Download - Melanoma: Skin Cancer Prevention and More
Beware of the SunA Melanoma May Result
Mitchell Chorost, M.D.
NY Hospital Queens – Cancer Center
Case example:
• Patient comes into your office and concerned about a mole on his arm
• Noticed mole has enlarged and looks different, but not sure how long its been there
• The question we ask ourselves is: “is this lesion a benign mole or a malignant melanoma?
Diagnosis ?
Is it OK to Get a Tan or Sunburn?Everyone, regardless of skin color,
can sunburn!
A suntan or sunburn are not indicators of good health.
Tanning and sunburns are just like smoking cigarettes; just one suntan or sunburn
can increase your risk of cancer, regardless of skin color.
Primary Prevention of Skin Cancer
Avoid Exposure to Ultraviolet Radiation• Use sunscreen > SPF 15• Wear hats and other protective clothing• Schedule outdoor activities before 10am and after 4pm• Avoid all indoor tanning activity including tanning salons
Primary Prevention of Skin Cancer
Proper Use of Sunscreens
• Apply generously and evenly• Reapply every 2 hours
- if perspiring
- if swimming• Consider waterproof formulas
How Do I Protect My Skin?“Slip, Slop, Slap, & Wrap”
SLIP on a shirt
SLAP on a hat with a 2 to 3-inch brim all around to protect neck, ears, nose and scalp
SLOP on sunscreen and lip balm with an SPF of 15 or higher
WRAP on sunglasses to protect the eyes and skin around them
Secondary Prevention of Skin Cancer
Screening and Early Detection
• Inspect moles for changes• Remove suspicious moles• Remove actinic keratoses and other precancerous
lesions
Recommendations for Skin Cancer Screening
• Skin examinations by a physician, as part of every cancer-related checkup
• Monthly self-examinations are recommended for persons with:
- personal history of skin cancer
- family history of skin cancer
- precursor lesions
- sun damaged skin
Risk Factors for MelanomaRisk Factors for Melanoma
• Light pigmentationLight pigmentation• Family history of malignant melanomaFamily history of malignant melanoma• >3 sunburns during childhood>3 sunburns during childhood• >3 years outdoor occupation during childhood>3 years outdoor occupation during childhood• Immunosuppression Immunosuppression
Source: Balch, et al, 1992.Source: Balch, et al, 1992.
ABCDs
•Asymmetry
•Border
•Color
•Diameter
AAsymmetrysymmetry
One half does not match
the other half.
BBorder irregularityorder irregularity
•The edges are ragged, notched, or blurred.
CColorolor
•The pigmentation is not uniform.
•Shades of tan, brown, or black
•A mottled appearance.
DDiameteriameter
•Greater than ¼ inch. •Any sudden or continuing
increase in size is of special concern.
EEvolutivolutionon
•Changing characteristics of the mole independent of the size or color.
Work-up
• FDG-PET• sensitivity 17% in study with SLN biopsy• some use in distant disease
Additional Therapy
• Radiation• Chemotherapy • Vaccines• Immunotherapy
• Targeted therapy - help the immune system kill cancer cells• Vemurafenib (BRAF inhibition)• Ipilimumab (An antibody CTLA-4 on T cells)
A New Paradigm in Cancer TreatmentA New Paradigm in Cancer Treatment
Haber, Gray, Baselga Cell 2011
See Spot
See Spot Change
See Doctor…………….
Or, See Spot Kill!
Knowledge is Power.
And Hope.