Share:
New therapy creates hope in skin cancer
Black skin cancer (malignant melanoma) is considered to be particularly malignant because it spreads early in the blood and lymph channels and developed in this way quickly metastases in lymph nodes or other organs of the body. In order to be able to treat the cancer in the best possible way, an early diagnosis is therefore particularly important. Researchers at the University Hospital Essen have investigated a new, promising technique that could replace much of the surgery in the future. Their results are now published in the journal "Science Translational Medicine".
Most malignant form of skin cancer
Skin malignant melanoma - also known as black skin cancer - is the most malignant form of skin cancer. Although the form of the cancer comes from the skin, but from there, cancer cells scatter at an early stage in the blood and lymph vessels. Thus, they can spread throughout the body and form metastases in the lymph nodes or other organs (e.g., lung, bone, brain). In order to predict the course of the disease, physicians must therefore first of all clarify whether the tumor has already formed metastases. For if this is the case, the chance of a cure drops significantly.
New hope in skin cancer. Image: Peter Hermes Furian - fotolia The metastases usually form at the beginning in the first lymph nodes in the drainage area of the affected skin region. In order to detect the carryover of tumor cells into the lymphatic flow, the patients are currently injected with a protein with radioactive technetium into the tumor area, which accumulates in the so-called "Sentinel Lymph Node" (SLN). Subsequently, this node is surgically removed and further investigated. However, this procedure is very complicated and is considered not very reliable, because a high proportion of examined sentinel lymph nodes incorrectly receives an inconspicuous finding.
New procedure could replace surgery
However, there could be a new, promising approach to treating the aggressive form of cancer. Because possibly could be avoided by an innovative imaging method in the future, the removal of lymph nodes. This emerges from a recent study by the University Hospital Essen. Accordingly, the so-called "multispectral optoacoustic tomography" (MSOT) can provide information about whether the tumor has already spread to the lymph nodes or not.
As the researchers around Ingo Stoffels and Joachim Klode from the University Hospital Essen report to the news agency "dpa", the new procedure could be very important for the prognosis of the disease process. Their investigation has shown that the MSOT recognized all affected lymph nodes and therefore responded much more sensitively than previous techniques. In contrast to the previous use of radioactive technetium, the new method will irradiate the tissue with laser flashes, the researchers explain. As soon as these affect melanin, the color pigment contained in the melanoma, the tumor will light up, and the resulting heat would expand the area around the affected area. The resulting pressure wave can finally be registered by means of an ultrasonic microphone, the scientists continue.
MSOT achieves much more accurate results
The team led by Ingo Stoffels and Joachim Klode tested both the old and the new technique on 506 lymph nodes taken from 214 melanoma patients and recognized that the MSOT achieved significantly more accurate results. For while metastases were found in the conventional method only in 14.2 percent of samples, they came with the new method to 22.9 percent. Subsequently, the researchers used the MSOT in 20 patients with black skin cancer who had not yet had lymph nodes removed. It showed that the new technique discovered all existing lymph node metastases and in most cases diagnosed an inconspicuous finding.
For the first time, the study clearly shows scientists that the new procedure is a supplement to or even an improvement to today's diagnostic possibilities - which may also apply to other skin cancers or, for example, breast cancer. "If a non-invasive approach could reliably exclude thyroid metastasis, nearly 80 percent of patients could avoid this surgery," the researchers said.
Everyday suitability must be tested in further studies
But the new method is not completely free from mistakes. Because the MSOT can also trigger false alarms, such as the remains of small bleeding or pigments from tattoos. Nevertheless, the technique represents a valuable aid in the diagnosis, by means of which metastases could reliably be detected or excluded, the authors conclude. Stefan Delorme of the German Cancer Research Center (DKFZ) in Heidelberg also classifies the study of the Essen colleagues as very carefully and elaborately performed.
The innovative combination of ultrasound and molecular imaging technology may therefore be superior to the previous methods - but if the process actually works reliably in everyday life, would now clarify further investigations. "If that turns out to be true, that would be a tremendous relief for patients," Delorme told the news agency. According to the Essen-based physicians, the next step is already in progress: "We are planning a prospective multicentre trial to confirm these results with a larger number of patients."
More than 18,000 new cases a year
According to the German Cancer Society e.V., more than 18,000 people suffer from it each year in this country alone, in addition to another 9,000 cases in which an early form of melanoma is diagnosed. Overall, men and women are affected equally often. While black skin cancer most commonly develops on the back of men, it is most common in women on the lower legs.
If the melanoma has already formed metastases, it is one of the most difficult to treat tumors. If it is not detected in time, it very often leads to death. Accordingly, it is generally recommended to take advantage of the possibility of skin cancer screening ("skin cancer screening"), which everyone from the age of 35 years is entitled to every two years. People with an increased risk (such as fair skin, family history or large congenital liver spots) should, as a precaution, be screened every year. (No)