5 ms·

Not a dermatologist but I've following melanoma research for several years now thanks to my wife's diagnosis. What's exciting about this one to me is that if t

Not a dermatologist but I've following melanoma research for several years now thanks to my wife's diagnosis. What's exciting about this one to me is that if the detection mechanism is truly sound, this is a great leap over the ABCD(E) criteria which have been the clinician's main tool, and which has a high false negative for one of the deadliest forms of melanoma, nodular melanoma. This often does not present with varigated coloration and because it tends to invade tissue rather that spread superficially its morphological characteristics aren't as apparent until its more developed, greatly increasing the risk of metastases. This was the case with my wife's primary, which her dermatologist almost didn't send out for a pathological workup, and had been missed by a couple of different doctors thanks to its atypical presentation. All of which is not to say that ABCDE isn't a valuable rule of thumb, but its always struck me as somewhat subjective, which I guess is tempered with the experience of the physician but also does have the false negative problem, even with specialists.

epmaybe 9y ago
Best of luck to you and your wife. ABCDE is awful, don't get me wrong. I've always felt it was like holding your finger out to see what the wind direction is like. It has a horrible sensitivity (50%-90% depending on the type, I'd err on the side of lower). But if this technique also only has a 50% sensitivity, that is what would bother me. Hopefully the sensors they are using are sensitive enough to detect these temperature changes well.
- karmajunkie 9y ago
  Thank you, her prognosis is very good—we caught it just early enough. There was a micrometastasis to the sentinel node but no further spread, and we're coming up on the 5 year mark next year. Agree wrt sensitivity—obviously while this is novel and exciting to me at least, it bears further study before becoming part of the standard of care.
- robocat 9y ago
  > [ABCDE] has a horrible sensitivity (50%-90% depending on the type). But if this technique also only has a 50% sensitivity... If the sensitivity of the two techniques are not correlated, a 50% improvement on top of ABCDE would be fantastic.
  - lovemenot 9y ago
    Then call it ABCDEF (Frigid cells warm quicker)
taneq 9y ago
Thanks for your insight. Do you know how well the Molescan system compares with manual identification? My wife has had a few suspicious moles flagged and removed (none tested positive yet, thank goodness).
- karmajunkie 9y ago
  I don't know much about the efficacy of those systems, I just looked into patents on diagnostic systems for melanoma awhile back—there's a dermatologist elsewhere in the comments who might be able to speak with some authority about it. My sense is that such systems are primarily for surveillance, detecting changes over time. I suspect that in a controlled study against standard photographs of your body over time (the kind you can do at home) both methods are equally useful. The variable would be how diligent you are in taking those photographs—if you do those with the frequency one should, and cross referencing photos over time, my guess is you're as likely to catch something as what you'd get out of a regular series of visits to a Molescan clinic.

epmaybe 9y ago

Best of luck to you and your wife. ABCDE is awful, don't get me wrong. I've always felt it was like holding your finger out to see what the wind direction is like. It has a horrible sensitivity (50%-90% depending on the type, I'd err on the side of lower). But if this technique also only has a 50% sensitivity, that is what would bother me. Hopefully the sensors they are using are sensitive enough to detect these temperature changes well.

karmajunkie 9y ago
Thank you, her prognosis is very good—we caught it just early enough. There was a micrometastasis to the sentinel node but no further spread, and we're coming up on the 5 year mark next year. Agree wrt sensitivity—obviously while this is novel and exciting to me at least, it bears further study before becoming part of the standard of care.
robocat 9y ago
> [ABCDE] has a horrible sensitivity (50%-90% depending on the type). But if this technique also only has a 50% sensitivity... If the sensitivity of the two techniques are not correlated, a 50% improvement on top of ABCDE would be fantastic.
- lovemenot 9y ago
  Then call it ABCDEF (Frigid cells warm quicker)

taneq 9y ago

Thanks for your insight. Do you know how well the Molescan system compares with manual identification? My wife has had a few suspicious moles flagged and removed (none tested positive yet, thank goodness).

karmajunkie 9y ago
I don't know much about the efficacy of those systems, I just looked into patents on diagnostic systems for melanoma awhile back—there's a dermatologist elsewhere in the comments who might be able to speak with some authority about it. My sense is that such systems are primarily for surveillance, detecting changes over time. I suspect that in a controlled study against standard photographs of your body over time (the kind you can do at home) both methods are equally useful. The variable would be how diligent you are in taking those photographs—if you do those with the frequency one should, and cross referencing photos over time, my guess is you're as likely to catch something as what you'd get out of a regular series of visits to a Molescan clinic.