Deadly Skin Cancer Can

Now Be Identified By Lasers

To Assist Doctors...

High-resolution images
from a laser-based tool
developed at Duke
University could help
doctors better diagnose
melanoma, the deadliest
form of skin cancer, while
potentially saving
thousands of lives and millions of dollars in unnecessary healthcare costs each year.

The tool probes skin cells using two lasers to pump small
amounts of energy, less than that of a laser pointer, into
a suspicious mole. Scientists analyze the way the energy
redistributes in the skin cells to pinpoint the microscopic
locations of different skin pigments.

For the first time, scientists have the ability to identify
substantial chemical differences between cancerous

and healthy skin tissues using the new two-laser
microscopy technique.

The Duke team imaged 42 skin slices with the new tool.
The images show that melanomas tend to have more
eumelanin, a kind of skin pigment, than healthy tissue.
Using the amount of eumelanin as a diagnostic criterion,
the team used the tool to correctly identify all eleven melanoma samples in the study. The results appear
in the Feb. 23 Science Translational Medicine.

The technique will be further tested using thousands
of archived skin slices. Studying old samples will verify

whether the new technique can identify changes in moles
that eventually did become cancerous. Even if the

technique proves, on a large scale, to be 50 percent
more accurate than a biopsy, it would prevent about

100,000 false melanoma diagnoses said Warren S.
Warren, director of Duke's Center for Molecular and

Biomolecular Imaging and a chemistry professor.
Warren oversaw the development of the new
melanoma diagnostic tool.

Melanoma is the fifth-most common cancer for males
and sixth-most common for females. In 2010, U.S.

doctors diagnosed nearly 115,000 new cases of the
disease, with nearly 8,700 resulting in death. The
cancer is also one of the few where the death rate
is increasing.

Doctors typically use a light and a magnifying glass
or tissue biopsy, where a pathologist removes
suspicious skin cells and looks at them under a
microscope, to spot signs of disease. But using a
lens and a light is a "17th century" technique that is
only 85 percent accurate, at best, and tissue biopsy
is not much more reliable, the lead researcher
explained.

In 14 percent of biopsy diagnoses, pathologists would
disagree on whether or not the sampled cells were

cancerous, according to a 2010 study published in
the Journal of American Academy of Dermatology.
The statistic implies that two pathologists would have
opposing diagnoses on 214,000 to 643,000 melanoma

cases each year.

When studying biopsied tissue, doctors typically follow
the "when in doubt, cut it out" philosophy. If they are

not sure about the health of the skin tissue, doctors
remove additional skin around the diseased cells. The
first and second tissue biopsies can cost thousands of
dollars. If the melanoma is thought have spread, patients
may then have lymph nodes in their arms removed or
undergo chemotherapy, which dramatically adds to
treatment costs.

But not all of the extra treatment is necessary because
not all of the biopsied tissues are actually cancerous.

Doctors need a more accurate way to diagnose
melanoma.

The highly specialized lasers are currently commercially
available and would only need to be added to the

microscopes pathologists already use to diagnose
melanomas. If each false positive melanoma diagnosis

costs thousands of dollars, having such an instrument
available for questionable cases could considerably

reduce health care costs overall, Warren said.

Journal Reference: Pump-Probe Imaging Differentiates
Melanoma from Melanocytic Nevi. Sci Transl Med 23,

February 2011: Vol. 3, Issue 71,

Editor's Note: This article is not intended to provide medical advice, diagnosis or treatment.

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