Skin cancer is the most common form of cancer today affecting over 1,5 million Americans annually. Currently, the majority of skin cancers is confirmed using an invasive biopsy after which they are treated surgically. Merely 20 percent of the biopsies performed however diagnose a malignancy. "It is not surprising that most people are anxious about being poked, cut or stuck", commented Mark Goldgeier, MD, a Rochester, New York private practice dermatologist. "Consequently, many delay seeing their doctor when they suspect something and others avoid going at all. We know, however, that early detection of skin cancers generally means less involved treatment and a greater likelihood of a positive outcome."
VivaScope technology, developed by Lucid, has the potential to change all of this. The technology, which researchers have been utilising at a number of major medical institutions like Massachusetts General Hospital, Memorial Sloan Kettering Cancer Center, Massachusetts Eye and Ear Infirmary, and the Dana-Farber Cancer Institute, images living skin from the surface down to the upper dermis in thin optical slices showing individual cells and groups of cells, and is about to begin broader clinical studies. "If these clinical studies confirm that a trained pathologist can diagnose skin cancer using a VivaScope, we can potentially eliminate the majority of invasive skin biopsies performed today", stated Stuart Itkin, Lucid's senior vice president of marketing and business development.
Other developments in the field of medicine have also been concentrating on skin cancers. "There are a number of new non-surgical treatments for skin cancer which are being tested today and show great promise. Because these non-surgical alternatives are bloodless and painless, we expect they will be attractive to patients", explained George Anstadt, MD, Lucid's medical director. "Like most forms of treatment however, these are unlikely to be effective for a 100 percent of the population and it is important to monitor each patient to assess efficacy." At present, post treatment assessment still involves a biopsy which entails cutting, punching or shaving out a small piece of tissue and preparing it for microscopic examination.
"While VivaScope technology is still being tested, the results from pilot studies support our belief that VivaScopic imaging can become a painless, non-invasive alternative to biopsy in the future", stated Jim Zavislan, Ph.D., a Lucid senior vice president and the company's chief technology officer. "As new classes of non-surgical treatments emerge, a non-surgical means of confirmation and diagnosis is required. Laser confocal microscopy, coupled with these non-invasive treatments, may herald a fully bloodless non-invasive era of diagnostics and therapeutics in our future practices", added Allan Halpern, MD, Service Chief of the Dermatology Department at Memorial Sloan Kettering Cancer Center.
While clinical studies continue for both the potential treatments and the VivaScope, Lucid believes that medicine is on the cusp of totally non-invasive treatment systems which will combine its non-invasive cellular imagers with these new therapeutics. The current standard of care is a biopsy, surgically removing a small tissue sample and examining it under a microscope. Often, a surgical biopsy seems contradictory to months of non-invasive treatment, whereas the results of the biopsy are limited to only a small portion of tissue removed. VivaScope's revolutionary technology however can non-invasively image skin one layer at a time showing cellular and nuclear detail.
"The VivaScope allows us to see cells and patterns of cells at various skin depths. Good cells tend to be uniform in size and shape and arranged in an orderly manner. Basal cell carcinoma has a number of characteristic features which make it distinct, including irregularly shaped and clustered cells which form elongated, finger shaped patterns", explained Mark Goldgeier, MD. He is one of several dermatologists conducting clinical trials using the device, supported with information provided by a pathologist who remotely examines the VivaScope images over a special Internet link.
The dermatologist confirmed the device has been used to image patients with other skin diseases as well, including melanoma. Melanoma forms the most serious type of skin cancer and, according to the American Cancer Society, it resulted in 7300 deaths in the United States in 1999, which is a staggering 6 percent increase over the previous year. "Over half of all biopsies the dermatologists perform today, and more than 80 percent performed in total, result in a negative reading. As we suspect, if ongoing studies confirm that we can easily diagnose skin cancer tumours without a traditional biopsy, patients will undergo less pain, less bleeding and have a greater comfort in the quality of care provided by their doctor", Dr. Goldgeier added.
Lucid is an innovator in developing real time medical diagnostic support for cancer screening and evaluation of diseased tissue. The company combines its patented Internet and VivaScope confocal imaging technologies to create solutions that are focused on improving patient outcomes and the standard of care. Please, also read the VMW February 2001 article Ediscim to detect skin cancer at its earliest stages with confocal imaging and tele-diagnosis on similar European research.