March 15, 2013

Diagnose Cancer with Flash of a Light!

Traditionally, cancer is diagnosed by a surgical biopsy with pathology results taking days later. Supportive evidence for a cancer is also determined based on visualizing the lesion as well as radiological studies (CT, MRI, Ultrasound, etc).

However, there is a very exciting breakthrough technology that may be able to make a cancer determination under 1 second with only a flash of a light... meaning no biopsy with associated pain and scar to go along with it.

Called Verisante Aura, a probe emits a light that non-invasively analyzes a lesion by scanning 21 different cancer biomarkers at the cellular level using Raman spectroscopy.

Raman spectroscopy (RS) is a technology that involves shining a laser onto a material and interpreting the reflected light to learn more about its biochemical composition.  Healthy cells have a different reflected light "fingerprint" compared with diseased cells. Although this technology won the Nobel Prize in 1930, such RS units used to be huge and complicated machinery to operate. Fortunately, only recently has RS units been miniaturized and made robust enough to be idiot-proof to operate by Canadian researchers.

How accurate is it?

It has up to 99% accuracy leading to potential reduction in unnecessary biopsies by 50 to 100 per cent [link]. Given each scan is under 1 second, a complete body scan can also be accomplished in a single office visit. However, in order to obtain sensitivities between 95% and 99%, the specificities did range between 15% and 54% which is comparable to clinical examination and other optical-based methods.

The one caveat is that the probe needs to be able to shine a light directly on the suspicious lesion... meaning it is applicable only for lesions found on the skin and body cavities (mouth, colon, esophagus, etc)... not lesions under the skin (like a thyroid nodule). The lesion also needs to be larger than 3.5mm in size.

With such instant diagnostic accuracy, it would not only revolutionize in the diagnosis of cancer, but also in treatment! The big question mark for any surgeon is "did you get all the cancer out"? Well, with this probe, one could just scan the wound bed after excising the cancer and see if there's any residual cancer left behind that needs to be removed further. In essence, every surgeon can now perform a Mohs-like resection instantly and without need for pathology assistance with frozen sections.

Verisante Aura is currently approved for use in Canada, Europe, and Australia... but not yet available in the USA pending FDA approval.

Simply Amazing! Instantly Diagnose Melanoma with the Flash of a Light. Forbes 3/14/13

Real-time Raman spectroscopy for in vivo skin cancer diagnosis. Cancer Res. 2012 May 15;72(10):2491-500. doi: 10.1158/0008-5472.CAN-11-4061. Epub 2012 Mar 20.

Fauquier blog
Fauquier ENT

Dr. Christopher Chang is a private practice otolaryngology, head & neck surgeon specializing in the treatment of problems related to the ear, nose, and throat. Located in Warrenton, VA about 45 minutes west of Washington DC, he also provides inhalant allergy testing/treatment, hearing tests, and dispenses hearing aids.

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