Dermatologist Ann-Marie Wennberg works broadly in both physics and technology in her research on skin cancer. After having been an adjunct professor for several years, she has now received an announced position as Professor of Dermatology.
Malignant melanoma may be the best known kind of skin cancer, but there are also two non-malignant forms of skin cancer: basal cell carcinoma and squamous cell carcinoma. Ann-Marie Wennberg conducts research on how all of these skin cancers can be prevented, discovered earlier and better treated.
Her doctoral thesis from 1999 was about a treatment called photodynamic therapy or PDT. At the time, the treatment was new and interesting. Today, it is well-established and documented as effective against superficial basal cell and squamous cell carcinoma. PDT involves a cream first being applied to the skin area, which is then subjected to red light from a lamp. The cream contains aminolevulinic acid, which is converted to light-sensitive porphyrin, which in turn reacts in the energy from the light, leading to the destruction of the tumor cells.
“It’s a very attractive treatment. It doesn’t affect the surrounding tissue, it causes no scars and the active compound in the cream exists completely naturally in the body. So we get help from the body’s own enzyme system to destroy tumor cells,” says Ann-Marie Wennberg.
Many areas of use
Photodynamic therapy has also proven to work well for patients with transplanted organs, an area where Ann-Marie Wennberg was one of the pioneers. Transplant patients have to take immunosuppressants that can often lead to cancer-like changes on large areas of the skin.
In another project, the research team is successfully testing the treatment on serious forms of acne.
“There is a group of patients with severe acne for which large amounts of a certain kind of antibiotics are prescribed, and we want to find a treatment that doesn’t affect the patients themselves or the environment like antibiotics do. We have good healing statistics, where 90 percent of acne disappears and some actually appear to be able to be cured completely,” says Ann-Marie Wennberg.
For deeper effects
But photodynamic therapy can only penetrate to the skin’s upper-most layer. If the cancer has grown further down in the skin, just a millimeter or so, the treatment does not work. Through the SkinResque center, where Ann-Marie Wennberg is also on the steering committee, she collaborates with researchers in science and at Chalmers University of Technology to make better creams and better light that can penetrate deeper into the skin so that the treatment could be given to more patents with basal cell and squamous cell carcinoma. One of the two doctoral students that Ann-Marie Wennberg is the principal supervisor for, Despina Kantere, is working to refine methods to discover basal cell and squamous cell carcinoma, and is using double photon microscopy to monitor the substances in the layers of the skin.
Ann-Marie Wennberg and other researchers at the Dermatology Clinic have several rewarding collaborative arrangements with Chalmers. One project has now resulted in a technical solution for malignant melanoma. With a cell phone app, doctors at healthcare centers can send pictures of the patients’ suspicious skin spots and quickly receive a response as to whether the birth mark should be cut off or not. The app has proven to shorten the wait from referral to operation, and soon, 220 of the region’s healthcare centers will be equipped with the technology.
In hospital management
She believes that there is a clear advantage of having academic expertise at a university hospital, especially at the management level. For the past several years, Ann-Marie Wennberg has been the division head for Sahlgrenska University Hospital’s Division 2, which includes all psychiatry. She is interested in the conditions for managers at different levels in the organization, and wants to make the managers visible to the employees.
She has also been commissioned by hospital management to conduct a project intended to shorten the wait at the hospital’s four emergency wards:
“Growing numbers of people are turning to our emergency wards. In recent years, we have seen an increase of around 4 percent per year. The fact that patients turn to us is positive in that it shows that they have confidence in our care, but it’s not good when patients have to wait several hours before getting help,” says Ann-Marie Wennberg.
Right after our meeting, it is time for a half-time check for Ann-Marie Wennberg’s other doctoral student, Magdalena Claeson. Ann-Marie Wennberg picks up a pile of articles that will be included in the dissertation, which is about malignant melanoma. Malignant melanoma is increasing sharply, and is now four times more common in western Sweden than it was at the beginning of the 1970s. One of the studies is a huge mapping of a malignant melanoma in Västra Götaland:
“The further out towards the coast we go, the more melanoma we can see. We haven’t done more detailed analyses of what this is due to, but along the coast, there is more ultraviolet light than inland, and we believe this to be a strong factor.”
TEXT AND PHOTO: ELIN LINDSTRÖM CLAESSEN