Above from left: Christine Luk, Rachel Lambert, Sonia Parra and Elizabeth Stone.
A team of Rice University students hopes a device they developed to train doctors and nurses in developing countries and low-resource areas in the U.S. to prevent and treat cervical cancer will improve the outlook for women with this disease.
Cervical cancer kills close to 300,000 women per year worldwide, with approximately 85 percent of these deaths occurring in developing countries.
Rice students Christine Luk, Elizabeth Stone and Rachel Lambert are senior design students enrolled in the course Global Health Design. Together with bioengineering doctoral student Sonia Parra, they developed a low-cost, interactive training model that mimics a woman’s pelvic region and can be used to practice different cervical cancer screening and treatment procedures. The training model, which was developed at Rice's Oshman Engineering Design Kitchen (OEDK) and was based on models developed by other teams of students over the past few years, was created in collaboration with the Rice 360° Institute for Global Health and the University of Texas MD Anderson Cancer Center.
“More than 90 percent of cervical cancer cases are preventable,” Stone said. “Prevention is accomplished through screening and, if necessary, treatment. This device is specifically designed so health care providers in developing countries and low-resource regions -- many of whom lack gynecological training -- learn to screen for and treat cervical cancer.”
“The main reason for this is because these countries are not able to implement the standard of care,” Parra said, who is also a student in the Medical Scientist Training Program (MSTP) run jointly by Rice and Baylor College of Medicine. “Many times it’s also due to the lack of training for providers to learn standard cervical cancer screening and prevention skills needed in order to screen and provide prevention services for the entire population.”
Stone said these procedures can be dangerous when performed without proper training, so it’s not ideal for physicians not trained in gynecological care to practice the skills on a person.
“This is why the device is necessary and has such potential to save lives,” she said.
The device includes different cervix models that are 3-D printed to mimic human ones that are normal, have precancer or have evidence of cancer. The model cervixes fit into a holder that attaches to the back of the device. Once clipped into place, the holder can be adjusted to simulate the different positions of a human cervix. The models can easily be switched around during training to mimic different conditions encountered in a gynecologist’s office and can be viewed after the speculum is inserted. In addition, the model cervixes can be dabbed with hot water (in a clinical setting, doctors use acetic acid) to mimic the appearance of precancerous lesions doctors might see in a clinical setting.
The device also includes model cervixes made of a ballistic gel that can be used to train health care professionals to perform several procedures: colposcopy, which is a method of examining the cervix, vagina and vulva when results of a Pap smear, the screening test used to identify abnormal cervical cells, are unusual; cervical biopsy; cryotherapy, which uses freezing gas to destroy precancerous cells on the cervix; and loop electrosurgical excision procedure, known as LEEP, during which a small electrical wire loop is used to remove abnormal cells from the cervix. The gel allows trainees to practice these procedures at a low cost.
“Here in the states we have the ability to perform Pap smears and other practices, but in other countries where this model is used, such as Mozambique and El Salvador, they may not have the necessary infrastructure to do so,” Luk said. “That’s why it’s important that this model can train as many procedures as possible.”
Since developing the device, the students have used it in training clinics in El Salvador and the Rio Grande Valley in Texas. Each training session is modified to fit the specific needs of an area.
Lambert said the doctors attending these sessions have expressed interest in acquiring their own devices to continue training. Some have even tried to create their own models. In the future, the team hopes to work with a manufacturer to mass-produce the devices for areas in need so newly trained medical providers can train others.
For more information on this project and the other design projects at the OEDK, visit http://oedk.rice.edu/