Posts Tagged ‘melanoma’

It’s Melanoma Awareness Monday: Reduce Your Risk

melanoma awarenessDid you know that melanoma cases in the United States are growing faster than any other cancer? Malignant melanoma is a type of skin cancer that can be deadly if it spreads throughout the body. It usually grows near the surface of the skin and then begins to grow deeper, increasing the risk of spread to other organs. Detecting and removing a malignant melanoma early can result in a complete cure. Removal after the tumor has spread may not be effective.

Melanoma can occur anywhere on the skin, including areas that are difficult for self-examination. Many melanomas are first noticed by other family members.

Most patients with early melanoma have no skin discomfort whatsoever. See a doctor when a mole suddenly appears or changes. Itching, burning or pain in a pigmented lesion should cause suspicion, Visual examination remains the most reliable method for identifying a malignant melanoma.

Avoiding exposure to ultraviolet radiation is the best way to prevent melanoma and other skin cancers. Melanoma Monday is May 4th so here are a few tips for reducing your risk:

  • Avoid direct exposure between 10am and 4pm, opt for shade
  • Cover up with clothing (broad brimmed hat, sunglasses, long sleeves, etc.)
  • Use a sunscreen of SPF 30 or higher every day (including lip balm with SPF 30)
  • Apply 1 ounce (2 tablespoons) of sunscreen to the entire body, 30 minutes prior to going outdoors; reapply every 2 hours or after excessive sweating or swimming
  • Keep newborns out of the sun; if it cannot be avoided use a sunscreen with physical blockers to exposed areas (see below)
  • Avoid tanning beds
  • Remember water, sand, and snow reflect the sun; and clouds allow 70-80% UV penetration

Have fun this summer, but remember these tips for sun safety.

About Dr. Chen

chen, suephySuephy Chen, MD, MS, began practicing at Emory Healthcare in 2000 and has been board certified in dermatology since 1997. In addition to melanoma, Dr. Chen has clinical interests in pruritus, psoriasis, and atopic dermatitis.
Dr. Chen is a member of the Cancer Prevention and Control Research Program at Winship Cancer Institute of Emory University. She is also a member of the American Academy of Dermatology, the Society for Investigative Dermatology, and the Women’s Dermatology Society. In addition, she is a founding member of the Pigmented Lesion Group of the Melanoma Prevention Working Group.

Dr. Chen earned her Doctor of Medicine from Johns Hopkins University School of Medicine. She completed her internship at the Beth Israel Hospital, a Harvard University teaching hospital, before continuing on to a dermatology residency at Emory University Hospital. She obtained her Master of Science in Health Services Research at Stanford University and completed her fellowship at Stanford Hospital.

Dr. Chen is interested in quantifying the burden of skin disease, particularly the quality of life and economic burden on both patients and society as a whole. She is also interested in testing new technologies in the delivery of dermatologic care. She has contributed to numerous phase I-IV clinical studies of novel therapeutic regimens for the treatment of both inflammatory skin disorders and skin cancers.

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Dermatologist #1 Skin Care Rule – Wear Sunscreen!
Top 5 Skin Protection & Skin Cancer Prevention Tips for UV Safety
Skin Cancer Chat

Take Steps to Prevent Skin Cancer

Skin ExamI am a dermatologist in the Emory Clinic and my focus is medical dermatology with a monthly melanoma clinic. I see patients of all skin types but a large part of my practice is seeing patients for total body skin exams (TBSE). We recommend that patients with all skin types get a total body skin exam, but patients who have a family history of melanoma, atypical mole syndrome or non-melanoma skin cancer should be particularly proactive about scheduling their skin checks. As a broad rule, once a year skin checks should suffice. These checks become more frequent in patients who have a personal history of melanoma or non-melanoma skin cancer.

A skin exam entails wearing a gown at the dermatologist’s office and getting all parts of your skin looked at for moles that may appear abnormal or growths that may be non-melanoma skin cancers such as basal cell skin cancer or squamous cell skin cancer. If we see anything suspicious, the spot is biopsied, which involves removing a small sample of skin tissue. It takes five minutes or less to perform a biopsy and the results are usually available in a few days.

During this visit, we educate patients to be good about self-examination. I recommend that patients pick the first of every month and put it on their calendar to examine their skin head to toe. They should look for any changing moles or any new bumps that may have come up. It can be difficult to know what to worry about or not, but in general a melanoma can show up as a new mole or a changing or bleeding mole. A basal or squamous cell generally presents as a new bump or flat lesion that can bleed, or hurt, or just be new and growing. If you are worried about something, you should make an appointment to be checked by your dermatologist right away.

Sun protection is a big part of preventing skin cancers. The AAD (American Academy of Dermatology) recommends everyone use sunscreen that is broad spectrum (protects against UVA and UVB), has a sun-protection factor (SPF) of 30 or greater and is water resistant. And you need to apply an adequate amount of sunscreen for it to be effective: generally one ounce (enough to fill a shot glass) for the exposed parts of your body for each application. This needs to be repeated every 2 hours on continued sun exposure. Remember to apply sunscreen at least 15 minutes before going outdoors.

You can use any type of sunscreen that works for you, such as lotions, creams, gels, sticks or even sprays. Sprays, though, have the disadvantage of accidental inhalation and it’s sometimes hard to know when using a spray if you have applied an adequate amount.

Tanning bed use has been proven to increase the risk of melanoma and also accelerate photo-aging. It should be avoided at all cost. Sunbathing and a history of blistering sunburns also increase your risk of skin cancer. It is very important to avoid the sun between 10 am and 2 pm, when the rays are the strongest, and to use additional protective clothing such as long sleeved shirt, pants, a wide-brimmed hat and sunglasses.

As you get ready for fun summer weekends, here’s a checklist to help you prevent skin cancer: avoid the sun when it’s at its strongest, use sunscreen and protective clothing any time you are out in the sun, never use a tanning bed, and when in doubt, check it out! Schedule an appointment with a dermatologist along with your annual physical visit, and for accurate information about safe sun practices, check the AAD website.

About Dr. Bhandarkar

Sulochana Bhandarkar, MDSulochana Bhandarkar, MD, is an assistant professor of dermatology at the Emory School of Medicine. She completed her medical school education from her home country, India, at Kasturba Medical College in Mangalore, where she also did a three-year dermatology residency with a special interest in vitiligo, a condition affecting skin pigmentation. After moving to the U.S., she did a clinical research fellowship at the University of California San Francisco, as well as a melanoma research fellowship at Emory University. She did her residency in dermatology at Emory University and became a faculty member at Emory in 2011. Her clinical interests are vitiligo and melanoma.

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Sun Damage Lasts a Lifetime

Sun ProtectionAfter a long, rough winter, it feels good to put away the jackets and get out the swim gear. As a melanoma oncologist, the summer is a double-edged sword as it also means that many people will be out in the sun doing irreversible damage to their skin. Not only can sun safety decrease your risk of skin cancer, it also can help protect you from the visible signs of aging. Who doesn’t want less cancer and to look younger at the same time? Unfortunately, some people believe they need a good burn or base tan to start the summer. Hopefully, I can change your mind about this with some basic information about skin cancer and a few tips on enjoying the summer without increasing your risk of developing skin cancer (or more wrinkles).

Skin cancer affects over three million people each year, making it by far, the most common cancer. The three most common skin cancers are basal cell carcinoma, squamous cell carcinoma, and melanoma. Basal and squamous cell cancers are the most prevalent and originate from keratinocytes. These cancers are often referred to as “non-melanoma skin cancers.” They affect a little over two million Americans each year, with 80 percent of these being basal cell cancers. Most non-melanoma skin cancers are caused by repeated exposure of the skin to ultraviolet rays (primarily UVA and UVB) from sunlight or from artificial sources such as tanning beds. These rays damage the DNA in skin cells and cause them to grow and divide unregulated, thus producing a cancer. These types of skin cancers tend to stay in the skin, and therefore very few patients will die from basal or squamous cell cancers. It is estimated that approximately 2,000 people die each year from non-melanoma skin cancers.

In contrast, melanoma is a cancer that originates from melanocytes that normally make pigment to protect the other layers of the skin from sun damage. Melanocytes can also make non-cancerous growths like moles. The American Cancer Society estimates approximately 76,100 new melanomas will be diagnosed in 2014 with 9,710 deaths from this disease, making it the most deadly form of skin cancer. Lifetime risk of melanoma in the U.S. is about 1 in 50, and notably it is one of the most common cancers in those younger than 30. When diagnosed early, surgery alone has excellent survival rates. In the past there were few long-term survivors from advanced cases of melanoma. Fortunately, many novel therapeutic agents are being developed that have transformed the treatment of more advanced stages of melanoma with five new agents approved by the FDA since 2011. All of these new drugs are changing the landscape of melanoma treatment and patients are now not only living longer, but also with better quality of life.

Though melanoma development is more multi-factorial than basal or squamous cell cancer development, it is still linked to UV exposure through sunlight or tanning beds. The best way to decrease one’s risk of skin cancer development is to avoid long exposures to intense sunlight and practice sun safety measures. When outside, I recommend the use of broad spectrum sunscreen (SPF 30 or higher), use of sun protective clothing such as sun shirts and board brim hats, and avoid direct exposure between 10AM and 2PM when the intensity of the rays is the strongest. Sunscreen should be applied about 20-30 minutes prior to going outside and reapplied approximately every two hours. Because this is difficult to do, even for myself, I recommend barriers like sun shirts or umbrellas over sunscreen if possible.

Keep in mind the sun damage that occurs now will be with you for the rest of your life, so please don’t forget your sun protective gear on your way out to enjoy the beautiful weather.

About Dr. Kudchadkar

Ragini Kudchadkar, MDRagini R. Kudchadkar, MD is an assistant professor in the Department of Hematology and Medical Oncology at the Winship Cancer Institute of Emory University. She specializes in cutaneous oncology with an emphasis on the development of clinical trials for patients with metastatic melanoma. Dr. Kudchadkar previously worked as an assistant member of the Department of Cutaneous Oncology at the H. Lee Moffitt Cancer Center in Tampa, Florida. In addition to her clinical practice, Kudchadkar is involved in research that focuses on signal transduction inhibitors for the treatment of metastatic melanoma with a secondary interest in rare cutaneous malignancies such as advanced merkel cell and basal cell carcinomas.

Kudchadkar graduated from the Emory School of Medicine in 2003 and completed her internal medicine residency at Emory in 2006. She pursued her hematology and medical oncology training at the University of Colorado in Denver, CO, where she also served as chief fellow.

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Melanoma Chat TRANSCRIPT
Dermatologist #1 Skin Care Rule – Wear Sunscreen!
Skin Cancer Prevention: Which Sunscreen is Best?

Why I Run: To Raise Awareness & Funding For My Dad’s Cancer

Nething Family Melanoma Patient StoryWhen Sarah Nething learned that her father’s melanoma had come back, she knew it was time to take charge in the fight against cancer. “When cancer comes, you feel kind of helpless,” says Sarah. “Our family believes very strongly in the power of prayer, but you still feel like you want to do something.” And Sarah is doing something. As the oldest of ten children and a graduate student in South Carolina, Sarah has set up a team for the Winship Cancer Institute of Emory University’s Win the Fight 5K Run/Walk.

“I can’t take away my dad’s cancer; however, I can participate in something that raises research money to help the doctors try to figure out how to stop it,” says Sarah. So on October 5, Sarah and other members of the Nething family will run the 5K in their father’s honor. Their team – Race for Matt – is running to not only raise general awareness, but also funds for Winship’s Melanoma & Skin Cancer Fund. The Winship Melanoma & Skin Cancer Fund is one of 18 funds which Winship 5K participants can direct their donations to.

In preparing for the upcoming race, Sarah has yet to lose any motivation. “A friend of ours describes how our family feels perfectly when he says ‘Trust God completely, fight cancer aggressively.’ That’s exactly what we plan to do,” she concludes.

If you are interested in learning more about the Win the Fight 5K, want to run or simply help support other runners like the Nething family, visit the Winship 5K website for more information.

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Which Sunscreen Is Best?

Which Sunscreen is Best?Most of us know that wearing sunscreen is one of the best ways to protect our skin from damaging UV rays and prevent skin cancer. But with the plethora of sunscreen options out there, choosing a sunscreen can be more complicated than it should be. If you feel overwhelmed by the seemingly limitless SPF and UV protection options, not to worry! A recent New York Times article addressed changes that the Food and Drug Administration (FDA) has ordered sunscreen companies to incorporate into future product labeling.

As the occurrence of melanomas and other skin cancers continue to rise, awareness around proper use of sunscreen is more important now than ever. Approximately one million new cases of skin cancer are diagnosed each year, making it the most common type of cancer in the United States. The three forms of skin cancer are distinguished by the types of cells affected: melanoma, basal cell and squamous cell. The most dangerous form of skin cancer is melanoma; however, if caught early, it can be treated.

To prevent the misuse and confusion caused by misreading of sunscreen labels, the FDA has mandated that the following be included on every sunscreen product:

  • Listing of “broad spectrum protection,” meaning the sunscreen has been proved to protect against both UVA and UVB rays
  • Any product with an SPF lower than 15 must carry a label warning that it will not protect against skin cancer
  • Products cannot claim to be waterproof, only water-resistant, and labels must note a time limit before the sunscreen is ineffective
  • Manufacturers can still sell sunscreens with SPFs that exceed 50; however, the FDA is evaluating whether or not they should remain on the market

According to the New York Times article, the FDA also warns against the use of sunscreen sprays and powders, stating that there is not enough data to support the efficacy of these products on preventing sun damage, and that consumers should be cautious of products with endorsements and seals of approval, as this typically means the manufacturer has donated money to become an endorsed member of an organization.

In a past online live chat hosted by Winship Cancer Institute of Emory University, Winship dermatologist, Suephy Chen, MD, addressed some frequently asked questions around the topic of sunscreen use and skin cancer prevention. One major takeaway from the chat: sunscreen should be applied every day, especially for people who have experienced sunburns or used tanning beds in the past. “The amount of sunscreen you use during the first (whole body) application of the day should be enough to fill a standard sized shot glass,” says Dr. Chen. She goes on to advise that “sunscreen should be reapplied every two hours or after you’ve perspired and/or have gotten in and out of the water.”

Remember, skin cancer is generally treatable if detected early. All the more reason to slop on the SPF! And if you haven’t done so lately, give your body a quick scan, and repeat this practice at least once a month. Get to know the pattern of your moles, spots, freckles, and other marks on your skin. If you notice any new moles or changes in shape or color to existing ones, please contact your healthcare provider.

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Find Out the Best Medicine for Melanoma

Thank you for joining us for the live online chat on the topic of Skin Cancer and Melanoma on May 28. We had excellent questions on skin cancer and melanoma. The key takeaway from the chat is that prevention is the best medicine for skin cancer and melanoma. Once you are burned the damage is already done to your skin.  So remember to wear your sunscreen (SPF of 30 or greater), wear hats and protective clothing and avoid the sun in the heat of the day (10am – 2pm). Take action now to avoid detrimental long term effects from the sun.You can read a full transcript of the Skin Cancer and Melanoma chat here.

When do your Moles Require a Trip to the Dermatologist?

Skin Cancer MolesHave you performed your monthly mole check? If not, take time today to do it and put it on your calendar for this day every month! Checking your moles monthly can help you from developing malignant melanoma. The earlier you find suspicious moles or lesions, the better your chances of being cured.

Some helpful tips to examine your moles:

  • Examine your skin after a shower, in good light, in front of a mirror without your clothes on.
  • Make sure to do a thorough, full body inspection. Start with your toes or your face and work your way over every surface of your body. Be sure to also check your scalp, underarms and genitals, parts that could be covered with hair.
  • Look for moles or skin markings that you haven’t noticed before, or areas that have changed in appearance since your last exam. Pay special attention to lesions that bleed or don’t heal.
  • Photos taken over a period of time can be helpful in determining whether a skin marking has changed.
  • Follow the ABC method for examining suspicious markings:
    • A = Asymmetry – do both sides of the mole match? If one side does not match the other, it could indicate melanoma.
    • B= Border – If the border has jagged or irregular edges, see your physician right away.
    • C = Color – Black, red, white and multi-colored moles should be seen by a professional right away. Tan and brown moles are usually ok, but make sure to watch for changes to these moles as well.
  • Diameter – Usually moles should be smaller than the end of a pen.
  • Elevation – moles should be flush with the skin around the mole. If you notice a mole is raised, visit your physician right away.
  • Do what you can to prevent skin cancer. Some ideas:
  • Wear sunscreen in the sun, in all seasons!
  • Wear a hat and sunglasses
  • Avoid tanning salons
  • Try to stay out of the sun between 10am and 3pm

Take action today to protect yourself and your family members!

About Margi  McKellar, MS, PA  Emory Winship Cancer Institute’s Melanoma Coordinator

Margi plays a unique role for the team as our Melanoma Coordinator. In this position, she serves as the point of contact for referring physicians and the patients and guides  them from the point of  their initial referral through long-term follow up. She helps our patients use their time efficiently, analyzing patient flow, appointment availability, clinical trial eligibility and ensures that patients see the correct complement of specialist to receive optimal care – medical oncology, surgical oncology, radiation oncology, lymphedema specialists. Margi actively interfaces with our clinical trial nurses to ensure patients have the opportunity to be considered for clinical trials while facilitating prompt screening for these programs. In addition to coordinating the care of patients, she also sees patients in our long-term follow up clinics.

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Prepare Yourself for Summer – Join us for a Web Chat on Melanoma & Other Skin Cancers

Skin Cancer Online ChatIf not caught early, melanoma is the deadliest of all skin cancers. One-in-fifty Americans has a lifetime risk of developing melanoma. It develops from changes to the DNA of skin cells, which can happen when skin is over-exposured to ultraviolet light from the sun or from extended tanning bed use. Also, certain viruses can cause DNA changes that lead to skin cancer.

To prepare yourself and your family for the summer and protect yourself from any form of skin cancer, join Winship Cancer Institute of Emory University physician, Keith Delman, MD, Wednesday, May 29th for an online web chat at 12 noon.

Dr. Delman will be able to answer questions such as:

  • How to prevent melanoma and skin cancer
  • What causes skin cancer and melanoma
  • Signs of melanoma and skin cancer
  • Treatment options for melanoma and skin cancer
  • The latest research on the horizon

Skin Cancer Prevention: Which Sunscreen is Best?

Sunscreen Tips Skin Cancer PreventionFor many people, Memorial Day weekend is the kickoff to Summer. Schools are finishing up and thousands will flock to beaches and lakes for the first getaway of the season. Whether you are going away, or spending a relaxing weekend at home, remember to wear sunscreen! Also, as you are on the hunt for the right product, know that the Food and Drug Administration (FDA) has begun to unveil new requirements for the way sunscreen manufacturers need to label and market their products to the consumer. We touched on this topic, as well as the importance of using sunscreen, during our recent Melanoma live chat with Winship Cancer Institute of Emory University dermatologist, Suephy Chen, MD.

According to Dr. Chen, changes to sunscreen labeling are a way of making sure that all sunscreens meet FDA required standards for safety and effectiveness. Labels will include specific and accurate information to help consumers select the right sun protection for themselves and their families.

When selecting the right sunscreen, “people should look for an SPF of 30. Anything higher than that doesn’t hurt, but it also doesn’t give you any real additional protection,” says Dr. Chen. “Proper coverage comes from reapplying sunscreen every two hours, especially if you’re in direct sunlight, have perspired and/or have gotten in and out of the water.”

Currently, the numbering system on sunscreens (SPF) only refers to protection against UV-B rays, which cause sunburn, but does not address UV-A rays, which can attribute to skin cancer and early skin damage. Under FDA regulation, all sunscreens have undergone “broad spectrum” tests to determine whether or not they protect against both UV-B and UV-A rays. Sunscreens that pass the test will now include the term “broad spectrum” on the label, to help consumers identify that they’re receiving coverage from both types of radiation.

The importance of using daily protection is crucial in the prevention of melanoma and other skin cancers. According to Dr. Chen, “only about 25% of melanomas come from a pre-existing mole, and about 75% of them occur in areas in which there was previously normal looking skin. Once sunburn happens, there are ways to treat the symptoms of the burn, but the damage to the skin has already been done.” For more sun safety tips, see part one of our Melanoma post series.

So if you plan on spending time outside this weekend, make sure to head to the drugstore first to load up on sun protection. Need a recommendation on a good product that you won’t have to break the bank for? After conducting their own series of “broad spectrum” tests, Consumer Reports recently revealed their top picks for reliable yet inexpensive sunscreens. Top products include: NO-Ad SPF 45 and Walgreen’s Continuous Spray Sunscreen Sport 50. Try them and let us know what you think in the comments field below!

For more information or to see a dermatologist, please call 404-778-777 or visit Winship’s website.

Dermatologist #1 Skin Care Rule – Wear Sunscreen!

Melanoma Web MD ChatIt’s almost summer time, and many of us are already spending more time outside enjoying the warm weather. Most of us don’t consider the consequences of increased sun exposure on our skin, even indirect exposure. Skin cancer is the most common type of cancer in the United States, with about one million new cases every year. The three common forms of skin cancer are distinguished by the types of cells affected: melanoma, basal cell and squamous cell. While melanoma is less common than basal and squamous cell cancers, it is the most dangerous. If caught early, melanoma can be treated; however, if left untreated, melanoma can spread to other parts of the body.

What is Melanoma?

Melanoma is a cancer of melanocytes, which are cells whose primary function is to make pigment. These cells are located in the layers of epidermis, or the outer layer of skin. Melanocytes are also responsible for making birthmarks and freckles; however, in those cases, the cells are not cancerous. Melanomas can form on any part of the skin but are most commonly found on the chest and back in men, and the legs in women. Melanomas can also develop on the neck and face, and they sometimes occur in the eye and in mucosal surfaces, such as the mouth and bowel.

Why do dermatologists recommend applying sunscreen daily?

Skin cancer is most commonly a result of excessive exposure to the sun’s ultraviolet (UV) rays. The sun contains two types of these rays: UVB, which are responsible for sunburns, and UVA, which cause cell aging and long-term skin damage. Both rays cause damage to skin cells’ DNA, resulting in abnormal cell growth. Here are some tips to protect your skin from the sun’s harsh rays and prevent skin cancer:

  • Use a broad spectrum SPF of a level 15 or higher, which is a type of sunscreen that protects the skin from both UVA and UVB rays.
  • Avoid outdoor activity between 10 a.m. and 4 p.m., when the sun’s rays are most intense.• Wear protective clothing as well as a hat and sunglasses to protect more sensitive parts of the body.
  • Remember, the UV rays can go through light clothing, windshields, windows, and clouds.
  • While shade offers some protection, the sun’s UV rays can still penetrate through clouds and trees and have harmful effects.

Check yourself!

Remember, skin cancer is generally treatable if detected early. If you haven’t done so, give your body a quick scan, and repeat this practice at least once a month. Get to know the pattern of moles, spots, freckles, and other marks on your skin. If you notice any new moles or changes in shape or color to existing ones, please contact your healthcare provider.

Have additional questions? Join Dr. Suephy Chen on May 14, 2012 at 11:30 AM EST for a live online discussion about diagnosing and treating melanoma.

For more information about melanoma and other skin cancers, visit Winship Cancer Institute of Emory University.

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