Diagnosing Skin Cancer Without a Biopsy
Skin cancer, including melanoma and basal cell carcinoma, is highly treatable when detected and treated early. Diagnosing skin cancer typically requires a biopsy – excising part of the potential tumor, sending it to a laboratory, and then waiting for the results. Waiting to find out if you have cancer, which can take from several days to several weeks, is emotionally difficult for many people.
But a new technique might make both the invasiveness of a biopsy and the long wait obsolete. Multiphoton microscopy of mitochondria looks at the activity of the mitochondria in skin cells and allows doctors to know whether cancer is present – within minutes.
Mitochondria are found in the cells of animals, plants, and fungi. They are responsible for creating energy, in a sense, powering the cells to perform their specific function. Researchers, led by Irene Georgakoudi from the Department of Biomedical Engineering at Tufts University, found that mitochondria in healthy cells behaved differently than those in cancerous cells. In healthy cells, the mitochondria were spread out, in a web-like pattern. However, in cancerous cells, the mitochondria were clustered into smaller clumps. Using a multiphoton microscopy tool, the scientists were able to see the mitochondria in vivo, meaning they could view the cells without having to make any excisions of the skin.
To test the procedure, researchers tested 14 patients, 10 who had skin cancer and four who did not. In all cases, the scientists, without knowing the prior diagnosis, were able to detect, or not detect, the presence of cancer within minutes. For patients, this means no waiting, no unnecessary worrying, no invasive surgery, and a quick path to treatment, if needed. For people with melanoma, this could make a tremendous difference. Early detection and treatment is important. The five-year survival rate is about 97 percent and the 10-year survival rate is around 95 percent when melanoma is treated before it spreads to other areas of the body, according to the American Cancer Society.
The researchers hope that this test will be routinely offered in doctors’ offices within the next five years. The test requires a specialized laser microscope, which costs around $100,000, according to Georgakoudi, and this could make it difficult for some doctors to use in a small practice; however, larger medical facilities could make it available to doctors within a specific region until less expensive models become available. Georgakoudi says while the equipment is expensive, “this approach would enable a doctor to make a quick diagnosis and begin treatment immediately, which could ultimately lower healthcare costs associated with these very common cancers.” Some facilities, such as MD Anderson Cancer Center at the University of Texas, already have a multiphoton microscopy program in their research department.
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