Melanoma Skin Cancer Awareness Minnesota

Last year, Glamour published a feature about skin cancer—how to avoid it, how to spot it. After it hit newsstands, something remarkable happened—letters started to pour in from readers. What they read was amazing! So far, that article has saved 23 readers' lives.

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The skin cancer melanoma is treatable when caught early but often deadly if it has spread. New hopes:

*Doctors at the National Cancer Institute remove cancer-fighting cells from late-stage patients, grow more and then give them back. So far, this immunotherapy has shown it can shrink tumors in about 75% of the patients.

*The myeloma drug Velcade seems to put skin cancer cells in overdrive so they self-destruct, according to the doctors at the University of Michigan. Even better, it kills only the cancerous cells.

Next up (in 5+ years), seeing how actual patients react to Velcade, as this research was done only in a petri dish.

Incidence Of Melanoma On The Rise

ScienceDaily (Aug. 4, 2007) — Over the past several decades, the incidence of melanoma – the most serious form of skin cancer – has steadily increased in the United States. From 1995 to 2004, melanoma has increased by more than 1 percent per year in this country – in sharp contrast to overall cancer rates that have steadily decreased by 0.6 percent per year during this time.

While dermatologists and other public health officials work together to try to reverse this alarming trend, key findings from a successful multi-faceted intervention program designed to increase sun-safe behavior in children could play an important role in decreasing melanoma in future generations.

Speaking recently at the American Academy of Dermatology’s Summer Academy Meeting 2007, dermatologist Martin A. Weinstock, MD, PhD, FAAD, professor of dermatology and community health at Brown University in Providence, R.I., and chief dermatologist at Veterans Affairs Medical Center in Providence, presented a summary of recently published research on the rising incidence of melanoma and trends in sun exposure.

“While the increase in melanoma rates from 1995 to 2004 was not specific to one age group, we did notice an increase in the youngest age group (from ages 15 to 30) and in the age 60 and older age group,” said Dr. Weinstock. “The possible reasons for this increase in younger and older Americans are not documented, but one possible explanation could be more exposure to UV radiation – which we know is the most preventable risk factor for melanoma.”

Youth and Sun Exposure

One population-based study published in the September 2006 issue of the journal Pediatrics found that although there was not a significant change in the proportion of youths that reported getting sunburned from 1998 to 2004, there were some interesting distinctions between the younger and older youths. For example, the 16 - 18 age group had more sunburns during that time period compared to the 11 - 13 and 14 -15 age groups – including an increase in the reported number of sunburns over the six-year study period. In 2004, 70 percent of the 16- to 18-year-olds reported getting sunburned, an increase from 64 percent reported by this age group in 1998.

In contrast, the study found that the younger age groups (ages 11 - 15) reported fewer sunburns and a decrease in the number of sunburns from 1998 to 2004. Specifically, the youngest age group studied (ages 11 - 13) fared the best in terms of the fewest sunburns – dropping from 75 percent in 1998 to 67 percent in 2004. Those in the 14 - 15 age group also reported a decrease in the number of sunburns from 1998 to 2004 – from 79 percent in 1998 to 70 percent in 2004.

“The study did not provide a definitive explanation as to why the younger age groups had fewer sunburns than their older counterparts, but one possible reason is that younger adolescents are more responsive to parental guidance than older teens – who tend to be influenced more by their peers,” explained Dr. Weinstock. “This trend, however, is worth noting in future public education campaigns geared toward teens and adolescents.”

Another study published in the January 2007 issue of the journal Pediatrics found that a multi-component community-based intervention successfully increased sun-protection behaviors in adolescents entering 6th to 8th “SunSafe in the Middle Years” program, designed as a randomized, controlled trial. The intervention used a broad range of role models – including school personnel, coaches, pediatricians, teen peer advocates and lifeguards – who actively encouraged adolescents to practice proper sun protection in different environments.

“The study found that there was significant improvement in the areas of the body protected by sunscreen, clothing or shade in the adolescents in the 10 communities randomly selected for the intervention versus those in the control towns,” said Dr. Weinstock. “From previous research, we know that compliance with sun-protective behaviors goes down between 6th to 8th grades. I think this study demonstrates that a multi-component program which involves a variety of people influential to this age group can have a positive impact on sun protection behavior and should be considered a model for future educational efforts aimed at adolescents.”

Adults and Sun Exposure

Adults also failed to heed the warnings of dermatologists when it comes to practicing proper sun protection. A new article published in the June 1, 2007, issue of the Centers for Disease Control and Prevention’s (CDC’s) Morbidity and Mortality Weekly Report presented data showing an upward trend in the incidence of sunburns in U.S. adults. From 1999 to 2004, there was a 2 percent increase in the number of adults 18 years and older who reported getting sunburned (32 percent to 34 percent, respectively). While this represents only a slight increase, Dr. Weinstock pointed out that the data demonstrates that the occurrence of sunburns in the adult population is not decreasing.

“Dermatologists are concerned that melanoma and other skin cancers will continue to increase as long as sun exposure does,” said Dr. Weinstock. “Since we know that overexposure to UV radiation is the most preventable risk factor for developing skin cancer, it’s critical for dermatologists to emphasize that people should practice proper protection when engaging in outdoor activities.”

The Academy recommends that people of all ages Be Sun SmartTM by following these tips:

Generously apply sunscreen with a Sun Protection Factor (SPF) of at least 15 that provides broad-spectrum protection from both ultraviolet A
(UVA) and ultraviolet B (UVB) rays. Re-apply every two hours, even on cloudy days, and after swimming or sweating. Look for the AAD Seal of Recognition™ on products that meet these criteria.
Wear protective clothing, such as a long-sleeved shirt, pants, a wide-brimmed hat and sunglasses, where possible.
Seek shade when appropriate, remembering that the sun’s rays are strongest between 10 a.m. and 4 p.m.
Use extra caution near water, snow and sand as they reflect the damaging rays of the sun which can increase your chance of sunburn.
Protect children from sun exposure by applying sunscreen.
Get vitamin D safely through a healthy diet that includes vitamin supplements. Don’t seek the sun.
Avoid tanning beds. Ultraviolet light from the sun and tanning beds can cause skin cancer and wrinkling. If you want to look like you’ve been in the sun, consider using a sunless self-tanning product, but continue to use sunscreen with it.
Check your birthday suit on your birthday. If you notice anything changing, growing, or bleeding on your skin, see a dermatologist. Skin cancer is very treatable when caught early.

According to current estimates, there will be about 108,230 new cases of melanoma diagnosed in 2007 – 48,290 noninvasive and 59,940 invasive.

Adapted from materials provided by American Academy of Dermatology. American Academy of Dermatology (2007, August 4). Incidence Of Melanoma On The Rise. ScienceDaily. Retrieved November 15, 2007, from http://www.sciencedaily.com /releases/2007/08/070803145951.htm

The Melanoma Research Foundation had a teleconference to discuss melanoma basics. To hear a replay of the teleconference), click this link.

Special Assignment: Skin Cancer

Posted: 5:00 PM Aug 16, 2007
Last Updated: 8:50 AM Aug 17, 2007
Reporter: Meredith Anderson
Email Address: meredith.anderson@wrdw.com

News 12 First at Five, August 16, 2007

AUGUSTA, Ga.---Not too long ago, my brother-in-law noticed a mole on my back that didn't sit too well with him. He works for a dermatologist, so he removed it.

I didn't think too much about it, until I learned a former News 12 anchor, about my same age, died from melanoma. I started calling my friends and family, begging them to get checked. Then, I thought about all of you.

Usually I'm a reporter or a patient. Never have I been both at the same time. I invited News 12 cameras into my first appointment at the Medical College of Georgia.

Dr. Francis Florentino immediately noticed that I have a ton of moles. I've always called them my polka dots. These polka dots actually put me at a higher risk for skin cancer. Combine that with my fair skin and naturally blond hair, and you've got a powerful combination.

I even took it one step further as a teenager, laying out in the sun covered in baby oil. Dr. Florentino calls that "the smoking of our generation" because no one really knew how bad that was for our skin. Even with my risk factors, I figured Dr. Florentino would check the mole I already knew was bad, and I'd be on my way.

Then came the surprise. My one bad mole suddenly became six, and all of them had to go. A pathologist would then check the biopsies for cancer. Cancer. That was hard for me to swallow, but chances are, I'm okay. I might have a second chance here. Others aren't so lucky.

I never got the chance to meet Cindy Pleasants, but from what other people tell me, her last name describes her perfectly. She was full of life, working here at News 12 as the Midday anchor.

She always had a smile on her face, and that didn't change when she was diagnosed with melanoma.

Everyone who worked with her says she was a fighter, but in 1992, she lost her battle. She was just 30 years old.

If doctors had been able to catch it early, she might still be with us today.

Cindy's story is fresh in my mind as I go in for my procedure. The whole thing takes about an hour and half. It's uncomfortable but not painful. First, the doctors attack my back. After some numbing, they scrape off 3 of my polka dots. The two on my front are a little different. They are cut out. In the end, I had 13 stitches.

I had to wait two weeks to find out the news. I don't have melanoma, just some places that could turn into it. I'll have to watch my skin, and so will my doctors at MCG.

Now, it's your turn. Make that appointment. Have a doctor look at your skin, especially if you wear lots of polka dots, like I do.

It's actually not over for me. I have to get some more cut out of my back...but what's a few stitches to stay cancer-free? I wanted to share my story with you because you can prevent and even cure this type of cancer. But you have to catch it early...and I hope all of you will give yourself that chance.

Here's a tip when you check yourself. The most common place for melanoma on men is the back. For women, it's the back of the calf. That's why you should never just look, say, on your chest or shoulders.

Also, take the time to memorize your moles. If they change, that's a bad sign. If you notice new ones, you need to call your doctor.

Sunscreen Picks Derms Love

Dermatologists have access to every product, well, under the sun. So what do they use?

Solbar Shield SPF 40 ($12.95). “Great for sensitive skin. Its physical blockers like zinc and titanium dioxide keep damaging rays out.”
—Amy McMichael, MD, associate professor of dermatology at Wake Forest University School of Medicine

Neutrogena Fresh Cooling Body Mist Sunblock, SPF 45 ($9.49). “I like the high-SPF, broad-spectrum protection. And it’s not greasy, so it won’t clog pores.”
—Elizabeth McBurney, MD, clinical professor of dermatology at Louisiana State University School of Medicine

Banana Boat UltraMist Sport SPF 30 Continuous Clear Spray ($9.99). “I spray it on my daughter when she won’t stand still. Just a few hits give even coverage.”
—Debra Jaliman, MD, assistant professor of dermatology at New York’s Mt. Sinai School of Medicine

LaRoche-Posay Anthelios SX ($29). “It’s ideal for very fair skin because it protects from a wide range of UV rays.”
—Rhoda S. Narins, MD, clinical professor of dermatology at New York University Medical School

Cetaphil Daily Facial Moisturizer SPF 15 With Parsol 1789 ($10.50). “This lightweight lotion won’t clog pores or cause breakouts.”
—Francesca Fusco, MD, assistant attending physician of dermatology at Beth Israel Medical Center

Melanoma Research Foundation Article: Report on the Latest Information on Sunbed Use in Tanning Salons.
A report has been issued by the International Agency for Research on Cancer (IRAC) following its assessment of available evidence relating to health effects of exposure to artificial UV radiation through the use of indoor tanning facilities, in particular whether their use increases the risk of skin cancer. The data from the report highlighted:

*A clear increase in melanoma risk associated with the use of sunbeds in people who first used sunbeds in their twenties or teen years.

*An increase in risk of squamous cell cancer associated with the use of sunbeds in teens.

*A suggested detrimental effect from the use of sunbeds on the skin's immune response and possibly on the eyes (ocular melanoma).

*Artificial tanning confers little if any protection against solar damage to the skin nor does the use of the indoor tanning facilities grant protection against vitamin D deficiency.

In a public health message Dr. Peter Boyle, Director of IARC, concluded that "while IARC's mandate is one of scientific expertise and assessment of epidemiological risk, in view of the strength and seriousness of the findings, effective action to restrict access to artificial tanning facilities (solariums, tanning salons, tanning parlours) to minor and young adult should be strongly considered."

One-Time Melanoma Screening of Older Adults Appears to be Cost-Effective. Public release date: 15-Jan-2007. Lisa Brown 617-414-1401 JAMA and Archives Journals.

One-time melanoma screening of adults age 50 or older appears to be as cost-effective as other nationally recommended cancer screening programs, according to an article in the January issue of Archives of Dermatology, one of the JAMA/Archives journals.

Melanoma is the only cancer for which incidence and death rates continue to increase in the United States, while screening continues to be underused, according to background information in the article. Treating melanoma costs more than $740 million each year in the United States. Older patients and those who have immediate relatives with melanoma are at higher risk. Knowledge regarding risk factors and the availability of treatment has spurred greater interest in screening; however, the lack of a large randomized trial proving screening efficacy has been cited as an obstacle preventing its widespread implementation.

A New Anticancer Agent Battles Melanoma
Lawrence D. Piro, MD LACMA member since 2006 Piro, CEO of The Angeles Clinic and Research Institute in Santa Monica, recently conducted a study of a new anticancer agent that battles advanced metastatic melanoma. The study reveals the agent doubles the survival rate of cancer patients compared with conventional treatment.

The new molecule, or STA-4783, induces tumor cells to produce a heat shock protein on the cell surface, which flags them for destruction by the patient's own immune system. "The Angeles Clinic was established as a center where cancer patients could get the best, most advanced care, including access to clinical trials of novel treatments such as STA-4783," says Dr. Piro, an internist with an emphasis in melanoma and lymphoma. "Principal investigator Steven O'Day, MD, has built an outstanding team at the clinic, and his role in leading this trial is an example of the robustness of our melanoma research program. Patients come from all over the country to the clinic for access to clinical trials such as this, and it's exciting that we are helping to make progress in establishing the efficacy of new molecules to treat melanoma."

A Promising New Vaccine for Melanoma
A Promising New Vaccination Strategy For Late-Stage Melanoma 02 Oct 2006.

A therapeutic cancer vaccine being developed by an international team of cancer immunologists working within the Cancer Research Institute/Ludwig Institute for Cancer Research Cancer Vaccine Collaborative (CVC) successfully induced a comprehensive, tumor- specific immune response in patients with late-stage metastatic disease, with results indicating that the vaccine had a favorable impact on disease progression in some patients, according to a paper to be published on September 26 in the scientific journal, Proceedings of the National Academy of Sciences USA. The paper is currently available in the journal's online advance edition, Cancer Research Institute, Inc. 681 Fifth Ave., Fl. 12 New York, NY 10022-4209.

Why Don't All Moles Progress to Melanoma?
Source: University of Michigan Health System

Everyone has moles. Most of the time, they are nothing but a cosmetic nuisance. But sometimes pigment-producing cells in moles called melanocytes start dividing abnormally to form a deadly form of skin cancer called melanoma. About one in 65 Americans born this year will be diagnosed with melanoma at some point during their lifetime. Biopsied tissue from a human mole shows melanocytes with cancer-causing mutations that have been targeted by the unfolded protein response.

Scientists know that 30 percent of all melanomas begin in a mole. They know that 90 percent of moles contain cancer-causing mutations. What scientists didn't know is how melanocytes stop these mutations from triggering the development of cancer. Maria S. Soengas, Ph.D., and other scientists in the Multidisciplinary Melanoma Clinic at the University of Michigan Comprehensive Cancer Center, have found the answer to this important question in an unexpected place -- a structure inside cells called the endoplasmic reticulum, or ER. "Our results support the direct role of the endoplasmic reticulum as an important gatekeeper of tumor control," says Soengas, who is an assistant professor of dermatology in the U-M Medical School. "Until now, no one knew there was a connection between ER stress and the very early stages of tumor initiation." Results of the U-M study -- involving melanocytes from normal human skin and biopsies of non-malignant human moles -- are being published in the October issue of Nature Cell Biology.

Cancer Information From CancerConsultants.com
Genasense® Improves Survival in Some Patients with Advanced Melanoma According to results recently published in the Journal of Clinical Oncology, the addition of Genasense® (oblimersen) to dacarbazine provides a significant survival benefit in patients with Stage III or IV melanoma. The benefit, however, was only present in patients with normal levels of the enzyme lactate dehydrogenase (LDH).

Melanoma is a cancer of the skin that usually begins in the form of a mole. The cancer can grow deep into the skin and spread to different parts of the body through blood or lymph vessels. It usually spreads first to lymph nodes that are near the site of cancer origin and, when advanced, can spread to organs and other lymph nodes throughout the body. The prognosis for patients diagnosed with melanoma that has spread to distant sites in the body (Stage IV) is poor because this disease typically does not respond well to standard therapies. In an effort to improve outcomes for metastatic melanoma, new drugs and new drug combinations are being explored.

Dacarbazine is a chemotherapy drug that is commonly used in the treatment of melanoma. Genasense is an investigative drug that targets the bcl-2 protein, a protein that melanoma cells need to survive. It is overexpressed in more than 80% of patients with melanoma. Laboratory studies also suggest that bcl-2 may be involved in cancer resistance to chemotherapy. In order to evaluate whether treatment of metastatic melanoma with the combination of Genasense and dacarbazine results in better survival than treatment with dacarbazine alone, researchers conducted a multi-national phase III clinical trial (phase prior to FDA review). The trial enrolled 771 patients with Stage III or IV melanoma who had not received prior chemotherapy. Patients were randomly assigned to receive Genasense plus dacarbazine or dacarbazine alone. All patients have been followed for at least two years since the start of the study. The study included measurement of blood levels of the enzyme LDH. High levels of LDH are linked to tissue damage. Overall, there was not a significant difference in survival between the two groups of patients—median survival was nine months for patients treated with Genasense plus dacarbazine versus 7.8 months for patients treated with dacarbazine alone. Among patients with normal LDH levels, survival was better among patients treated with Genasense plus dacarbazine (11.4 months) than among patients treated with dacarbazine alone (9.7 months). Furthermore, 17.2% of the patients treated with Genasense plus dacarbazine had a reduction in detectable cancer, compared to 9.3% of patients treated with dacarbazine alone. Among patients with high LDH levels, survival was similar in the two study groups (4.5 months in both groups), as were response rates (5.7% among patients receiving Genasense plus dacarbazine and 4.6% among patients receiving dacarbazine alone). The researchers concluded that the combination of Genasense and dacarbazine offers promise for the treatment of metastatic melanoma among patients with normal LDH levels, but does not appear to benefit patients with high LDH levels. Reference: Bedikian A, Millward M, Pehamberger H, et al. Bcl-2 Antisense (oblimersen sodium) Plus Dacarbazine in Patients With Advanced Melanoma: The Oblimersen Melanoma Study Group. Journal of Clinical Oncology. 2006; 24:4738-4745.