Doctor Joseph Liao has been using the world's smallest microscope and he is still amazed by what he has been able to see with it.
"It was... wow. We were able to see individual cells live inside a human being," he says.
In one recent case, that human being was Noble Chaney, an 85-year-old Navy veteran who had come to the VA Medical Center in Palo Alto for treatment. His symptoms pointed to bladder cancer, but instead of a traditional biopsy, doctors decided to take a look around first.
"Doctor comes in, inserts the camera in my bladder and they have a monitor they look at all the time," Chaney describes.
Dr. Liao is leading a first-of-its-kind study at the VA using the flexible microscope known as "Cell-Vizio" to examine tumors inside the bladder. He says the resolution is so clear that his team has been able to determine if there is cancer present, even before taking a biopsy.
"We can see individual cells. We can see normal cells, we can see cancer cells and different types of cancers cells. We can even see individual blood cells flowing inside the patient and the images are unbelievable," he says.
"I couldn't see what it was, but doctor said 'Yeah, there's a small tumor there and it has to come out,'" Chaney recalls.
Doctors successfully removed Noble's tumor a short time later, but since bladder cancers can reoccur, some patients need to be re-examined every three months and often undergo unnecessary biopsies.
Dr. Liao believes the microscope, which uses a tiny beam of laser light to illuminate images, could change how the patients are treated.
"Our goal is to do a biopsy optically without invasive, to actually have to remove a piece of tissue in a clinic setting," he explains.
The device is still investigational in urology patients, but it has already been used successfully in the stomach. As for Noble, he is relieved doctors can now peak inside his body.
"They did save my life. Because if not removed, it would break down and spread to other organs," he says.
In one previous trial involving gastrointestinal cancer, researchers say the scope was able to identify cancerous tissue that traditional endoscopic exams miss about 50 percent of the time.