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Tunnell Cancer Center Annual Report 2010-2011

Tunnell Cancer Center Annual Report 2010-2011

Melanoma

Lawrence CHANG, MD i aasim Sehbai, MD i james Spellman, jr., MD

by Lawrence CHANG, MD i aasim Sehbai, MD i james Spellman, jr., MD

Public awareness has grown when it comes to the prevalence of skin cancer, especially understanding that melanoma can be deadly. Most of us know to keep an eye out for the tell-tale sign of melanoma—the irregular mole that increases in size or changes in color. We also know that the major risk factor for any skin cancer is the ultraviolet radiation from the sun. Many of us are not aware that tanning beds are just as dangerous.

Yet, the number of cases of skin cancer is on the upswing. Despite the use of sunscreens, skin cancer is the No. 1 diagnosed cancer in the nation, and more melanomas are being diagnosed each year. Tunnell Cancer Center has seen a 53% increase in the number of patients treated for melanoma in the last five years alone (15 in 2005 to 23 in 2010). Though the incidence of melanoma at Tunnell Cancer Center in 2010 represented only 3.3% of the cancers diagnosed, patients diagnosed with late stage (stage IV) melanoma between 2001 and 2005 did not survive five years. On the other hand, those diagnosed in the early stage (stage I) during the same time period had a 90.6% survival rate.

“Education is an essential tool we provide our patients for use throughout their cancer journey.”    —Brandi Carr, BSN, RN, OCN,       Manager of Oncology Nursing       and Research

According to the American Cancer Society, melanoma is diagnosed in people of all ages, though the highest incidence is in older adults. At Tunnell Cancer Center, over the past 10 years, 66% of patients diagnosed with melanoma were 60 years of age and older. The highest rate was in the age 70-to-74 range (38 patients).

This past year a Tunnell Cancer Center patient met the guidelines for the new drug Ipilimumab (Yervoy), which the U.S. Food and Drug Administration approved in March 2011 and which is available by prescription. Bristol-Myers Squibb, the product manufacturer, reports that study data indicates that while patients in late stages of melanoma lived about a year longer using the drug.

Medical oncologists at Tunnell Cancer Center will be looking at the new drug Zelboraf, manufactured by Genetech, which was approved by the FDA in August 2011. Studies indicate that it can extend survival for the 50% of melanoma patients whose tumors carry the BRAF mutation.

What is skin cancer?

Non-melanomas: Most skin cancers are classified as non-melanomas, which are located at the base of the outer layer of the skin and are noticeable. They rarely spread to other parts of the body but need to be treated. They can be cured if treated early. Most are caused by ultraviolet radiation from the sun or from tanning booths.

Melanoma: Melanoma is a cancer that begins in the melanocytes—the cells that produce the skin coloring or pigment known as melanin. There are four types of melanoma:

Superficial spreading melanoma—the most common. It is usually flat and irregular in color and shape Nodular melanoma—starts as a raised area; Lentigo melanoma—occurs in older people and is most common on sun-damaged skin Acral lentiginous melanoma—the least common, occurs on the palms of the hands and soles of the feet. UV radiation causes about 65% of melanoma cases.

Prevention and Screening for Early Diagnosis and Treatment

The good thing about skin cancers, whether in the case of the common, non-melanoma skin cancers—such as basal cell and squamous cell—as well as melanoma, is that we have the opportunity to find them early and to treat them. We also can have some impact on their onset by taking preventive action.

Signs

It is important to visit a healthcare provider if any of these signs or symptoms are present: Any change on the skin, especially in the size or color of a mole or other darkly pigmented growth or spot, or a new growth Scaliness, oozing, bleeding, or change in the appearance of a bump or nodule The spread of pigmentation beyond its border such as dark coloring that spreads past the edge of a mole or mark A change in sensation, itchiness, tenderness, or pain

It also is important to have a full-body examination by a healthcare provider or dermatologist if any of the following risk factors are present:

Risk Factors

Excessive exposure to ultraviolet (UV) radiation Sunburns in childhood Family history Fair or redheaded complexion Many atypical moles Occupational exposures to carcinogens