Point-of-care devices

Easy cancer detection devices coming to GP offices

By Rosie Lombardi

This year, innovative technology developed by the BC Cancer Agency will bring skin cancer detection devices that non-specialist providers such as GPs and nurses can use right in their offices. Called Aura, the system has an excellent sensitivity rate and is being commercialized by BC-based medical device developer Verisante Technology Inc. Many more Verisante point-of-care devices for other types of cancer will be coming in the future, says Thomas Braun (pictured), Verisante’s CEO.

“Eighty-five percent of cancers are in the epithelial layer. The idea is that if Aura works on skin, then its approach is very likely to work on all of these other epithelial cancers in the GI tract, lung, cervix and colon. The BC Cancer Agency has developed a platform technology that is being modified for the early detection of many specific cancers,” says Braun, adding that Aura has been approved by Health Canada and its European counterparts for skin cancer detection.

Published preliminary clinical results of the first 274 lesions scanned show that the Verisante Aura device caught each of the 34 cases of melanoma among the 274 and were later confirmed as melanoma by biopsy. The results were published in 2008 in the Journal of Innovation in Optical Health Sciences.

Braun says that pilot studies are already underway for a lung cancer detection system using the Aura platform that will build on the success of the skin cancer detection system. “Researchers started with skin because it’s the easiest to test – pointing a probe at somebody’s lesion before you biopsy is not really a big deal. But to test for lung cancer, you have to give patients a bronchoscopy. So before you take that difficult and expensive step, you really want to make sure your technology works.”

Another reason skin cancer detection was chosen as the first wave is because it’s an underserviced area, he says. “To address the shortage of dermatologists and family doctors, you need a device that can be used by any medical professional, including nurses and technicians. What really distinguishes our device is that it can be used by non-experts.”

He points out there’s a big trend afoot to develop point-of-care devices that can help move medical care wherever possible out of expensive hospital settings and into doctor’s offices. “Things that don’t require a lot of interpretation but have an algorithm and are spectroscopic are suitable as they can be used by non-experts outside of major medical centres. Devices like Aura will act to triage patients. The reason dermatologists have a 12-month waiting list is they're seeing many healthy people for every one who actually has a melanoma.”

Braun says the Aura system will cost about $60,000 to acquire in Canada, which may sound like it’s beyond the means of a typical medical practice. But he lays out a convincing business case that it’s a worthwhile investment for dermatologists, and that it can be profitable for private and high-performance clinics if they bill in the same way as dermatologists do.

“It’s within the means, in my estimation, of dermatologists because in Canada, there’s only one dermatologist for every 60,000 people. If you amortize the costs over five years, it’s about $1100 a month. Some medical practices may find it too expensive, but remember it’s approved for use by any medical professional. Dermatologists can have an associate GP use it, or nurses and trusted assistants. They would do the scanning and if something needs to be biopsied, they call the dermatologist in.”

He points out that dermatologists frequently purchase even more expensive skin treatment laser machines, which can cost about $90,000 to acquire – but they can charge willing patients large fees to recoup the costs. “The Lions Laser Centre, which uses a laser machine, charges $500 a treatment for removal of a mole, and it can take up to 10 treatments to get rid of it. Dermatologists think differently than other doctors. My guess is that they’ll charge around $500 for an Aura scan.”

Braun believes the proliferation of Aura systems in doctors’ offices will ultimately be driven by patients, as they’ll gravitate towards practices that offer cancer detection scans quickly and conveniently. “When I talk to cancer patients who’ve already had skin cancer and have a recurrence, they say there’s a lot of anxiety when they call their doctor up and are told they have to wait 12 months for an appointment. If there’s somewhere they can go and get scanned right away by a device that has excellent sensitivity, I’ve asked them, ‘Would you pay $500 to go for your annual check-up with this?’ And every single one of them says yes.”

Posted January 19, 2012