From the physician's perspective, melanoma is one of the most challenging diseases to treat. If melanoma is caught after it has spread, it needs to be treated with intense anti-cancer medications. Several new agents are in late stages of testing and others are being evaluated. As more information becomes available about these agents, we will be reporting on them in future Living With Cancer blogs. Please write to us if you have any questions regarding melanoma. If you notice changes in your skin spots, I urge you to have them checked out by your physician.
My colleague, Dr. Diana Post, recently wrote about a new study that, sadly, shows that melanoma rates are rising in young women. The study, which looked at data on cancer rates in the U.S. fromÂ 1973 through 2004, found that melanoma rates for young men and women both rose until 1980. Then the rate for men stopped rising, but among women it rose another 50% by 2004. The study was published in the Journal of Investigative Dermatology.Â
Here is what Dr. Post had to say:
This news report about increasing rates of melanoma in young women is worrisome. Melanoma is the seventh most common cancer in this country. It is also the deadliest form of skin cancer. Experts predict that 1% to 2% of all people in the United States will develop a melanoma at some point in life. This is a dramatic increase from the figures seen 50 years ago.
There are now about 60,000 new cases in this country each year, with many deaths. So I was quite disturbed to read that the rate of melanoma in young women has risen so dramatically in the last 25 years.
It has been known for many years that exposure to ultraviolet (UV) rays from the sun increases your risk of developing melanoma. Another source of ultraviolet rays is the tanning salon. We know also that genes may play a role in the development of melanoma.
Your risk of developing melanoma is higher if you are white, with fair skin and red or blond hair. However, anyone can get melanoma. Family history also raises risk. You are eight times more likely to develop melanoma if your parent, child or sibling had it.
Public health campaigns have encouraged people to use sunscreen to reduce exposure to the sun's harmful rays. Young women actually tend to use sunscreen more regularly than young men.
So why is this increase in melanoma being seen in young women? This is not clear yet, but it might mean that young women like to sunbathe more. Sunscreens may give women a false sense of protection. Most sunscreens block only some of the sun's harmful rays.
Another possible explanation is that young women use indoor tanning beds more often than men. This might also be responsible for some of the increase in melanoma. You get enormous exposure to harmful ultraviolet rays in a tanning bed. This increases your risk of developing melanoma.
One other possible reason that the overall rate of melanoma is increasing is the climate change caused by greenhouse gases. The ozone layer is thinner. That makes the sun's rays stronger here on Earth.What Changes Can I Make Now?
Â·Â Â Â Â Â Â Â Â Avoid sun exposure when the sun's rays are strongest, in the middle of the day. This intense exposure is most dangerous, especially if you get sunburned.
Â·Â Â Â Â Â Â Â Â Wear protective clothing and a good sunscreen with a high sun protection factor (SPF) when outside. Wear a hat also!
Â·Â Â Â Â Â Â Â Â Do not go to tanning salons. If you want to look tan, use sunless tanning creams.
Â·Â Â Â Â Â Â Â Â Check your skin regularly for darkly pigmented or changing moles. Use a full-length mirror and a hand-held mirror. Have someone examine areas that are hard to examine yourself. If you have moles, look regularly for the A, B, C, D and E of melanoma:
oÂ Â Â Â Â Â Â Asymmetry
oÂ Â Â Â Â Â Â Borders that are irregular
oÂ Â Â Â Â Â Â Colors that are different within the same mole
oÂ Â Â Â Â Â Â Diameter greater than 6 millimeters (larger than a pencil eraser)
oÂ Â Â Â Â Â Â Enlargement
Â·Â Â Â Â Â Â Â Â Ask your doctor if any medicines you take can increase your sensitivity to the sun. They can make your skin more vulnerable to sun damage.
Have your skin checked once a year by your doctor or a dermatologist. If you have already had a melanoma, then you need to be checked more often. You are at higher risk of developing another one.What Can I Expect Looking to the Future?
Current treatments for melanoma include chemotherapy and radiation. People also can take medicines to stimulate the immune system, such as interleukin-2. Other drugs are now being studied to try to expand the options available to treat this disease.
I think that we will see many more treatments developed that use the power of the body's own immune system to fight cancer. This is often called immunotherapy.
A few weeks ago, for example, there was a report of a man with melanoma who had his immune cells studied. Some were found to be able to kill his melanoma cells. These "killer cells" were then grown in the laboratory. About 5 billion copies were given back to him to try to kill his melanoma. The initial response was very exciting. All signs of melanoma disappeared.
Studies like this suggest that in the near future we may be able to treat melanoma and other cancers in entirely new ways. If so, we could make them controllable, chronic illnesses instead of fatal ones.
Marc Garnick, M.D., is an internationally renowned expert in medical oncology and urologic cancer, with a special emphasis on prostate cancer. He is a Clinical Professor of Medicine at Harvard Medical School and maintains an active oncology practice at Beth Israel Deaconess Medical Center. Dr. Garnick serves as Editor in Chief of Perspectives on Prostate Diseases, a quarterly report from Harvard Health Publications.
Time and sun are tough on your skin, and troublesome skin conditions can set in at any age. But skin treatments have changed dramatically in recent years. Skin Care and Repair, a special report from Harvard Medical School, explains the latest high-tech solutions and drug regimens available to control both cosmetic and medical skin problemsâ€”from age-related wrinkles to life-threatening cancers.
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