, the
filler material having a high conductance; and
a third conductor disposed within the intervening member such
that the filler material of the intervening member completely surrounds the third
conductor.
52. The apparatus of claim 51 , wherein passage of the electric
field through the dividing cells in late anaphase or telophase transforms the
electric field into a non-homogenous electric field that produces an increased
density electric field in a region of a cleavage furrow of the dividing cells, the non-homogeneous electric field produced within the dividing cells being of
sufficient intensity to move the polarizable, polar or charged intracellular
members toward the cleavage.
53. The apparatus of claim 51 , wherein the third conductor
disposed within the intervening member comprises a flat conductor plate.
54. The apparatus of claim 51 , wherein a length of the third
conductor is equal to or about equal to a length of each of the first and second
conductors.
55. The apparatus of claim 51 , further including:
a first conductive lead operatively connecting the first electrode to
the electric field source; and
a second conductive lead operatively connecting the second
electrode to the electric field source.
56. The apparatus of claim 51 , wherein the first electrode
includes a first dielectric member that is in contact with the first conductor, the
first dielectric member for placement against the living tissue to form a capacitor
and wherein the second electrode includes a second dielectric member that is in
contact with the second conductor, the second dielectric member for placement
against the living tissue to form a capacitor.
57. The apparatus of claim 51, wherein the alternating electric
potential has a frequency of between about 50KHz to about 500KHz.
58. The apparatus of claim 51 , wherein the first insulated
electrode is of a first size and the second insulated electrode is of a second size
that is greater than the first size, the intervening member associated with the first
insulated electrode being of a smaller size than the intervening member
associated with the second insulated electrode.
59. The apparatus of claim 58, wherein the electric field near
the first insulated electrode is of a higher field density than the electric field in
other locations between the first and second insulated electrodes.
60. The apparatus of claim 59, wherein the electric field tapers
inwardly to the first insulated electrode.
61. The apparatus of claim 51 , wherein the intervening filler
comprises a gel formed of at least one material selected from the group consisting
of hydrogels, gelatins and agar.
62. An apparatus for selectively destroying dividing cells in a
target area of living tissue, the dividing cells having polarizable or polar or
charged intracellular members, the apparatus comprising:
a first insulated electrode having a first conductor; a second insulated electrode having a second conductor;
an electric field source connected to the first and second insulated
electrodes for applying an alternating electric potential difference across the first
and second conductors to create a condition in the dividing cells that encourages
the destruction thereof;
an intervening member disposed between one of the first and
second insulated electrodes and a skin surface, the intervening member being
formed of a filler material that has a high conductance and a high dielectric
constant; and
wherein the first insulated electrode is of a first size and the
second insulated electrode is of a second size that is greater than the first size, the
intervening member associated with the first insulated electrode being of a
smaller size than the intervening member associated with the second insulated
electrode, resulting in the electric field near the first insulated electrode being of a
higher field density than the electric field in other locations between the first and
second insulated electrodes.
63. The apparatus of claim 62, wherein the electric field tapers
inwardly to the first insulated electrode.
64. The apparatus of claim 62, wherein the first electrode
includes a first dielectric member that is in contact with the first conductor, the
first dielectric member for placement against the living tissue to form a capacitor
and wherein the second electrode includes a second dielectric member that is in
contact with the second conductor, the second dielectric member for placement
against the living tissue to form a capacitor.
65. The apparatus of claim 62, wherein the alternating electric
potential has a frequency of between about 50KHz to about 500KHz.
66. The apparatus of claim 62, wherein the electric field source
comprises a generator that generates an alternating voltage waveform at
frequencies between about 50KHz to about 500KHz.
67. The apparatus of claim 62, wherein the intervening filler
comprises a gel formed of at least one material selected from the group consisting
of hydrogels, gelatins and agar.
68. An apparatus for selectively destroying dividing cells in a
target area of living tissue, the dividing cells having polarizable or polar or
charged intracellular members, the apparatus comprising:
a first insulated electrode having a first conductor;
a second insulated electrode having a second conductor; an electric field source connected to the first and second insulated
electrodes for applying an alternating electric potential difference across the first
and second conductors to create a condition in the dividing cells that encourages
the destruction thereof;
an intervening member disposed each of the first and second
insulated electrodes and a skin surface, each intervening member being formed of
a filler material having a high conductance and a high dielectric constant; and
a third conductor disposed within the living tissue in close
proximity to the target area and between the first and second insulated electrodes,
the third conductor causing increased electric field density in the target area.
69. The apparatus of claim 68, further including:
a conductor protective member that is disposed around an organ to
be shielded and protected from effects of an electric field generated by the
electric field source.
70. The apparatus of claim 69, wherein the conductive
protective member comprises a net formed of conductive elements that is
disposed around at least a portion of the organ to be protected.
71. The apparatus of claim 68, wherein each insulated
electrode includes a conductor and a dielectric member in contact therewith and
for placement against the living tissue to form a capacitor.
72. The apparatus of claim 68, wherein the intervening filler
comprises a gel formed of at least one material selected from the group consisting
of hydrogels, gelatins and agar.
73. The apparatus of claim 72, wherein the gel includes salt
dissolved therein to increase the conductivity of the gel.
PCT/IB2003/004321 2002-10-02 2003-10-01 Apparatus for treating a tumor by an electric field WO2004030760A2 (en)

Priority Applications (13)

Application Number Priority Date Filing Date Title
EP10012716.6A EP2281604B1 (en) 2002-10-02 2003-10-01 Apparatus for treating a tumor by an electric field
EP03799042.1A EP1545704B1 (en) 2002-10-02 2003-10-01 Apparatus for treating a tumor by an electric field
EP19219623.6A EP3656441B1 (en) 2002-10-02 2003-10-01 Apparatus for treating a tumor by an electric field
JP2004541094A JP4350042B2 (en) 2002-10-02 2003-10-01 Apparatus for treating tumors and the like, as well as a product comprising a device for treating tumors
EP19183539.6A EP3572123B1 (en) 2002-10-02 2003-10-01 Apparatus for treating a tumor by an electric field
ES03799042T ES2813059T3 (en) 2002-10-02 2003-10-01 Device for treating a tumor using an electric field
EP10012706.7A EP2281603B1 (en) 2002-10-02 2003-10-01 Apparatus for treating a tumor by an electric field
AU2003265066A AU2003265066A1 (en) 2002-10-02 2003-10-01 Apparatus for treating a tumor by an electric field
EP10012702.6A EP2281602B1 (en) 2002-10-02 2003-10-01 Apparatus for treating a tumor by an electric field
EP10012777.8A EP2281605B1 (en) 2002-10-02 2003-10-01 Apparatus for treating a tumor by an electric field
DK03799042.1T DK1545704T3 (en) 2002-10-02 2003-10-01 DEVICE FOR TREATING A TUMOR WITH AN ELECTRIC FIELD
EP19219652.5A EP3659671A1 (en) 2002-10-02 2003-10-01 Apparatus for treating a tumor by an electric field
CA2499845A CA2499845C (en) 2002-10-02 2003-10-01 Apparatus for treating a tumor or the like and articles incorporating the apparatus for treatment of the tumour

Applications Claiming Priority (6)

Application Number Priority Date Filing Date Title
US10/263,329 2002-10-02
US10/263,329 US7136699B2 (en) 2002-10-02 2002-10-02 Apparatus for destroying dividing cells
US10/285,313 US7089054B2 (en) 2002-10-02 2002-10-31 Apparatus and method for treating a tumor or the like
US10/285,313 2002-10-31
US10/315,576 US6868289B2 (en) 2002-10-02 2002-12-10 Apparatus for treating a tumor or the like and articles incorporating the apparatus for treatment of the tumor
US10/315,576 2002-12-10

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EP (8) EP2281602B1 (en)
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CA (3) CA3100056A1 (en)
DK (7) DK2281602T3 (en)
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