Caring for sexuality and reproduction: experiencing community based care and state-run health care in a Ngöbe indigenous community in Costa Rica

Abstract

Despite advances in prevention, detection, and treatment of cancer, this disease remains the second leading cause of death in the United States. The majority of cancer related deaths are due to metastasis rather than primary tumors and, although mortality rates have decreased over the last two decades, efforts to achieve comprehensive diagnoses and effective treatments still encounter obstacles due to lack of non-invasive technologies that accurately assess cancer. The goal of this project is to design a non-invasive approach for the assessment of sentinel lymph node metastasis using ultrasound and photoacoustic imaging, augmented with contrast agents. The focus is two-fold: first, contrast-enhanced ultrasound and photoacoustic imaging are evaluated as a tool to track functional and molecular changes of metastatic lymph nodes in relevant in vivo cancer models. Specifically, imaging of immune cell uptake and transport of lymphotropic nanoparticles to the sentinel lymph node, and imaging of clearable nanoparticles targeted to the epidermal growth factor receptor provide diagnostic information regarding metastatic nodal involvement. Second, alternative contrast agents are designed with the goal of solving challenges of the proposed techniques and augmenting therapeutic capabilities. Overall, the study is expected to help identify cancer based on functional and molecular changes, therefore augmenting and potentially replacing sentinel lymph node biopsy.