Skin cancer is one of the most common forms of the disease. The most dangerous type — malignant melanoma — is on the rise and, according to UK cancer organisations, it’s because we’re sunning ourselves too much without protection.
There are more than 7,300 cases of malignant melanoma diagnosed each year in the UK and the figure is set to treble over the next 30 years, according to some estimates.
But despite this, the first stage of diagnosis is a subjective business. Your doctor must decide whether a dark patch on the skin indicates a normal mole or the first signs of a melanoma. Is that mole growing? Is it becoming irregular in shape? Has it changed in colour or texture? But a new scanning technique, SIAscopy, may make the whole process less liable to human error and less traumatic for the patient.
According to Per Hall, a consultant plastic surgeon at Addenbrooke’s Hospital, Cambridge, the probability of diagnosing malignancy by simply looking at the skin is only about 54 per cent. “GPs are probably asked to look at about 100 moles each year,” he says, “but they will see very few malignant melanomas, perhaps one every three to four years.”
If a doctor thinks a mole looks suspicious, the second step is a biopsy: cutting out any skin that looks unusual and examining it for cancerous cells. If a melanoma is confirmed, then more biopsies may follow to confirm the extent of the cancer. This costs both time and money, and can result in disfigurement.
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With the new technique, a hand-held scanner is placed in contact with the skin and directs separate pulses of infrared, red, green and blue light at it. Blood, the dark skin pigment melanin and the skin protein collagen all absorb and reflect different wavelengths of light in different ways and this information is transmitted to a laptop. Software reads the way the light is reflected and generates onscreen images in a few seconds . Diagnosis is then based on interpreting the levels and distribution of the substances in the skin.
Julie Loraine, a 43-year-old mother of two, is one beneficiary of the technique. Her melanoma was diagnosed by chance four years ago, after her husband paid for the thread veins on her legs to be removed. She had consulted Hall, who was more concerned about a suspicious-looking mole on her calf. He removed it that day and sent it to the laboratory for analysis. The results showed a malignant melanoma.
More of Loraine’s skin around the site of the melanoma had to be excised and checked in the lab to make sure that all cancerous cells had been removed.
“Julie’s experience is typical,” Hall says. “Until recently, microscopic analysis of the excised tissue has been the only method of confirming the diagnosis and making sure that we get all the cancer; we can’t stop cutting until we have removed some healthy skin.”
He uses SIAscopy to examine Loraine’s skin when she comes for her regular check-ups. “SIAscopy is the only skin-imaging technology that lets us look at what is happening up to 2mm below the surface of the skin,” he says. According to Astron Clinica, the company behind the technique, SIAscopy has been shown to increase diagnostic accuracy from about 70 per cent to 95 per cent. It cites research evidence on its website, www.astronclinica.com.
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The company’s Dermetrics system, which incorporates SIAscopy, costs £9,700, and there are about 40 SIAscopes in use around the world.
There are a few hospitals in the UK that can provide SIAscopic scanning on the NHS, including Addenbrooke’s, Bedford Hospital, Norfolk & Norwich University Hospital, and Solihull Hospital. Patients are referred for treatment by their GP.
Private clinics using the system include the Anelca Clinic, Central London, the Burghley Park Clinic, Swindon, and LifeScan UK, Guildford. Private consultations start at about £200.
“Thousands of unnecessary biopsies are carried out each year,” says Dr Symon Cotton, Astron Clinic’s scientific director. “SIAscopy is the most accurate method of deciding whether a mole should be removed or not.”
Loraine says: “I was lucky that my melanoma was found so early, but I know my risk of another is now higher.”
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For further information, visit www.sunsmart.org.uk
MOLE WATCH
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According to Cancer Research UK, you should visit your doctor if you see the following signs: