Sunday, December 1, 2013
Early detection of skin cancer
When is the last time you went tanning? For many young adults and teenagers tanning and being outdoors is a day to day event. However, if not properly protecting your skin from the sun you have a higher chance of melanoma or skin cancer. Melanoma incidents have risen in the past decade. Last year alone there were 75,000 americans impacted. There has been increased awareness of what to look for to try and help early detection to decrease melanoma-related morbidity and mortality.
Melanoma is a tumor produced from melanocytes in the skin. They can occur from pre-existing moles or form as a new growth. They can be detected by the ABCDE mnemonic: A for asymmetry, B for borders that are shaped irregularly, C for color, D for diameter (6-8mm), and E for evolving. These cancers are caused by damage to the cells DNA from the UV light of the sun or from inherited mutations in the individuals genes.
In the past, doctors have used their judgement to see if patients needed a biopsy on a dangerous looking mole. With doctors uncertainty in classifying the mole as malignant or benign, doctors had to use an invasive procedure leaving behind scaring for the patient. Many times these moles were benign and caused the patients pain that was not needed. With new technology, doctors can now identify whether a mole is cancerous or not. Melafind is providing dermatologists with a new optical scanner to better identify malignant versus benign moles. While this technology is not a definite diagnosis, it's goal is to give doctors a second opinion to see if a biopsy is needed. Melafind's mission is to have less invasive procedures leaving patients with less scars and reduce money spent on these procedures.
So the next time you plan on heading to the beach, lake, or mountain don't forget to put on your sunscreen because even though technology can detect whether you have a malignant tumor it cannot save your life.
Ferris L, Harris R. 2012. New diagnostic aids for melanoma. Dermatol Clin. 30(3):535-545.
Kupetsky E, Ferris L. 2013. The diagnostic evaluation of MelaFind multi-spectral objective computer vision system. Expert Opinion on Medical Diagnostics. 7(4):405-411.
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Graham, I found your blog post very interesting. I worked in a dermatology clinic for over a year and I had never heard any mention on MelaFind. This made me wonder if MelaFind is really that good at detecting malignant mole? I did find that the article you cited by Ferris that MelaFind has a 98% sensitivity for melanoma diagnosis (1). This is above the normal sensitivity rate from a dermatologist using dermatoscopy. However, MelaFind is not able to detect basal cell carcinomas or squamous cell carcinomas which makes some dermatologist nervous that these types of skin cancer won't be biopsied because of the low score MelaFind would give (2). Other doctor's say they are worried that MelaFind says every pigmented lesion is positive for melanoma thus increases the number of biopsies rather than decreasing them (2). But as with most technologies, there are pros and cons. I then wondered how much MelaFind costs. Dermatologist are able to lease the device for $7,500. The pricing per procedure is estimated at $150 per patient. However, insurance is not expected to cover the use of the device putting the cost on the patient (1). Regardless, the price is less than biopsy and histopathology which does make it a cost effective alternative. But, if more lesions are coming up positive when using the device, that cost effectiveness will be negated.
ReplyDeleteI feel that MelaFind can help in the diagnostic aspect of melanoma but should not be solely relied upon by dermatologists. I am excited to ask the dermatologist I worked for his opinion on MelaFind. I will let you know what he says.
1. Ferris LK, Harris RJ. July 2012.New diagnostic aids for melanoma Dermatol Clin. 30(3):535-45.
2. Schwitzer G. July 2013. Melanoma detection device: helping doctors? Or causing dissent, polarizing field of skin-cancer detection? Health New Review. Available at: http://www.healthnewsreview.org/2013/07/melanoma-device-helping-doctors-or-causing-dissent-polarizing-field-of-skin-cancer-detection/
As a native Phoenician, skin cancer has long been something on my radar. We hear about it from an early age, constantly being told to "wear your sunscreen"; however, I know skin cancer rates have actually risen in the last couple of years (1) and so it would be great to develop better diagnostic technologies. I found another article which discusses the use of what's called reflectance confocal microscopy for the diagnosis of melanoma. This technology essentially allows dermatologists to see a skin lesion better to assess whether or not it actually looks like melanoma. It has been shown to have a sensitivity of 93% and a specificity of 76%, both of which I thought were pretty good (1). I was wondering if you saw this technology show up anywhere in your research in addition to MelaFind?
ReplyDelete1. Stevenson AD, Mickan S, Mallett S, and Ayya M. 2013 Oct. Systemic review of diagnostic accuracy of reflectance confocal microscopy for melanoma diagnosis in patients with clinically equivocal skin lesions. Dermatology Practical and Conceptual 3(4): 19-27.