With Melanoma on the Rise, Advanced Treatment and Prevention More Important Than Ever

Posted in GUMC Stories

MAY 19, 2015—The latest session of Doctors Speak Out — held May 13 during Melanoma Awareness Month — brought Georgetown physicians and scientists together to explore both the alarming and positive trends in the disease.

“Melanoma represents a significant and growing public health problem both in the United States and around the world,” said panelist Michael B. Atkins, MD , deputy director of Georgetown Lombardi Comprehensive Care Center and professor of oncology and medicine at the School of Medicine.

Atkins was joined by Maral Kibarian Skelsey, MD , clinical associate professor of dermatology at the School of Medicine and Waddah Al-Refaie, MD , John S. Dillon Chair in Surgery Oncology and surgeon-in-chief at Georgetown Lombardi Comprehensive Care Center.

Jan Smith, freelance television journalist, moderated the panel.

Incidence on the Rise

In the United States, 80,000 people are diagnosed with melanoma every year.   

According to Atkins, the incidence of melanoma has steadily increased over the past 40 to 50 years, especially in young women. The reason? Increased exposure to ultraviolet light — particularly increased use of indoor tanning beds.

“Never go in a tanning salon and advise all your family members not to as well,” said Skelsey. “Your tan is actually a sign of sun damage, and the more of that there is, the more you will increase your risk of skin cancer and specifically melanoma.”

The panelists were united about the negative effects of tanning beds and too much sun exposure. But they also indicated everyone is at risk for melanoma, even if they take precautions to protect themselves from the sun.  According to Skelsey, risk factors include having light skin, red or blonde hair and history of breast or thyroid cancer increases the average risk.

Advanced Treatment

Up until five years ago, 50 percent of stage IV melanoma patients didn’t live more than six to nine months after being diagnosed. Atkins said two types of treatment, targeted molecular therapy and immunotherapy, have been instrumental in increasing survival for these patients.

In recent years, researchers identified a mutation that caused melanoma tumors to grow. Targeted molecular therapy involves administration of a drug or drugs that can selectively inhibit the function of the mutated protein. The result can be dramatic tumor shrinkage in 70 to 80 percent of patients.

Immunotherapy involves re-activating the immune system against the tumor.

While these methods have revolutionized stage IV melanoma treatment, they are also changing the role of surgery in this patient population. More often than not surgery is being coordinated with the timing of systemic drug therapies. Surgery can happen either prior to or after therapy, depending on each individual situation.

“We see stage IV patients responding to treatment in a dramatic way, and then end up with one or two areas of their tumor that do not respond,” said Al-Refaie. “We feel that if we take a selective surgical approach to those patients, we can further enhance the outcome of these novel therapies.”

Effective Prevention

Despite significant advancements in treatment, melanoma kills 9,000 people in the United States every year, so prevention is extremely important.

In addition to staying away from tanning beds and applying sunscreen thoroughly and often, Skelsey stressed self-examination. She urged the audience to thoroughly check their bodies for signs of unusual bumps, oddly shaped moles or multi-colored splotches and to see a dermatologist if they find anything suspicious.

“With early detection and prevention, melanoma is a very curable disease,” said Skelsey.

By Leigh Ann Renzulli
GUMC Communications