Hoag Unveils New Skin Cancer Detection System: 'This Is the Future'

Hoag Memorial Hospital Presbyterian says it's implementing a new, futuristic way to diagnose skin cancers.

The Newport Beach-based hospital system has installed a state-of-the-art 3D imaging system machine at its expanding campus in Irvine, which along with its Newport Beach base, reports over half a million outpatient visits annually and revenue topping $1.4 billion.

The imaging system counts 92 cameras that flash simultaneously to capture a patient's entire skin surface in less than one second. Hoag says this machine, the Vectra WB360, is the only one of its kind on the West Coast.

"This is cutting-edge technology," Dr. Steven Wang, Hoag's program director of dermatologic oncology, told the Business Journal during a recent demonstration.

"We can detect skin cancer really early. This is the future of skin cancer detection."

The product's cost was $400,000, which was provided by a gift from Hoag Innovators, a group of philanthropists, entrepreneurs and community leaders who want to catalyze innovation at Hoag.

Hoag Innovators was founded and led by incoming Hoag Hospital ­­Board Chair Robert Brunswick and his wife, Kitty.

Hoag is one of several hospital systems expanding their cancer research and treatments in Orange County, others include City of Hope and UCI Health. Several billion dollars worth of investments into cancer prevention and treatments are underway at these groups, as well as at numerous local businesses in the county's rapidly expanding healthcare industry.

A mix of execs and scientists at those groups, along with Wang and other Hoag officials, are included in this week's edition of the OC50, the Business Journal's annual listing of most influential local business execs.

This year's edition of the OC50, which begins on page 33, focuses on those shaping the future of healthcare in Orange County.

Dermatologic Surgery Pedigree

Hoag last year convinced Wang to leave New Jersey's Memorial Sloan Kettering Cancer Center, where he worked for 16 years, including as head of dermatology section and director of dermatologic surgery and dermatology.

He's one of the world's foremost experts on skin cancers, having written five books and hundreds of peer-review papers on the subject.

"This will be bigger scale" than Kettering's system, Wang said of his latest project.

"Hoag is a unique place. The people in leadership down to ancillary services are committed to delivering the best of care and they want to innovate. They have this can-do attitude. There's less bureaucracy.

"They’re bringing here world-class scientists and researchers."

Common Cancer

Cancers of the skin are by far the most common of all types of cancer, with 3.5 million new cases of skin cancer diagnosed annually in U.S. About 2,000 people in the U.S. die each year from basal and squamous cell skin cancers while another 7,990 people are expected to die of melanoma in 2023.

A typical dermatologist office won't take photos of the person's body to track moles that potentially may grow, Wang said.

"They’re just looking at you," Wang said.

The problem is that out of hundreds of lesions on a body, it's "really difficult to tell which one has melanoma and which one is benign," he said. As a result, doctors will order too many biopsies, he said.

Photos are a useful baseline to track hundreds of moles on a person's body. Hence, some dermatologists may request photographs of a person's entire body by a professional photographer, a procedure that can be embarrassing.

"Imagine you’re in your underwear and standing in front of a stranger who takes 30 minutes to take photos of every part of your body," Wang said.

"The embarrassment is a key factor that prevents many patients from undergoing the photo session."

By contrast, the 92 cameras on the Vectra, which looks like a giant game one would find in a video arcade, take simultaneous photos within one second. It then turns the photos into a 3D avatar of a patient's entire body, mapping out the moles and lesions with high-resolution fidelity.

Vectra was developed by New Jersey-based Canfield Scientific, a supplier of digital photographic systems and imaging software. It's installed the Vectra system along the U.S. East Coast as well as in countries like Australia, China and Greece.

25% Diagnosis Improvement

In one example of Vectra's use, a 50ish man's body is shown with 283 moles. The doctor can rotate images of the person's body, enlarging potential trouble spots. Wang and his team have developed AI to help spot trouble-looking moles and eliminate smaller ones.

"There's no way anyone is going to remember how many moles a patient has and what the moles look like. That's why you need baseline photo documentation," Wang said.Doctors eyeballing the moles have an accuracy around 64%, Wang said, adding that the Vectra can improve that diagnosis by 25%.

"With this advanced noninvasive technology, our physicians will be able to detect changes in high-risk patients at the earliest possible stage," said Dr. Burton Eisenberg, executive medical director of Hoag Family Cancer Institute.

"In sunny Southern California, melanoma remains a prevalent problem, and nothing is more powerful than prevention or early detection."

Rewarding Field

Wang was born in Shanghai and came to the U.S. at age 13 where he was raised in New York City.

When asked why he didn't return to his native country, Wang quipped, "This country is a lot better."

A graduate of Cornell, he attended New York University for medical school and internship before getting residency in Minnesota. In Houston, he became trained in micrographic mole surgery.

Wang is the co-founder of the Nanodermatology Society and serves as the president of the Photodermatology Society and chair of the Photobiology Committee of the Skin Cancer Foundation.

A mentor inspired him to enter the field of skin cancers.

"It's a difficult time in someone's life," he said. "It involves fear and anxiety. I can take care of them and make them better.

"I find it rewarding."

He has expertise as a Mohs micrographic surgeon, a relatively new technique where the doctor is both the surgeon removing the skin cancer and a pathologist to determine how much of the skin to remove.

"It's the highest cure rate," he said. "We don't take out big chunks but smaller sizes. The final length of the cut is smaller."

Besides the Vectra system and the Mohs surgery, Hoag is implementing several programs such as seminars for dermatologists and primary care physicians to teach the newest information on skin cancers.

"We are implanting lots of interesting programs," Wang said.

The Importance of Sunscreen

Dr. Stephen Wang, one of the world's experts on sunscreen, was caught by surprise when he arrived in Orange County.

"When I first got here, I got burned a few times," Wang said. "One thing I didn't realize is the sun here is so intense."

Wang has invented his own sunscreen that doubles as a hair gel to put protective lotion on scalps to prevent sunburns. He wants to steer people away from habits that turn them into what he calls "Swiss cheese."

He recommends everyone apply 30 SPF to their faces, hands and arms at the beginning of every day. For those who are active activities like swimming, jogging or walking, he advises 50 SPF or higher.

"Even days like this, you still got a lot of radiation coming through," he said on a recent cloudy day. "It's chronic exposure that puts you at risk."

Other tips include reapplying every two hours, particularly if surfing or swimming; using hat and sunglasses and applying sunscreen even under an umbrella or in a car because rays reflect off other surfaces.

Wang also advises testing several sunscreens to feel for texture and fragrance.

"If you don't like the way it smells or feels, you’re not going to put it on."

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