Cutting Edge Age Management Medicine
New Technology to Detect Melanoma
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Detecting melanoma-the most lethal form of skin cancer-still relies on dermatologists examining moles and deciding which ones warrant a biopsy.

For patients whose melanoma isn't caught early, the life expectancy is less than a year.

And rates of the disease are skyrocketing:

the current estimate is that one in 58 Americans will get melanoma in their lifetime, up from one in 1,500 in 1935.

A new handheld device developed by scientists at the British Columbia Cancer Agency (BCCA) and licensed to Verisante Technology could provide instant information about the molecular makeup of moles.

The device, called the Verisante Aura, is held above a mole, and uses Raman spectroscopy, a technique that distinguishes molecules using their vibrational states, to scan for those whose relative concentrations are characteristic of melanoma.

The device returns a verdict within seconds.

Following a successful small clinical trial, Verisante is now analyzing the results of another trial with 1,000 moles.

The company plans to seek approval from the U.S. Food and Drug Administration and Canada Health later this year.

Work on the new device began in 2000, when dermatologists at BCCA were studying whether certain skin diseases could be identified by their unique spectral characteristics.

In Raman spectroscopy, laser light changes the vibrational state of the bonds within molecules, which in turn causes a shift in the light that is reflected back to a sensor.

The magnitude and direction of that shift reveal what molecules are in the sample, and at what concentration.

Even if the melanoma looks benign to the naked eye, the Raman spectrum signature will identify it.

The device compares a mole's spectral signature to those in a database containing examples of melanoma and other skin diseases.

It will help dermatologists decide whether to biopsy or not.

And it could eventually be used by non-dermatologists in areas where dermatologists are scarce, such as rural areas.

New Technology to Detect Melanoma
 
The Challenges
melanoma

A danger that regulatory bodies will likely consider, however, is the chance for false negatives in such situations-that is, whether the device might dismiss a mole that turns out to be melanoma.

Another concern is whether some dermatologists might use the device as a way to diagnose melanoma instead of using it to help them determine whether or not to do a biopsy.

Other companies seeking to commercialize melanoma detection technology, including U.S.-based MelaSciences, which uses infrared scanning, are already facing such scrutiny at the regulatory level.

Whatever U.S. and Canadian regulatory agencies decide, there is a need for devices that can help identify melanoma, says Darrell Rigel, a professor of dermatology at NYU's Langone Medical Center, and former president of the American Academy of Dermatology.

It is a challenge to diagnose melanoma clinically. It is subjective.

And while it is not so difficult with one spot, many people have lots of spots-how do you decide what to biopsy?


Preventing Melanoma
 
Couple Sunset

How to Prevent Melanoma:

No cancer, including melanoma, can ever be prevented with 100% certainty.

Some genetic and hereditary risk factors for melanoma, such as skin type and family history, cannot be changed.

Sometimes melanoma may develop despite your best efforts to prevent it from occurring.

The good news is the risk factors for melanoma are well known.

RISK FACTORS FOR MELANOMA:

MOLES:Moles are pigmented spots on the skin.

The medical term for mole is nevus (plural, nevi). Most moles are harmless and normal, and remain stable over a lifetime.

However, having certain types of moles increases your risk of developing melanoma.

A change in the size, shape, or color of an existing mole or the appearance of a new mole is often the first sign of melanoma.

If you note any of these changes, contact a dermatologist for a professional skin examination.

If you have 50 or more small, normal moles, or five or more normal moles of at least 5 millimeters (almost 1/4 inch) in diameter, you are at 3 times the risk of developing melanoma than the general population.

This is because melanoma usually arises in existing moles, so having numerous moles increases the risk.

RACE is the primary risk factor for developing melanoma, with fair-skinned races at significantly greater risk than darker-skinned races.

This is because darker-skinned races produce more melanin, the pigment that gives color to skin and hair, and protects the skin against damage from ultraviolet radiation.

In the United States, white Americans are 20 times more likely to develop melanoma than African Americans.

Worldwide, white populations have the highest risk of developing melanoma, and Asian populations the lowest risk.

SUN EXPOSURE/ULTRAVIOLET LIGHT: The primary environmental risk factor for melanoma is overexposure to the sun's damaging rays, known as ultraviolet (UV) radiation.

You are likely to receive about 80% of your lifetime sun exposure during the first 18 years of life.

Therefore, sun safety for infants, children, and teens is vital to preventing skin cancer in later years.

People who use tanning beds, tanning booths, or sunlamps for cosmetic purposes increase their exposure to intense ultraviolet radiation and their risk for developing melanoma.

Individuals who undergo psoralen and UVA (PUVA) therapy for psoriasis, particularly if they receive 250 treatments or more, are also at greater risk.

Frequent and intense exposure to ultraviolet radiation is the major environmental risk factor for melanoma, as well as for other forms of skin cancer.

A history of one or more severe, blistering sunburns before the age of 18 increases your risk for melanoma.

PERSONAL HISTORY OF PAST MELANOMA: People with a past history of melanoma are at an approximately 100-fold increased risk for developing a second primary tumor some time after the original occurrence.

At least 5% of persons who have had one melanoma will develop a subsequent, independent melanoma.

At particularly high risk are those individuals who, in addition to a previous melanoma, have dysplastic nevi( irregular moles) or a family history of melanoma.

These persons have a 500-fold increased risk of developing melanoma due to the presence of dysplastic nevus syndrome.

Frequent skin examinations are strongly recommended for anyone who has had a previous melanoma.

FAMILY HISTORY OF MELANOMA: About 10% of all people with melanoma have a family history of melanoma.

You are at increased risk of developing melanoma if there is a family history of melanoma in one or more of your first-degree relatives (parent, brother or sister, or child).

Depending on the number of affected relatives, the risk can be up to eight times greater than that in the general population.

SUPPRESSED IMMUNE SYSTEM: The risk for developing melanoma is directly related to the degree to which the immune system is suppressed.

For example, individuals who have undergone organ transplants and are taking anti-rejection medication are at 3 times the risk for developing melanoma, basal cell, or squamous cell cancers of the skin.

Stress and a low nutrient diet can also suppress your immune system.

I cannot emphasize enough how important it is to strengthen your immune system through your nutrition and supplementation.

Make sure your Vitamin D level- which is a very important hormone for optimal immune system functioning and prevention of many types of cancer- is optimal.

Keep stress levels low and don't make everything in your life an emergency.

Make sure the fuel that you put into your body every day is nutrient rich instead of high calorie and low in nutrients.

Again, this is where I am a great believer in using freshly prepared organic, vegetable juices ( no- not V8) to increase nutrients in your diet on a daily basis.

A diet high in refined sugar- the white stuff (syrups, honey, High Fructose Corn Syrup and table sugar for example) have all been shown to suppress the immune system for several hours after consumption.

Remember- lower in calories and nutrient dense is the best choice.

AGE: About half of all melanomas occur in people over the age of 50, with the median age at diagnosis between 45 and 55.

However, young people are also at increased risk, with 25% of cases occurring before age 40.

Young people are at greater risk if there is a family history of melanoma.

AGE MANAGEMENT MEDICINE TIP:

Find a board certified dermatologist that you trust and have a regular skin examination as part of your proactive, preventive Age Management Medicine program.

If you have any of the risk factors, you need to have even more regular skin examinations and you need to be very alert to early diagnosis.

Perform self examinations regularly and have someone you trust at home help you examine the skin in areas you cannot see well (like behind your ears and on your back).

Take photos of your skin and compare them periodically to determine if moles are changing.


My Recommendation: Dermatologist
 
Ana Casas M.D.

I am very fortunate to be able to recommend my own husband, Damian Dhar, MD, JD as a Board Certified Dermatologist and Skin Cancer Surgeon with additional fellowship training and who is Ivy League Trained (Dartmouth).

He is perhaps one of the most dedicated and astute physicians that I have ever met.

When choosing a dermatologist, you want to be sure to select someone that you can trust and who will spend the time examining your skin thoroughly.

I can highly recommend him and his medical partners at North Atlanta Dermatology for skin cancer screening and skin cancer treatment in the North Atlanta area.



Melanoma can be a fatal type of cancer if it is not detected and treated early.

Prevention of Melanoma and other types of skin cancer is an important part of an Age Management Medicine Program.

Self-examination is the most effective way to find melanoma in its early, most treatable stages.

Your relationship with your dermatologist is the most important weapon that you have for early detection in conjunction with your self examinations.

You must be aware of the risk factors and check your skin regularly to determine if there are any moles that are changing and need further evaluation.

Best Wishes For Good Health,


Ana Casas M.D., Board Certified, Internal Medicine ;Board Certified Anti-Aging and Regenerative Medicine; Board Certified, Integrative Holistic Medicine
Atlanta Age Management Medicine