Melanoma

This past weekend, The Miami Herald published a special section called skin health.  In it, they talked about two new drugs for the treatment of advanced (stage 3 and 4) melanoma.  These are the FDA approved Ipilimumab, or Yervoy, and the not-yet approved Vemufafenib.  These drugs are very promising and exciting because patients diagnosed with advanced melanoma have previously had few options for treatment, and are often facing a sentence of less than 6 months to live.  The studies, (part of which were performed at Mount Sinai in South Florida) are promising and show a lot of hope for those with advanced disease.

It's really important to realize though, that IF melanoma is caught and treated early, it can be nearly 100% curable.  Thankfully, the majority of melanomas that I see are called melanoma in situ (stage 0).  This means that the melanoma is in the very very top layer of the skin and has not penetrated deeply.  It's removed surgically, done in the office under local anesthesia.  Even melanomas that go a little bit deeper in the skin (stage 1, 2) often have a good prognosis and are treated with surgical excision.  Melanomas that measure deeper need more testing (in addition to the surgical removal), such as lymph node testing and imaging.  If a melanoma is deeper than that, then it is considered advanced and chemotherapy is added to the treatment regimen. 

Early detection is the KEY.  Any new, changing, itchy, bleeding, crusting mole needs to be evaluated asap by a dermatologist.  Don't wait to see your doctor.  With melanoma, the depth is the greatest predictor of survival.  The earlier we catch it, the better.  But once you've been diagnosed with melanoma, you're at increased risk for developing another one.  You'll need close monitoring by your dermatologist for the rest of your life. 

While genetics definitely plays a role in the development of melanoma, what you do on a daily basis makes a difference.  Of course, sunburns are a big no no, which I think pretty much everyone knows.  But any tan is a sign of sun damage, which puts you at risk for melanoma.  DON'T TAN - either in the salon or outdoors.  "Oh, don't worry, Doc, my skin is naturally tanned."  Really?  Take a look at your buttocks.  That is your real skin color.  Still think you're naturally tanned?  Slather on a physical blocker, at least an SPF 30, and reapply.  Avoid the sun between 10 am - 4 pm, when the rays are strongest.  Wear a hat, sunglasses, and sun protective clothing.  Stay in the shade.  And teach your kids to do the same. 

While we are all excited over the new developments for advanced melanoma, my hope is that with prevention and early detection, we won't have to use them.