Sniff out skin cancer

Kevin Berman, MD, PhD Health Guide January 05, 2009
  • Hi everyone. Skin cancers typically have a usual appearance that leads your dermatologist to perform a skin biopsy to get the diagnosis. But are there any features other than appearance that may help us diagnose skin cancer before it has taken on the typical appearance? Recently, chemists have reported that skin cancers may have a certain odor that may be detected while the cancer is in a very early stage.

     

    There have been reports of dogs being able to detect persons with melanoma, bladder cancer, lung cancer, and breast cancer based on smell but researchers are now trying to identify the chemical compounds that give off these unique odors. The ultimate goal would be to have a noninvasive aid in diagnosing skin cancer that would allow your dermatologist to be more precise and biopsy lesions most likely to be cancerous.

     

    Researchers created a selection of organic compounds that can be derived from skin and found that two of the substances have abnormal amounts in persons with basal cell carcinoma. Although the smell producing substances showed no differences between genders, there was a difference in smell between older and younger persons. It is not clear if these differences are due to age or to diet or other factors.

     

    The most striking feature is that the levels of these substances can change while the skin appears healthy so perhaps we would be able to detect skin cancer before it is even apparent on the skin treat it as early as possible. Keep in mind that this is currently just a research tool and is still a long way from any potential use in the clinics. For now, the standard of diagnosis remains a biopsy and the usual pathology. The hope is that this along with other technology will allow us to more accurately biopsy lesions so that fewer noncancerous lesions are biopsied. Work is being done on certain types of microscopy that would allow for us to see the cells of the skin without having to cut into the skin. This is also a research tool and not used in everyday practice but this technology would also allow us to accurately diagnose with less cutting.

     

    As we understand cancer better, we will hopefully indentify skin cancers earlier in development so that treatments can be less invasive and more effective. Perhaps a basal cell carcinoma will have a certain "smell" that can allow us to differentiate it from a squamous cell carcinoma or a melanoma. While certain characteristics aid in diagnosis, we also hope that these characteristics may also tell us something about the best therapeutic approach. For example, a basal cell carcinoma with a certain "smell" may respond to a topical chemotherapeutic whereas another may need a specific surgical procedure. Fortunately, we currently have very good treatments with high cure rates for basal cell and squamous cell carcinomas so the majority of future research will be with melanoma, which is a much more serious skin cancer.