Human Tumor Cell Destruction by Distilled Water: An in Vitro Evaluation

Abstract

A distilled water lavage is sometimes used during tumor surgery in an effort to kill tumor cells spilled into a cavity or wound. To test the efficacy of this technique, a model study utilized nine different human tumor cell lines, subjected in v i m to hypotonic exposure for I to 10 minutes. Only the carcinoid, multiple myeloma, leiomyosarcoma cell lines, and normal lymphocytes were destroyed by the treatment. Although breast, ovarian, gastric, bladder, and melanoma cell lines were damaged to varying degrees, viable cells persisted in all cases. These data suggest that hypotonic shock is not an effective method to kill human tumor cells.Cancer 55:2779-2782, 1985.OLE AND COFFEY' reported that cells released from C the tumor margins cut during surgical excision provide a potential seed population for local tumor recurrences. Seeding may be especially troublesome when en bloc excision is not possible. In an effort to destroy such cells, Welsh and Welsh2 have advocated irrigation with warm distilled water on the premise that tumor cells would be lysed by hypotonic shock. In practice, this procedure usually involves filling the affected cavity wound, or hollow organ, with sterile water for I to 2 minutes. Many surgeons continue this practice. Although this procedure may flush cells from the area, no evidence of cell killing has been reported. Controlled evaluation of this technique would seem to be appropriate to establish its efficacy. To this end, we measured the sensitivities of nine human tumor cell lines to osmotic shock in vitro. These cell lines were challenged for I to 10 minutes with distilled water and their subsequent viability and replicative potential were assessed. Materials and Methods Cell LinesNine human tumor cell lines and peripheral lymphocytes from one donor were used. The ovarian (COLO 319), breast (COLO 533N), colon carcinoid (COLO 321), and multiple myeloma (RPMI 8226) cell lines were provided by Dr. George E. Moore, Denver General Hospital. The melanoma (FAMC 113 and I15), leiomyosarcoma (FAMC 151), gastric (FAMC 187), and transitional cell of the bladder (FAMC 191) cell lines were established in this laboratory. Cell lines were screened for contamination and verified as to transformed state and tissue type by karyotype analysis and heterotransplantation. Purified lymphocytes, concentrated over Histopaque (Sigma, St. Louis), were obtained from a healthy donor. All cultures were maintained in antibiotic free GEM 17 17 supplemented with 10% fetal bovine serum. With the exception of the multiple myeloma and normal lymphocytes, all the cell lines grew attached to the plastic substrate.

Effect of distilled water on rapid inactivation of tumour cells attached to surgery instruments

“…observed a decrease in DNA synthesis in different tumour cell lines after exposure to distilled water for 1–10 min. However, the remaining cells did not lose their replication capacity . As distilled water has the characteristic for hypotonic, but no data are available supporting this hypothesis that cancer cell injury was related to distilled water in surgery of tumour resection.…”

In-vitro cytocidal effect of water on bladder cancer cells: The potential role for intraperitoneal lavage during radical cystectomy

“…While this practice is not unique to our institution or urology, there is little evidence to suggest the utility of this practice or appropriate duration of this treatment to have an effect on bladder cancer cell death. 7 Prior research studies in colorectal and ovarian cancer show conflicting results in regards to the cytolytic efficacy of intraperitoneal lavage with sterile water. 12,13 Furthermore, prior bladder cancer research has demonstrated conflicting evidence regarding the role of intraperitoneal lavage with sterile water.…”

“…12,13 Furthermore, prior bladder cancer research has demonstrated conflicting evidence regarding the role of intraperitoneal lavage with sterile water. [7][8][9] Our study was specifically intended to study the time course of events in bladder cancer cells after exposure to water. First, we confirmed the cytocidal effect of hypotonic shock induced by sterile water on bladder cancer cells.…”

“…This is the first study, to our knowledge, which was able to quantify the exposure time required to achieve cell lysis and decrease cell viability. The lytic effect of sterile water on tumour cells has been well-studied in a variety of cancer settings, [7][8][9]13 however, the dwell time required to achieve cancer cell lysis has not been reported. We found the required duration of exposure to sterile water to severely limit the number of cancer cells in each bladder cell line by a re-incubation experiment.…”

“…[4][5][6] There are conflicting data regarding the utility of this approach; others have even considered intraperitoneal chemotherapy to lyse potential tumour cells. 7,8 While studies have attempted to explain the exact molecular mechanism in support of intraperitoneal lavage with sterile water, its benefit is controversial. In one study analyzing cultures of bladder cancer cells, sterile water led to significant cytolysis.…”