Dermatologist doggedly pursues unconventional cancer research

0 Comments | Insight on the News, Oct 21, 1996 | by Cynthia Long

Man's best friend may have more to offer than companionship. Some doctors are investigating the notion that dogs can sniff out disease -- in particular, melanoma, a deadly form of skin cancer.

George, a decorated veteran of the Tallahassee, Fla., police force recently traded in his badge to embark upon a medical career. But George is not a fortysomething man searching out new challenges as he hits midlife; he is a friendly, 6-year-old gray schnauzer who went from sniffing out bombs to sniffing out cancer.

Tallahassee dermatologist Armond B. Cognetta Jr. came up with the idea of cancer-sniffing canines after he read a letter in a British medical journal. Two doctors described a case in which a 44-year-old woman had a mole examined after her dog continued to sniff at it. The mole turned out to be cancerous, prompting the doctors to question whether skin cancer might have an odor dogs can detect.

"This dog may have saved her owner's life," they wrote. "The use of animals with highly developed sensory modalities in cancer diagnosis is worth considering."

Fully aware that using dogs in skin-cancer research could earn him the scorn of his colleagues, Cognetta nevertheless went forward with the project. "Until we come up with a cure, we shouldn't leave any stones unturned," he says, noting his long frustration with the elusive and deadly disease.

Teaming up with Duane Pickel -- a retired dog trainer with 33 years of experience including a stint as a sergeant with the canine corps in Vietnam -- Cognetta set out to determine whether dogs make good diagnosticians.

George came highly recommended -- and no wonder. In addition to knowing and obeying 127 hand signals, the energetic dog has won more than 400 ribbons and trophies for obedience and was voted "first in the country" among standard schnauzers by the American Kennel Club in 1994.

"George is a very loving, loyal, congenial dog that enjoys working," says Pickel. "I think most dogs tend to be much happier if they have a purpose in life."

George, Pickel and Cognetta went to work using delicate samples of melanoma stored in test tubes and ordinary dog-training techniques. Pickel first taught George to retrieve the sample. Then he began hiding it so George would have to locate the tube by smell. Eventually, after a good many doggie treats and cookies, George was able to locate the sample in one of 10 holes in a long rectangular box with an accuracy rate of 99 percent.

The next phase of training involved Tallahassee nurse Kim Edwards. Edwards has a family history of skin cancer and was eager to participate in the research.

Lying on an examining board that looks much like an oversized gingerbread man, she covered herself with bandages -- sometimes placing a cancer sample underneath one. Again, George was able to locate the sample with an accuracy level close to 100 percent.

George then moved on to actual cancer patients who volunteered for the research. Time after time, the dog would circle the table and, after sniffing out what he was looking for, sit down next to the patient near the suspect spot. "Show me," Pickel would command, and George would obediently lift his paw and place it on the melanoma.

Although George had a high accuracy rate, many other factors and controls must be considered before an accuracy rate of dog diagnostics can be determined. According to Cognetta, because each examination would require two or more doctors, a dog handler and, of course, a dog that would take months to train, the effort may be impractical.

However, Cognetta maintains, because we still are losing the war against melanoma, "we just owe it to our patients to look at every side and facet. I hope [the dog research] shakes people up a bit."

Indeed it has. Cognetta's study has led to research that will determine whether dogs can be trained to detect other diseases -- including tuberculosis and lung or bladder cancer -- by smelling breath and urine.

RELATED ARTICLE: The Skinny on Melanoma

Unlike other forms of internal cancer, skin cancers usually are recognizable through a careful exam conducted by a dermatologist. People with a family history of skin cancer or melanoma should receive regular checkups.

Malignant melanoma, the deadliest form of skin cancer, is on the rise with 38,300 new cases expected to be diagnosed in 1996 alone. Early detection of melanoma remains the greatest challenge among people with a family history of the cancer, multiple moles or several past sunburns. Any changes in moles -- size, color or shape -- should be examined.

For additional information on skin cancer, contact the American Cancer Society at (202) 483-2600, or the National Cancer Institute at (301) 496-4000.