JOHN LEHMANN/THE GLOBE AND MAIL
If you find a suspicious-looking mole, chances are a biopsy and a scar are in your future - after a wait to see a dermatologist.
But a new device developed at the B.C. Cancer Agency could change all that.
Using a skin-cancer detector called the Verisante Aura, general practitioners may soon be able to catch melanoma - the type of skin cancer that has the highest risk of becoming lethal - at the earliest stage by shining a ray of light.
The technology uses fibre optics to gather wavelengths emitted by various molecules in response to laser light, says David McLean, who invented the device with doctors Harvey Lui and Haishan Zeng. Cancer molecules show up as abnormalities on a computer screen, Dr. McLean says.
"We found that certain skin lesions, certain skin diseases, had certain signatures … that would appear to be unique."
The device has been tested on 1,000 skin lesions at the Skin Care Centre in Vancouver. According to preliminary results, the Verisante Aura picked up every case of melanoma in 274 lesions flagged for biopsy.
Early data suggests the device has a high detection rate for two other forms of skin cancer - basal cell and squamous cell carcinomas - and may identify precancerous lesions, says Dr. McLean, a professor of dermatology at the University of B.C. "The results are very encouraging."
Verisante Aura is being engineered for mass production by T-Ray Science Inc., a Vancouver-based medical device company. Chief executive officer Thomas Braun expects that the $30,000 skin cancer detector will receive Health Canada approval later this year.
Cancer agencies and dermatologists are target markets, he says, adding that general practitioners may purchase the equipment to expand their menu of privately funded services.
According to Mr. Braun, wide adoption of the device could reduce wait times for patients with enlarged, misshapen or discoloured moles, all of which are signs of skin cancer. Skin lesions are usually examined by dermatologists with the naked eye or a magnifying device called a dermascope. But a technician using the Verisante Aura can scan every mole on a patient's body in 10 to 15 minutes, Mr. Braun says.
"It's a device that would make the average health-care practitioner as good as a dermatologist at identifying skin cancer."
According to Dr. McLean, the Verisante Aura is easier to use than laser-hair-removal equipment, with no capacity for damaging the skin. Nurses could be trained to use it, he says. "It should be very cost-effective."
Patients diagnosed with early-stage melanoma have a five-year survival rate of 98 per cent, compared with 15 per cent for those diagnosed at a late stage, according to the American Cancer Society.
Although moles flagged by the Verisante Aura still require excision, the device would reduce the number of biopsies performed on skin lesions that turn out to be benign, says Dr. McLean. More importantly, he adds, fewer early-stage skin cancers would go unnoticed.
He notes that older patients have so many brown spots that "it can be bewildering to a practitioner as to which is which."
Duane Lichtenwald, a Saskatoon-based dermatologist and spokesman for the Canadian Dermatology Association, says the device is based on solid science and has the potential to become a useful screening tool. But "it's still a test, it still takes some interpretation," he says, adding, "it's going to take years to prove that this would replace the clinical acumen of a dermatologist."
A trial is underway to screen for lung cancer using Verisante technology. Since the fibre-optics component can fit down standard scopes, the software and hardware can be adapted to detect cervical, bladder and colorectal cancers as well, says Dr. McLean. In fact, there's potential for use "anywhere that light can get to," he says.