BEVERLY HILLS, Calif., May 2, 2011-- Natural menopause cures are often sought by many women to lessen symptoms that occur during menopause, which can be a difficult time. Dr. Shoreh Ershadi, director of the ANTIAGING Institute of California, wants to bring to the attention of menopausal women that now there may be a link between early menopause, with the onset of menopause symptoms, and exposure to common PFCs, or perfluorocarbons.
PFCs are used in a wide range of products, including plastic food containers, non-stick cookware, carpeting and furniture. By 2015, PFCs will be phased out. In the meantime, they are very prevalent and can be found in water, animals, soil, plants and people.
Animal studies show that PFCs inhibit the functioning of hormones, which may be responsible for bringing on early menopause in women. Natural menopause remedies may be sought by women who want to find relief from the symptoms that they will experience. If women are starting menopause at an earlier age due to PFCs in the environment, they will also be seeking help, very often a natural menopause remedy, in order to live their lives without troublesome sensations.
Natural menopause relief can be found when menopause does begin. But women may want to consider limiting their exposure to PFCs just as a precaution. It is not certain that PFCs definitely bring on early menopause, but there have been correlations between women with a higher exposure to PFCs and an earlier menopause. This is a red flag and bears further investigation.
Regardless of the age that women experience menopause, one thing is certain. Women with busy lives may seek a menopause treatment that can help them to cope with the symptoms that plague them. Dr. Ershadi advises the use of natural menopause supplements with safe ingredients that do not require a prescription to ease symptoms. DON'T PAUSE is a natural product, developed by Dr. Ershadi, that has been beneficial in alleviating menopause symptoms in women.
By limiting exposure to PFCs and using natural menopause solutions when symptoms occur, women can help themselves deal with menopause in a safe and natural way. For more information, visit http://www.naturalmenopauseremediesandcures.com. You may also call the ANTIAGING Institute of California at (310) 858 7006.
SOURCE Dr. Shoreh Ershadi
http://www.dermahealthinstitute.com
Showing posts with label early. Show all posts
Showing posts with label early. Show all posts
Monday, June 13, 2011
Wednesday, July 28, 2010
Advances Help Dermatologists Diagnose, Treat Early Melanomas
According to estimates from the American Cancer Society, melanoma, the most serious form of skin cancer, was responsible for an estimated 8,650 deaths in the United States in 2009. Of growing concern among dermatologists is the fact that melanoma is now the most common form of cancer for young adults 25-29 years old and the second most common cancer in adolescents and young adults 15-29 years old1. Early diagnosis is the key to curing this potentially deadly disease, and diagnostic tools are playing a crucial role in aiding dermatologists to spot melanomas at earlier – and more curable – stages.
Speaking today at the 68th Annual Meeting of the American Academy of Dermatology (Academy), dermatologist Harold S. Rabinovitz, MD, FAAD, volunteer professor in the department of dermatology at the University of Miami Miller School of Medicine in Miami, Fla., reviewed the latest diagnostics used to catch early stage melanomas and why a long-standing visual aid continues to help dermatologists – and patients – understand the nuances of this cancer.
“Unfortunately, melanoma is the great masquerader and millions of moles have at least one feature that falls into the criteria dermatologists refer to as the ABCDEs of melanoma,” said Dr. Rabinovitz. “That’s why in addition to visually inspecting the skin, high-tech diagnostic tools in the future will be helpful in determining whether a suspicious mole is actually a melanoma or a benign lesion.”
ABCDs and E of Melanoma
One of the key educational tools used to train physicians, medical personnel and the general public on how to recognize early melanomas is the ABCDEs of Melanoma Detection. These characteristics of moles for which individuals should check their skin include Asymmetry (one half unlike the other half), Border (irregular, scalloped or poorly defined), Color (varies from one area to another; shades of tan and brown, black; sometimes white, red or blue), and Diameter (the size of a pencil eraser or larger).
Dr. Rabinovitz explained that recently the Academy has added an “E” to these criteria, which stands for Evolving (or changing in size, shape or color). “A mole with any of these characteristics, or one that is an ‘ugly duckling’ – meaning it looks different from the rest – should be brought to a dermatologist’s attention immediately for proper evaluation,” said Dr. Rabinovitz. “Visually inspecting a suspicious mole is the first step in determining whether it is a melanoma, and dermatologists now have a host of technologically advanced tools to confirm a diagnosis.”
Dermoscopy
Since there are few surface features to distinguish melanomas from benign pigmented lesions, more dermatologists are using hand-held microscopes to identify features not visible to the naked eye. Dr. Rabinovitz explained that these hand-held microscopes, known as dermatoscopes, work by magnifying and illuminating the mole – increasing the ability to diagnose melanoma.
“In instances where a definitive diagnosis cannot be determined with dermoscopy, a biopsy – in which a small sample of tissue from the suspicious lesion is removed and examined in the laboratory – would be needed,” said Dr. Rabinovitz.
Full-Body Photography and Mole Mapping
Total-body photography is an important tool used by some dermatologists in the surveillance of high-risk individuals who may develop melanoma. For example, having numerous moles puts an individual at high risk for melanoma. Dr. Rabinovitz noted that there are some individuals who are at higher risk for developing melanoma not only within their existing moles but also within their normal skin. Only 30 percent of melanomas occur within a pre-existing mole.
Photographs provide a record against which we can assess changes in moles over time,” said Dr. Rabinovitz. “The documented change, or lack thereof, is biologic information that we can use to consider whether an excision is necessary.”
Some of the indications for using total-body photography include personal history of melanoma, family history of melanoma, atypical mole syndrome, or multiple moles of different size, shape and color.
Another less commonly used method of following change with pigmented lesions is mole mapping. With this technology, suspicious moles can be digitized with demoscopy cameras and reimaged at three- to six-month intervals to determine if any changes in characteristics have occurred in this time.
“Mole mapping has been selectively useful in detecting early melanomas, as it offers a baseline for comparing changes in skin lesions,” said Dr. Rabinovitz. “It is especially beneficial in high-risk patients who may have so many atypical moles that it becomes difficult to remove all of these unusual appearing moles that are not melanoma on biopsy.”
Reflectance Confocal Microscopy (RCM)
The ongoing effort to enhance the clinical diagnosis of melanoma has led to the development of other non-invasive imaging techniques. One such technique is reflectance confocal microscopy (RCM), which offers imaging at cellular level resolution and allows the visualization of both the epidermis (top layer of skin) and the upper dermis (the deepest layer of skin) in real time. This procedure is performed with a laser light that is able to focus on a specific spot within the tissue, which is then automatically scanned over the entire level of the skin.
“The ability to scan both the epidermis and the dermis has made RCM a promising technique for the non-invasive diagnosis of skin growths and response to non-invasive treatment,” said Dr. Rabinovitz. “In fact, a recent study has demonstrated that RCM enhances the secondary evaluation of moles and melanoma, making it potentially an important diagnostic tool in monitoring changes beneath the skin.”
Gene Profiling
Based on preliminary data, gene profiling is an exciting new research area within medicine that Dr. Rabinovitz believes might play a role in the clinical evaluation of melanoma. Gene profiling measures the activity of thousands of genes simultaneously to create an overall impression of how cells function.
Cancer at its most basic level is a genetic disease, and the biological events that initiate the malignancy represent alterations in the expression of genes. Like normal cells, biomarkers exist for cancerous cells and this signature can be used to identify“cancer,” said Dr. Rabinovitz. “In the case of melanoma, the object would be to identify an alteration in genes to create a classifier for clinical diagnostic purposes.” This is being performed with tape stripping of moles.
Future Technologies
Over the past 15 years, researchers have studied technologies that could accurately diagnose pigmented lesions, with the goal of developing a reliable, non-invasive diagnostic tool to aid dermatologists in the early detection of melanoma. One such device, the computerized image analysis system, uses a computerized analysis algorithm for the automatic diagnosis of melanoma.
“The technological advances in melanoma detection in the future will significantly improve our ability to detect early melanomas and help save countless lives,” said Dr. Rabinovitz. “However, keeping a vigilant eye on our skin for any changes that could signal a problem is an irreplaceable first step in the process.”
Academy Provides Free, Do-it-Yourself Tool for Tracking Moles
To help spot melanoma at its earliest, and most curable, stage, the Academy recommends that everyone should be familiar with the ABCDEs of melanoma and report any suspicious moles or changes in the skin to a dermatologist for proper diagnosis. In addition, the Academy’s “Body Mole Map,” which can be downloaded on the Academy’s website at http://www.melanomamonday.org/documents/Body_Mole_Map_11-09.pdf, is a tool that creates a record for people to track where spots appear on their skin and if these spots have changed over time when new skin self-exams are performed.
Headquartered in Schaumburg, Ill., the American Academy of Dermatology (Academy), founded in 1938, is the largest, most influential, and most representative of all dermatologic associations. With a membership of more than 16,000 physicians worldwide, the Academy is committed to: advancing the diagnosis and medical, surgical and cosmetic treatment of the skin, hair and nails; advocating high standards in clinical practice, education, and research in dermatology; and supporting and enhancing patient care for a lifetime of healthier skin, hair and nails. For more information, contact the Academy at 1-888-462-DERM (3376) or www.aad.org.
Derma Health Institute
http://www.dermahealthinstitute.com
Speaking today at the 68th Annual Meeting of the American Academy of Dermatology (Academy), dermatologist Harold S. Rabinovitz, MD, FAAD, volunteer professor in the department of dermatology at the University of Miami Miller School of Medicine in Miami, Fla., reviewed the latest diagnostics used to catch early stage melanomas and why a long-standing visual aid continues to help dermatologists – and patients – understand the nuances of this cancer.
“Unfortunately, melanoma is the great masquerader and millions of moles have at least one feature that falls into the criteria dermatologists refer to as the ABCDEs of melanoma,” said Dr. Rabinovitz. “That’s why in addition to visually inspecting the skin, high-tech diagnostic tools in the future will be helpful in determining whether a suspicious mole is actually a melanoma or a benign lesion.”
ABCDs and E of Melanoma
One of the key educational tools used to train physicians, medical personnel and the general public on how to recognize early melanomas is the ABCDEs of Melanoma Detection. These characteristics of moles for which individuals should check their skin include Asymmetry (one half unlike the other half), Border (irregular, scalloped or poorly defined), Color (varies from one area to another; shades of tan and brown, black; sometimes white, red or blue), and Diameter (the size of a pencil eraser or larger).
Dr. Rabinovitz explained that recently the Academy has added an “E” to these criteria, which stands for Evolving (or changing in size, shape or color). “A mole with any of these characteristics, or one that is an ‘ugly duckling’ – meaning it looks different from the rest – should be brought to a dermatologist’s attention immediately for proper evaluation,” said Dr. Rabinovitz. “Visually inspecting a suspicious mole is the first step in determining whether it is a melanoma, and dermatologists now have a host of technologically advanced tools to confirm a diagnosis.”
Dermoscopy
Since there are few surface features to distinguish melanomas from benign pigmented lesions, more dermatologists are using hand-held microscopes to identify features not visible to the naked eye. Dr. Rabinovitz explained that these hand-held microscopes, known as dermatoscopes, work by magnifying and illuminating the mole – increasing the ability to diagnose melanoma.
“In instances where a definitive diagnosis cannot be determined with dermoscopy, a biopsy – in which a small sample of tissue from the suspicious lesion is removed and examined in the laboratory – would be needed,” said Dr. Rabinovitz.
Full-Body Photography and Mole Mapping
Total-body photography is an important tool used by some dermatologists in the surveillance of high-risk individuals who may develop melanoma. For example, having numerous moles puts an individual at high risk for melanoma. Dr. Rabinovitz noted that there are some individuals who are at higher risk for developing melanoma not only within their existing moles but also within their normal skin. Only 30 percent of melanomas occur within a pre-existing mole.
Photographs provide a record against which we can assess changes in moles over time,” said Dr. Rabinovitz. “The documented change, or lack thereof, is biologic information that we can use to consider whether an excision is necessary.”
Some of the indications for using total-body photography include personal history of melanoma, family history of melanoma, atypical mole syndrome, or multiple moles of different size, shape and color.
Another less commonly used method of following change with pigmented lesions is mole mapping. With this technology, suspicious moles can be digitized with demoscopy cameras and reimaged at three- to six-month intervals to determine if any changes in characteristics have occurred in this time.
“Mole mapping has been selectively useful in detecting early melanomas, as it offers a baseline for comparing changes in skin lesions,” said Dr. Rabinovitz. “It is especially beneficial in high-risk patients who may have so many atypical moles that it becomes difficult to remove all of these unusual appearing moles that are not melanoma on biopsy.”
Reflectance Confocal Microscopy (RCM)
The ongoing effort to enhance the clinical diagnosis of melanoma has led to the development of other non-invasive imaging techniques. One such technique is reflectance confocal microscopy (RCM), which offers imaging at cellular level resolution and allows the visualization of both the epidermis (top layer of skin) and the upper dermis (the deepest layer of skin) in real time. This procedure is performed with a laser light that is able to focus on a specific spot within the tissue, which is then automatically scanned over the entire level of the skin.
“The ability to scan both the epidermis and the dermis has made RCM a promising technique for the non-invasive diagnosis of skin growths and response to non-invasive treatment,” said Dr. Rabinovitz. “In fact, a recent study has demonstrated that RCM enhances the secondary evaluation of moles and melanoma, making it potentially an important diagnostic tool in monitoring changes beneath the skin.”
Gene Profiling
Based on preliminary data, gene profiling is an exciting new research area within medicine that Dr. Rabinovitz believes might play a role in the clinical evaluation of melanoma. Gene profiling measures the activity of thousands of genes simultaneously to create an overall impression of how cells function.
Cancer at its most basic level is a genetic disease, and the biological events that initiate the malignancy represent alterations in the expression of genes. Like normal cells, biomarkers exist for cancerous cells and this signature can be used to identify“cancer,” said Dr. Rabinovitz. “In the case of melanoma, the object would be to identify an alteration in genes to create a classifier for clinical diagnostic purposes.” This is being performed with tape stripping of moles.
Future Technologies
Over the past 15 years, researchers have studied technologies that could accurately diagnose pigmented lesions, with the goal of developing a reliable, non-invasive diagnostic tool to aid dermatologists in the early detection of melanoma. One such device, the computerized image analysis system, uses a computerized analysis algorithm for the automatic diagnosis of melanoma.
“The technological advances in melanoma detection in the future will significantly improve our ability to detect early melanomas and help save countless lives,” said Dr. Rabinovitz. “However, keeping a vigilant eye on our skin for any changes that could signal a problem is an irreplaceable first step in the process.”
Academy Provides Free, Do-it-Yourself Tool for Tracking Moles
To help spot melanoma at its earliest, and most curable, stage, the Academy recommends that everyone should be familiar with the ABCDEs of melanoma and report any suspicious moles or changes in the skin to a dermatologist for proper diagnosis. In addition, the Academy’s “Body Mole Map,” which can be downloaded on the Academy’s website at http://www.melanomamonday.org/documents/Body_Mole_Map_11-09.pdf, is a tool that creates a record for people to track where spots appear on their skin and if these spots have changed over time when new skin self-exams are performed.
Headquartered in Schaumburg, Ill., the American Academy of Dermatology (Academy), founded in 1938, is the largest, most influential, and most representative of all dermatologic associations. With a membership of more than 16,000 physicians worldwide, the Academy is committed to: advancing the diagnosis and medical, surgical and cosmetic treatment of the skin, hair and nails; advocating high standards in clinical practice, education, and research in dermatology; and supporting and enhancing patient care for a lifetime of healthier skin, hair and nails. For more information, contact the Academy at 1-888-462-DERM (3376) or www.aad.org.
Derma Health Institute
http://www.dermahealthinstitute.com
Wednesday, July 29, 2009
Early Detection of Melanoma is Vital For Beating Disease
SCHAUMBURG, Ill., May 4 /PRNewswire-USNewswire/ -- On television's popular "Grey's Anatomy," Dr. Izzie Stevens faces a grim diagnosis: stage IV metastatic melanoma. As the drama unfolds, viewers get a glimpse at why patients with the deadliest form of skin cancer -- in the most advanced stage of diagnosis -- face a mere 10-month median survival rate. In real life, this type of prognosis is devastating and leaves melanoma patients with few options for beating this disease that claims the life of one American almost every hour (every 62 minutes). But dermatologists agree that when melanoma is diagnosed in its earliest, most treatable stages, time is on your side.
http://www.dermahealthinstitute.com
Dermatologist Gary S. Rogers, MD, FAAD, professor of dermatology and surgery at Tufts University School of Medicine in Boston, and dermatologist Jason K. Rivers, MD, FAAD, clinical professor of dermatology at the University of British Columbia in Vancouver, reviewed the most common treatments for the different stages of melanoma and offered suggestions for melanoma patients aiming for their five-year survival mark.
Melanoma Treatments Vary Depending on Stage
When detected in its earliest stages (stage 0 - stage I), melanoma is highly curable. In fact, the American Cancer Society estimates that the average five-year survival rate for individuals whose melanoma is localized and has not spread beyond the outer layers of the skin is 99 percent. Dr. Rogers explained that for patients diagnosed with a stage 0 or stage I melanoma, a routine, typically office-based surgical procedure to remove the tumor and a margin of normal-looking skin around it is performed and neither chemotherapy nor radiation is required.
In special circumstances where a melanoma occurs on a cosmetically or functionally critical site, such as the lip, nose, eyelid or finger, Dr. Rogers noted that a new technology based on a variation of Mohs surgery is being used successfully. The procedure uses an anti-melanoma targeted antibody known as MART-1 (Melanoma Antigen Recognized by T cells), which improves the speed and accuracy of the procedure. The technique allows the surgeon to microscopically identify and remove the melanoma cells with minimal sacrifice of healthy tissues in real-time (16-20 minutes). The ability to successfully resect (or surgically remove) the cancer with potentially an 1/8 inch margin rather than an inch margin is critical when working on delicate structures such as an eyelid, said Rogers.
For stage II melanomas, surgery is performed to remove the tumor and surrounding tissue. In addition, the dermatologic surgeon often tests the lymph nodes to determine if the cancer has spread. If the melanoma is going to spread, Dr. Rogers noted that 57 percent of the time the first place the cancer goes is to the local draining lymph nodes. A procedure known as a sentinel lymph node biopsy tests the first lymph nodes into which the melanoma drains. If the lymph nodes are free of cancer cells, then the melanoma is considered in stage II with an average five-year survival rate of 70 percent. In this stage, Dr. Rogers explained that interferon may be given as an adjuvant (or drug-enhancing agent) to boost the patient's immune system.
However, if the lymph nodes are determined to be involved, then the melanoma is classified as stage III. In this stage, the cancer has spread to one or more nearby lymph nodes and the average five-year survival rate drops to 50 percent or less. Once a melanoma has spread beyond the skin growth, a more extensive treatment plan -- which may include surgical removal of the tumor with wide margins, usually including the affected regional lymph nodes; chemotherapy; immunotherapy or radiation therapy -- is often indicated.
When the tumor has spread to a distant site, such as the lung, brain or other organ, this is considered a stage IV melanoma with an average survival rate of only 10 months. One drug being used to treat patients with advanced melanoma is known as dacarbazine or DTIC. However, the remission rate with this drug is only 10 percent.
"No studies to date show that chemotherapy or any treatment regimens are effective when melanoma has spread to other organs," said Dr. Rogers. "The silver lining is that given the explosion in our understanding of the molecular biology of melanoma, there are a number of drugs and therapies in the pipeline that are being studied to treat the more advanced stage melanomas."
One potential therapy involves targeting specific drugs to specific genes that are known to go awry in the development of melanoma. There are multiple genes involved in melanoma progression from local tumor to disseminated disease. And, on a molecular level, there are many differences between melanomas that form in chronically sun-exposed areas versus areas of the body that are not sun-exposed, such as the soles or palms. The goal is to find a drug that will target a specific type of gene defect responsible for certain types of melanoma. "Just as one shoe does not fit all sizes, we are on the verge of being able to tailor therapy to a particular patient," added Dr. Rogers.
Clinical trials also are underway to test a vaccine known as the MAGE-A (melanoma antigen - family A) vaccine that would be used as an adjuvant to treat certain types of stage III and IV melanoma. MAGE is an antigen that exists in every cell in the body, but it is not expressed (or made apparent as an observable inherited characteristic) except in cancer. The gene that produces the MAGE protein lies dormant but becomes activated on the surface of melanoma cells and other cancers. Now, this vaccine is being tested to target cells that express or produce inherited characteristics of the MAGE antigen. Dr. Rogers estimated that 60 to 70 percent of melanoma patients express the MAGE antigen, and he believes the vaccine could hold tremendous promise in treating more advanced melanomas in the future.
Tips for Melanoma Survivors: Remain Vigilant
Individuals diagnosed with melanoma are at risk for developing another melanoma and other types of cancer. Dr. Rivers explained that melanoma patients, especially those with atypical moles, are at increased risk for melanoma of the eyes. He reported that studies also show that melanoma seems to increase the likelihood of contracting breast cancer and possibly some lymphomas. In families where more than one family member has melanoma, Dr. Rivers said these patients also are at increased risk for developing pancreatic cancer.
"Once a patient is diagnosed with melanoma, he or she should be checked by a dermatologist as often as every three months to once a year, depending on the individual's prognosis," said Dr. Rivers. "The most important factor in beating melanoma and improving survival rates is increased public awareness, as this has been shown to save lives by identifying melanoma at an early, curable stage."
In his practice, Dr. Rogers offers tips for melanoma survivors that he personally believes are good for their overall health. These include:
Eating foods rich in anti-oxidants, such as legumes, kale, green leafy vegetables, carrots, fish (especially salmon), fruits, whole grains, and flax seed.
Taking recommended daily doses of anti-oxidant supplements, including beta carotene, selenium, vitamin C, vitamin E and fish oils (also known as EPA).
Drink one to two glasses of red wine a day. Resveratrol, a polyphenol found in the skins of grapes (part of the plant's immune system), has potent anti-cancer properties and becomes concentrated in red wine during the fermentation process.
Avoiding other forms of alcohol other than red wine, as alcohol in general is detrimental to a person's health in many ways and suppresses the immune system.
"I always tell my melanoma patients to remain hopeful and vigilant, and see your dermatologist regularly," added Dr. Rogers. "Even if you beat melanoma once, you have an increased risk of getting another one in the future. With melanoma, you can never let your guard down."
Visit www.melanomamonday.org to find out how to perform a skin self-exam, download a body mole map to track changes in your skin and find free skin cancer screenings in your area. For more information on skin cancer, go to the "SkinCancerNet" section of www.skincarephysicians.com, a Web site developed by dermatologists that provides patients with up-to-date information on the treatment and management of disorders of the skin, hair and nails.
Headquartered in Schaumburg, Ill., the American Academy of Dermatology (Academy), founded in 1938, is the largest, most influential, and most representative of all dermatologic associations. With a membership of more than 15,000 physicians worldwide, the Academy is committed to: advancing the diagnosis and medical, surgical and cosmetic treatment of the skin, hair and nails; advocating high standards in clinical practice, education, and research in dermatology; and supporting and enhancing patient care for a lifetime of healthier skin, hair and nails. For more information, contact the Academy at 1-888-462-DERM (3376) or www.aad.org.
Source: American Academy of Dermatology
http://www.dermahealthinstitute.com
Dermatologist Gary S. Rogers, MD, FAAD, professor of dermatology and surgery at Tufts University School of Medicine in Boston, and dermatologist Jason K. Rivers, MD, FAAD, clinical professor of dermatology at the University of British Columbia in Vancouver, reviewed the most common treatments for the different stages of melanoma and offered suggestions for melanoma patients aiming for their five-year survival mark.
Melanoma Treatments Vary Depending on Stage
When detected in its earliest stages (stage 0 - stage I), melanoma is highly curable. In fact, the American Cancer Society estimates that the average five-year survival rate for individuals whose melanoma is localized and has not spread beyond the outer layers of the skin is 99 percent. Dr. Rogers explained that for patients diagnosed with a stage 0 or stage I melanoma, a routine, typically office-based surgical procedure to remove the tumor and a margin of normal-looking skin around it is performed and neither chemotherapy nor radiation is required.
In special circumstances where a melanoma occurs on a cosmetically or functionally critical site, such as the lip, nose, eyelid or finger, Dr. Rogers noted that a new technology based on a variation of Mohs surgery is being used successfully. The procedure uses an anti-melanoma targeted antibody known as MART-1 (Melanoma Antigen Recognized by T cells), which improves the speed and accuracy of the procedure. The technique allows the surgeon to microscopically identify and remove the melanoma cells with minimal sacrifice of healthy tissues in real-time (16-20 minutes). The ability to successfully resect (or surgically remove) the cancer with potentially an 1/8 inch margin rather than an inch margin is critical when working on delicate structures such as an eyelid, said Rogers.
For stage II melanomas, surgery is performed to remove the tumor and surrounding tissue. In addition, the dermatologic surgeon often tests the lymph nodes to determine if the cancer has spread. If the melanoma is going to spread, Dr. Rogers noted that 57 percent of the time the first place the cancer goes is to the local draining lymph nodes. A procedure known as a sentinel lymph node biopsy tests the first lymph nodes into which the melanoma drains. If the lymph nodes are free of cancer cells, then the melanoma is considered in stage II with an average five-year survival rate of 70 percent. In this stage, Dr. Rogers explained that interferon may be given as an adjuvant (or drug-enhancing agent) to boost the patient's immune system.
However, if the lymph nodes are determined to be involved, then the melanoma is classified as stage III. In this stage, the cancer has spread to one or more nearby lymph nodes and the average five-year survival rate drops to 50 percent or less. Once a melanoma has spread beyond the skin growth, a more extensive treatment plan -- which may include surgical removal of the tumor with wide margins, usually including the affected regional lymph nodes; chemotherapy; immunotherapy or radiation therapy -- is often indicated.
When the tumor has spread to a distant site, such as the lung, brain or other organ, this is considered a stage IV melanoma with an average survival rate of only 10 months. One drug being used to treat patients with advanced melanoma is known as dacarbazine or DTIC. However, the remission rate with this drug is only 10 percent.
"No studies to date show that chemotherapy or any treatment regimens are effective when melanoma has spread to other organs," said Dr. Rogers. "The silver lining is that given the explosion in our understanding of the molecular biology of melanoma, there are a number of drugs and therapies in the pipeline that are being studied to treat the more advanced stage melanomas."
One potential therapy involves targeting specific drugs to specific genes that are known to go awry in the development of melanoma. There are multiple genes involved in melanoma progression from local tumor to disseminated disease. And, on a molecular level, there are many differences between melanomas that form in chronically sun-exposed areas versus areas of the body that are not sun-exposed, such as the soles or palms. The goal is to find a drug that will target a specific type of gene defect responsible for certain types of melanoma. "Just as one shoe does not fit all sizes, we are on the verge of being able to tailor therapy to a particular patient," added Dr. Rogers.
Clinical trials also are underway to test a vaccine known as the MAGE-A (melanoma antigen - family A) vaccine that would be used as an adjuvant to treat certain types of stage III and IV melanoma. MAGE is an antigen that exists in every cell in the body, but it is not expressed (or made apparent as an observable inherited characteristic) except in cancer. The gene that produces the MAGE protein lies dormant but becomes activated on the surface of melanoma cells and other cancers. Now, this vaccine is being tested to target cells that express or produce inherited characteristics of the MAGE antigen. Dr. Rogers estimated that 60 to 70 percent of melanoma patients express the MAGE antigen, and he believes the vaccine could hold tremendous promise in treating more advanced melanomas in the future.
Tips for Melanoma Survivors: Remain Vigilant
Individuals diagnosed with melanoma are at risk for developing another melanoma and other types of cancer. Dr. Rivers explained that melanoma patients, especially those with atypical moles, are at increased risk for melanoma of the eyes. He reported that studies also show that melanoma seems to increase the likelihood of contracting breast cancer and possibly some lymphomas. In families where more than one family member has melanoma, Dr. Rivers said these patients also are at increased risk for developing pancreatic cancer.
"Once a patient is diagnosed with melanoma, he or she should be checked by a dermatologist as often as every three months to once a year, depending on the individual's prognosis," said Dr. Rivers. "The most important factor in beating melanoma and improving survival rates is increased public awareness, as this has been shown to save lives by identifying melanoma at an early, curable stage."
In his practice, Dr. Rogers offers tips for melanoma survivors that he personally believes are good for their overall health. These include:
Eating foods rich in anti-oxidants, such as legumes, kale, green leafy vegetables, carrots, fish (especially salmon), fruits, whole grains, and flax seed.
Taking recommended daily doses of anti-oxidant supplements, including beta carotene, selenium, vitamin C, vitamin E and fish oils (also known as EPA).
Drink one to two glasses of red wine a day. Resveratrol, a polyphenol found in the skins of grapes (part of the plant's immune system), has potent anti-cancer properties and becomes concentrated in red wine during the fermentation process.
Avoiding other forms of alcohol other than red wine, as alcohol in general is detrimental to a person's health in many ways and suppresses the immune system.
"I always tell my melanoma patients to remain hopeful and vigilant, and see your dermatologist regularly," added Dr. Rogers. "Even if you beat melanoma once, you have an increased risk of getting another one in the future. With melanoma, you can never let your guard down."
Visit www.melanomamonday.org to find out how to perform a skin self-exam, download a body mole map to track changes in your skin and find free skin cancer screenings in your area. For more information on skin cancer, go to the "SkinCancerNet" section of www.skincarephysicians.com, a Web site developed by dermatologists that provides patients with up-to-date information on the treatment and management of disorders of the skin, hair and nails.
Headquartered in Schaumburg, Ill., the American Academy of Dermatology (Academy), founded in 1938, is the largest, most influential, and most representative of all dermatologic associations. With a membership of more than 15,000 physicians worldwide, the Academy is committed to: advancing the diagnosis and medical, surgical and cosmetic treatment of the skin, hair and nails; advocating high standards in clinical practice, education, and research in dermatology; and supporting and enhancing patient care for a lifetime of healthier skin, hair and nails. For more information, contact the Academy at 1-888-462-DERM (3376) or www.aad.org.
Source: American Academy of Dermatology
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