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Melanoma: Skin Cancer Prevention and More

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From Queens Library's expert-led panel, Cancer Awareness: What You Need to Know, featuring professionals from New York Hospital Queens, North Shore LIJ, the American Cancer Society, and the Leukemia and Lymphoma Society

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Melanoma: Skin Cancer Prevention and More

  1. 1. Beware of the Sun A Melanoma May ResultMitchell Chorost, M.D.NY Hospital Queens – Cancer Center
  2. 2. 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?
  3. 3. Diagnosis ?
  4. 4. 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.
  5. 5. Primary Prevention of Skin CancerAvoid 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
  6. 6. Primary Prevention of Skin CancerProper Use of Sunscreens• Apply generously and evenly• Reapply every 2 hours - if perspiring - if swimming• Consider waterproof formulas
  7. 7. How Do I Protect My Skin?“Slip, Slop, Slap, & Wrap”SLIP on a shirt SLOP on sunscreen and lip balm with an SPF of 15 or higher WRAP on sunglasses to protect the eyesSLAP on a hat with a 2 to 3-inch and skin around them brim all around to protect neck, ears, nose and scalp
  8. 8. Secondary Prevention of Skin CancerScreening and Early Detection• Inspect moles for changes• Remove suspicious moles• Remove actinic keratoses and other precancerous lesions
  9. 9. 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
  10. 10. Risk Factors for Melanoma• Light pigmentation• Family history of malignant melanoma• >3 sunburns during childhood• >3 years outdoor occupation during childhood• Immunosuppression Source: Balch, et al, 1992.
  11. 11. ABCDs•Asymmetry•Border•Color•Diameter
  12. 12. A symmetry One half does not match the other half.
  13. 13. B order irregularity •The edges are ragged, notched, or blurred.
  14. 14. C olor•The pigmentation is not uniform. •Shades of tan, brown, or black •A mottled appearance.
  15. 15. D iameter •Greater than ¼ inch. •Any sudden or continuing increase in size is of special concern.
  16. 16. E volution •Changing characteristics of the mole independent of the size or color.
  17. 17. Work-up • FDG-PET • sensitivity 17% in study with SLN biopsy • some use in distant disease
  18. 18. 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)
  19. 19. A New Paradigm in Cancer Treatment Haber, Gray, Baselga Cell 2011
  20. 20. See SpotSee Spot ChangeSee Doctor…………….Or, See Spot Kill!
  21. 21. Knowledge is Power. And Hope.

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