Bold Voices - December 2017 - 15

AT THE BEDSIDE

Smartphone App May Help
Screen for Pancreatic Cancer

P

©Dennis Wise/University of Washington

BiliScreen is a new smartphone app that is designed to screen for pancreatic
cancer by having users snap a selfie. It's shown here with a 3-D printed box that
helps control lighting conditions to detect signs of jaundice in a person's eyes.

article adds. The app also might help patients with pancreatic
cancer who need frequent bilirubin monitoring.
The next steps involve testing the app on more patients
"at risk for jaundice and underlying conditions, as well as
continuing to make usability improvements - including
removing the need for accessories like the box and glasses."

DNA Cancer Screening Shows Potential

A

blood test that uses DNA
sequencing to detect
several common cancers
may benefit as-yet-undiagnosed
patients at early stages.
According to "Direct Detection
of Early-Stage Cancers Using
Circulating Tumor DNA," in Science
Translational Medicine, targeted
error correction sequencing
(TEC-Seq) looks for DNA mutations
from tumor cells in blood. Using
deep sequencing (sequencing DNA
30,000 times over), the study identified 62 percent of patients with
stage I cancer and 90 percent of
patients with colon cancer at stage
II, III or IV.
Among the stage I types studied
in the 194 patients, the TEC-Seq

test identified 45 percent with lung
cancer, 67 percent with ovarian
cancer and 67 percent with breast
cancer. Although improvements
would be necessary to make the
test reliable, study co-author Victor
Velculescu, a professor at Johns
Hopkins University Kimmel Cancer
Center, says in a related article from
NBC News, "The survival difference
between late stage and early stage
disease in these cancers would
account for more than a million
lives each year worldwide."
The test also recorded no
false positives among 44 patients
without cancer. "You don't want to
go screening people for hallmark
(cancer) mutations unless you absolutely know that when you find

it, that there is a tumor there and
that it is a tumor that needs to be
treated," adds Wyndham Wilson of
the National Cancer Institute, who
was not involved in this study.
As the next steps, researchers
want to expand the scale to other
cancers with the goal of detecting
cancer in asymptomatic patients at
early stages, particularly high-risk
groups. "Cancer detection followed
by appropriate intervention at
earlier stages in even a fraction of
individuals would likely dwarf the
current health impact of most latestage cancer therapies," the study
adds.
REFERENCE: Phallen J, Sausen M, Adleff V, et al. Direct
detection of early-stage cancers using circulating tumor
DNA. Sci Transl Med. 2017;9(403).

15
AACN BOLD VOICES DECEMBER 2017

ancreatic cancer has a low
The app can
survival rate, partly because
detect minimally
there aren't any noninvasive
tools to detect tumors early. But a
elevated jaundice
new app may help.
before it's visible.
"New App Could Use
Smartphone Selfies to Screen for
Pancreatic Cancer," in University of Washington News, notes
that an app called BiliScreen helps patients check themselves
for pancreatic cancer and other diseases. The bilirubin blood
test is not routinely assessed in adults unless there is reason
for concern.
Developed by scientists at the University of Washington,
Seattle, the app uses the phone's camera and flash to take a
picture of the eyes. Algorithms and machine learning tools
measure increased bilirubin levels in the sclera and whether
there's any jaundice, which is a symptom of pancreatic
cancer, hepatitis or Gilbert's syndrome. The app can detect
minimally elevated jaundice before it's visible.
In a clinical study with 70 participants, the app correctly
identified 89.7 percent of cases, when it was used with paper
glasses that help calibrate color and a 3-D printed box that
blocks ambient light. "BiliScreen is designed to be an easyto-use, non-invasive tool that could help determine whether
someone ought to consult a doctor for further testing," the


http://www.washington.edu/news/2017/08/28/new-app-uses-smartphone-selfies-to-screen-for-pancreatic-cancer/ http://www.washington.edu/news/2017/08/28/new-app-uses-smartphone-selfies-to-screen-for-pancreatic-cancer/ http://www.washington.edu/news/2017/08/28/new-app-uses-smartphone-selfies-to-screen-for-pancreatic-cancer/ http://stm.sciencemag.org/content/9/403/eaan2415 http://stm.sciencemag.org/content/9/403/eaan2415 http://stm.sciencemag.org/content/9/403/eaan2415 https://www.nbcnews.com/health/health-news/blood-test-finds-cancer-symptoms-start-n793181 https://www.nbcnews.com/health/health-news/blood-test-finds-cancer-symptoms-start-n793181

Table of Contents for the Digital Edition of Bold Voices - December 2017

Another Angle
Pres Note Front Teaser
Masthead
AACN Updates Scope and Standards for Acute Care Nurse Practitioners
NTI 2018: Make Your Case for Attending and Register by December
Certification Holiday Reflections
Certified Nurses Day 2018
The Spirit of Giving: One Certified Nurse’s Contributions
Improving Joy in Work
Invest in Yourself With an AACN Scholarship
Disinfectant Use Associated With COPD in Nurses
The Joint Commission Revises NPSG 7 Requirements
Guidelines: Noninvasive Ventilation for Acute Respiratory Failure
High-Risk Vascular Surgeries and Postoperative Myocardial Infarction
FDA Clears MRI System for Premature Babies
New Assay Can Distinguish Bacterial From Viral Infections
Missions of Mercy
How Hospitals Can Save Without Sacrificing Care
DNA Cancer Screening Shows Potential
Smartphone App May Help Screen for Pancreatic Cancer
Cardiologist-Intensivist Model Improves Outcomes
Social Media: Legal and Ethical Issues
Unused Opioids May Pose Health Hazard
AACN’s Facebook Community Weighs In
Conscientious ‘Nudges’ Can Help Patients and Families
Helping ICU Patients With Spiritual Needs
In Our Journals
Transitions
President’s Note
Bold Voices - December 2017 - Cover1
Bold Voices - December 2017 - Cover2
Bold Voices - December 2017 - Pres Note Front Teaser
Bold Voices - December 2017 - Masthead
Bold Voices - December 2017 - NTI 2018: Make Your Case for Attending and Register by December
Bold Voices - December 2017 - Certified Nurses Day 2018
Bold Voices - December 2017 - The Spirit of Giving: One Certified Nurse’s Contributions
Bold Voices - December 2017 - Invest in Yourself With an AACN Scholarship
Bold Voices - December 2017 - The Joint Commission Revises NPSG 7 Requirements
Bold Voices - December 2017 - High-Risk Vascular Surgeries and Postoperative Myocardial Infarction
Bold Voices - December 2017 - New Assay Can Distinguish Bacterial From Viral Infections
Bold Voices - December 2017 - 12
Bold Voices - December 2017 - 13
Bold Voices - December 2017 - How Hospitals Can Save Without Sacrificing Care
Bold Voices - December 2017 - Smartphone App May Help Screen for Pancreatic Cancer
Bold Voices - December 2017 - Social Media: Legal and Ethical Issues
Bold Voices - December 2017 - Unused Opioids May Pose Health Hazard
Bold Voices - December 2017 - 18
Bold Voices - December 2017 - 19
Bold Voices - December 2017 - Transitions
Bold Voices - December 2017 - 21
Bold Voices - December 2017 - President’s Note
Bold Voices - December 2017 - Cover3
Bold Voices - December 2017 - Cover4
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