Skin Cancer Recurrence May Be Prevented with Combination Therapy

Posted on September 27, 2010 | Leave a comment
Skin Cancer, Melanoma

Skin Cancer, Melanoma

Combining treatments in the treatment of skin cancer may provide better outcomes than skin excision alone according to a story published in the September issue of Dermatology Times, “Skin cancer recurrence may be prevented with combo of surgery and adjuvant therapies“.

James M. Spencer, M.D., M.S., a New York City dermatologist and Associate Professor at Mt. Sinai School of Medicine in New York spoke at the January 2010 Orlando Dermatology Aesthetic and Clinical conference where he argued that “dermatologists tend to use only one skin cancer treatment, despite the fact that there are tried-and-true adjuvant therapies and emerging medical therapies, such as imiquimod cream.”

Patients’ desire for a small scar following skin cancer excision leads Dr. Spencer to consider the use of imiquimod cream before surgery. This is not performed to cure the cancer, but rather to shrink the tumor before the procedure.

There are only a few studies looking at outcomes of skin cancer surgery with and without prior treatment with imiquimod, and results are mixed. A 2004 study by Torres A et al published in Dermatologic Surgery reported that use of 5 percent imiquimod cream prior to Mohs surgery resulted in a smaller defect than with excision only of basal cell carcinoma. A more recent 2009 study published in Dermatologic Surgery found no statistically significant benefit in using imiquimod 5 percent cream as an adjunctive treatment of nodular, nasal basal cell carcinomas before Mohs surgery. However, the authors noted that a larger study might show a benefit.

Despite this potential concern and limited data showing effectiveness, Dr. Spencer says it is reasonable to consider imiquimod cream use prior to surgery for the bigger, trickier skin cancers.

Lentigo maligna, or melanoma in situ, has a local recurrence rate of 10 percent to 20 percent. “Imiquimod has been studied as an effective monotherapy for lentigo maligna. So, in my practice, I excise lentigo maligna and follow that with topical imiquimod”, says Dr. Spencer. “Do I have proof that is helping anybody? No. But I would argue that falls into the ‘Why not?’ category.”

“The worst that could happen is nothing; the best that could happen is that your recurrence rate would go down,” said Dr. Spencer.

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Posted in Skin Cancer Experts, Skin Cancer Medications

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Laser Treatment Effective for Pre-Cancerous Lesion on Lips

Posted on September 24, 2010 | Leave a comment

Laser treatment has shown to be effective for actinic cheilitis according to a new study published in the October 2010 issue Journal of the American Academy of Dermatology (JAAD), “Treatment of actinic cheilitis with the Er:YAG laser“.

Actinic cheilitis is a common pre-cancerous skin lesion, similar to actinic keratosis (AKs). Like AKs, it has the potential to develop into squamous cell carcinoma.

Current treatments for actinic keratosis includes cryotherapy, and topical medication (5-FU and imiquimod) but the sensitivity of the tissue on the lips makes treatment a challenge.

The role of the erbium:yttrium-aluminum-garnet (Er:YAG) laser in the treatment of actinic cheilitis has not been widely published, despite offering theoretical advantages over current treatment modalities. The main outcome measures were a subjective improvement in lip symptoms related to actinic cheilitis and objective improvement in the lips at routine follow-up.

Of those interviewed, 92.2% believed there had been an improvement in the cosmetic appearance of their lips; one hundred percent believed the function of their lips had improved or remained unchanged; and 84.8% remained completely disease free at the time of follow-up. The majority of patients (93.5%) were satisfied with the laser treatment. Scarring as a direct result of the laser occurred in 5.1% of patients.

The authors concluded that the “Er:YAG laser should be considered as a first-line treatment for the disease.”

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Posted in Actinic Keratoses, Skin Cancer Treatment

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Melanoma Treatment with Immunotherapy Shows Potential

Posted on June 1, 2010 | 3 Comments

The American Society of Clinical Oncology will hold its annual meeting in Chicago this week where it will announce results of several studies investigating the use of immunotherapies for the treatment of melanoma.

Many of the immunotherapies used in the treatment of cancer are antibodies generated in a laboratory. These “monoclonal antibodies” bind to select portions of the immune system to alter the way the immune system responds to cancer cells.

Ipilimumab is one immunotherapy developed by Bristol-Myers Squibb (BMS) that has gained significant attention. Ipilimumab is a human monoclonal antibody that is undergoing clinical trials for the treatment of melanoma. Results from three small trials found that ipilimumab extended the life of stage IV melanoma patients.

(Tremelimumab another  monoclonal antibody produced by Pfizer was being investigated for the treatment of advanced melanoma, but a phase III trial was stopped in 2008 when interim data showed that results were not superior to standard chemotherapy)

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Posted in Melanoma, Skin Cancer Medications

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Melanoma Risk From Indoor Tanning – Association Stronger Than Ever

Posted on May 28, 2010 | 2 Comments

Indoor tanning users are 74% more likely to develop melanoma than others, according to a study of 2,000+ participants reported in the June issue of Cancer Epidemiology, Biomarkers & Prevention. This study makes the strongest link yet between indoor tanning and melanoma.

Melanoma afflicts nearly 69,000 Americans a year and is the most dangerous form of skin cancer.

Researchers began with more than 2,000 individuals, one-half of whom had documented cases of melanoma. The participants were asked their tanning habits, including outdoor sun exposure and use of indoor tanning equipment.

The researchers found that there was an increased risk of developing skin cancer from the use of tanning beds, but not from lifetime exposure to outdoor sunlight, whether through jobs or leisure activities.

The results show such a strong link between exposure to artificial ultraviolet light and melanoma that it could influence the pending FDA decision on whether to tighten regulation of tanning salons. A ban on indoor tanning for teenagers is even possible.

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Posted in Indoor Tanning

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Sunscreen Use Less Likely Among Rural Residents

Posted on May 21, 2010 | Leave a comment

The regular use of sunscreen is an important step to protect oneself from the damaging effects of UV radiation that increases the risk of developing skin cancer.

In a study published in the June 2010 issue of the Journal of the American Academy of Dermatology (JAAD), “Rural-urban differences in behaviors to prevent skin cancer“, researchers investigated whether those in rural areas are less likely to use sunscreen and engage in other skin cancer preventive measures.

They found that, compared to those living in urban areas, people living in rural areas were 1/3 less likely to wear sunscreen when exposed to the sun for more than 1 hour.

However, the same study showed that the difference is likely due to other factors that lead to a decreased use of sunscreen, including age. (Elderly people anywhere are less likely to wear sunscreen and there is a preponderance of elderly people in rural areas).

So it appears that the “wear your sunscreen” message is getting out to rural areas, but is less likely to be followed by the same people who ignore the message elsewhere.

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Posted in Sunscreens

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Indoor Tanning Tax Supported by Dermatologists

Posted on May 10, 2010 | Leave a comment

“New Law Puts Heat on Indoor Tanning“, a May 4th article published in the San Diego Union-Tribune reported that a 10% tax on indoor tanning scheduled to start in July is unpopular with the tanning industry.

Dr. Mar Vierra

Mark Vierra, M.D. - Dermatologist

Many dermatologists, however, are in support of new indoor tanning tax. They have been diagnosing and treating an increasing number of skin cancer cases related to the use of indoor tanning salons, particularly among young women.

“I love the tan tax.  We know there’s an association between melanoma and tanning salons and we’d like to ban them completely,” said Darrell Gonzales, MD, FAAD.

Dermatologist Mark Vierra, MD, FAAD, recommended spray tanning as an alternative for those seeking a golden glow. “I spend a great deal of my day removing skin cancer from patients, so it’s hard for me to support any kind of UV tanning. The new (spray) technology is so much safer.”

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Posted in Indoor Tanning

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Don’t Fry Day, May 28th, Promotes Sun Safety

Posted on May 7, 2010 | 2 Comments

Don’t Fry Day is the Friday before Memorial Day

The National Council on Skin Cancer Prevention has established this day, Friday May 28, 2010, to raise awareness of sun safety.

Something as simple as wearing a wide-brimmed hat can help reduce the rising rate of skin cancer. By putting on a wide-brimmed hat before you step outdoors, you help reduce your risk and you may help reduce someone else’s risk.

The core message for this year’s Don’t Fry Day™ is that no single step can fully protect you from overexposure to ultraviolet (UV) rays from the sun. Learn more at Don’t Fry Day™.

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Posted in Skin Cancer Prevention

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