Last month, the FDA approved the drug Zelboraf (vemurafenib) for patients with melanoma, the deadliest form of skin cancer. The drug is designed to work only for late-stage melanoma patients whose tumors have a specific genetic defect known as the BRAF V600E mutation, which is present in approximately half of melanoma cases. The FDA also approved a diagnostic test that determines whether a patient's melanoma cells have this mutation.
The drug is the second to be approved this year for patients with late-stage melanoma -- Yervoy (ipilumumab) was approved last March. These approvals are an important advance, given the dearth of treatment options for late-stage melanoma.
Unfortunately, neither drug is a cure for the disease. Clinical trials have revealed that Zelboraf extends survival by a few months on average, compared with those taking traditional chemotherapy. What's more, it comes with a hefty price tag of about $9,400 per month.
To read more about the initial trials of Zelboraf (originally known as PLX4032) in humans and the path of this drug to market, see this fascinating series of articles by The New York Times reporter Amy Harmon.
Got a suspicious-looking mole that you're concerned about? There's an app for that. MelApp for iPhone lets you take a picture of your lesion using your smartphone's camera and analyzes it for risk of melanoma. The app could help you to detect melanoma in its earliest stages, when it is most easily cured.
After uploading your image, you'll be asked to answer two simple questions about your lesion or mole. Then the app uses "image-based pattern recognition technology" (which has been validated using a database of images licensed by Johns Hopkins University Medical Center, according to the app's creator, Health Discovery Corporation) to give you an estimated risk of melanoma. The program also allows you to store your pictures and collect them in albums by date, enabling you to review your suspicious moles or lesions for changes that occur over time. Users that receive a "high" risk of melanoma are directed to a nearby physician for follow-up using the smartphone's GPS technology.
While the app is certainly not intended to diagnose melanoma or to replace regular evaluations by your physician, at the very least it may help you to keep better track of your moles between check-ups. And for only $1.99, if it helps get you to the doctor more regularly, then it will be worth it's salt.
Numerous studies have shown that regular sunscreen use can prevent squamous cell carcinoma, but whether it's useful for preventing other skin cancers, such as melanoma, has remained controversial. New research published in the January 20 issue of the Journal of Clinical Oncology provides convincing evidence that sunscreen is indeed effective for preventing melanoma, the deadliest form of skin cancer.
Researchers at the Queensland Institute of Medical Research in Brisbane, Australia, randomly assigned 1,621 participants to two groups: sunscreen use, or discretionary use (which included no use). The first group was given an unlimited supply of broad-spectrum sunscreen with a sun protection factor (SPF) of 16 and was instructed to apply the product to their head, neck, arms, and hands each morning. Participants were also advised to reapply after bathing, heavy sweating, or prolonged sun exposure. People in the discretionary group were asked to continue using (or not using) sunscreen of any SPF as they always had.
Fifteen years after the start of the study, the researchers found half as many melanomas in the sunscreen group as in the control group (11 vs. 22, respectively), and an even greater difference in the number of invasive melanomas (3 vs. 11).
The results show that you can greatly reduce your risk of developing melanoma by regularly using sunscreen. However, sunscreen use is just one part of a more comprehensive sun protection strategy, which includes wearing a wide-brim hat, sunglasses, and long-sleeved shirts and pants.
Source: "Reduced Melanoma After Regular Sunscreen Use: Randomized Trial Follow-Up." Adèle C. Green, et al. Journal of Clinical Oncology, Vol. 29 no. 3, pp 257-263 (2011).
According to a recently published article in the Archives of Dermatology indoor tanning qualifies as an addiction.
The study surveyed University of Albany, in Albany, NY, college students. Of the 229 responders who have used tanning beds, 39.3% met the criteria for addiction. Those that were considered addicted to tanning showed classic signs of addiction - several unsuccessful attempts to completely stop or cut back on tanning; feeling annoyed when they were told they should stop; and skipping work, school or other scheduled activities to go to the tanning salon.
Slightly of two-thirds of the study participants were female.
According to a study published in the March issue of the Archive of Dermatology, the rate of non-melanoma skin cancer in the U.S. is reaching epidemic proportions, with more than two million people affected in 2006.
In that year, an estimated 3,507,693 cases of non-melanoma skin cancer were treated, affecting 2,152,500 people according to Howard Rogers, MD, PhD, of Advanced Dermatology in Norwich, Conn., and colleagues.
But between 2002 and 2006, Rogers and colleagues found that the number of procedures for nonmelanoma skin cancer per affected person increased 1.5% and the number of people who had at least one procedure increased by 14.3%.
"There is an epidemic of nonmelanoma skin cancer in the U.S.," they wrote, adding that "educational programs emphasizing sun protection have mainly been disappointing in slowing skin cancer rates."
"This is only going to get worse," said Dr. Suephy Chen, an associate professor of dermatology at Emory University School of Medicine in Atlanta told Fox47. "Our population is aging. Those people who grew up in the 1970s and 1980s when there was not a big sun-protection message out there are now coming into their 50s and 60s and are starting to develop skin cancers."
To lessen your chances of getting skin cancer, dermatologists recommend applying broad-spectrum sunscreen liberally and often; wearing hats and other protective clothing when out in the sun; avoiding sun exposure when the sun's rays are the strongest -- between 10 a.m. and 3 p.m. -- and never using tanning beds. This advice is especially useful in the upcoming summer months.
It's especially important to take these steps with children and teens, Rogers said. Skin cancer is turning up in younger and younger patients. In the past week or so, he removed non-melanoma cancer off the cheek of a 17-year-old boy and removed a melanoma from an 18-year-old girl.
Being diagnosed with skin cancer is different for everyone, but reading about how other people have coped may help you.
About.com's Guide to Cancer has created a space for you to share your story with others. Be sure to check there frequently to see when others have posted their stories.
The drug, which targets a specific gene mutation that drives cancer growth, has been shown to shrink tumors by more than 30% in 9 of the 16 melanoma patients in the phase 1 trial. However, it will take much more research before this treatment option is widely available.
You can read more about the specific outcomes of the PLX4032 trial in this Medical News Today article.
According to a new study, published in the Feb. 15 online issue of the Archives of Dermatology, prolonged use of non-steroidal anti-inflammatory drugs (NSAID's) such as aspirin, ibuprofen, and celecoxib offers no protection against skin cancer.
Researchers at Kaiser Permanente Northern California compared the medical records of 415 patients between the ages 43-85, diagnosed with squamous cell carcinoma in 2004 to 415 patients of similar age, race, sex and gender with no history of cancer.
Participants were required to provide information about their NSAID use 10 years prior to the study. Sixty-one percent of participants reported regular use of NSAID pain relievers.
The results of the study revealed that irrespective of type of drug used or the dosage taken the NSAID's did not reduce the risk of skin cancer.
A new book is claiming that former President Franklin D. Roosevelt died of a tumor caused by melanoma. The book, titled "FDR's Deadly Secret," was written by New York Post associate editorial page editor Eric Fettman and Dr. Steven Lomazow.
According to the authors, Roosevelt had a cancerous lesion above his left eyebrow, which metastasized and caused a tumor that lead to his death in 1945. They reached this conclusion after examining many photographs of the lesion, as well as other evidence.
The Post has more details on the book and FDR's health.
PLX4032 is designed to block a mutated form of a gene called BRAF, which is found in about half of all melanoma tumors. This new study showed that 64% of 22 patients who took PLX4032 showed at least some tumor shrinkage, which is much higher than the results typically seen with chemotherapy. That's especially impressive considering that these patients were really sick: all had failed previous therapies, either chemotherapy or treatment with interleukin-2, as well as surgery. The lead researcher said, "We are seeing some pretty dramatic and rapid responses, and they are occurring in sites where we rarely see responses to chemotherapy, such as in the bone."
These are indeed potentially exciting results, but a reality check is needed to curb any "irrational exuberance" (as Alan Greenspan would say!). This was a very small (27 patients), unblinded, early-stage study done at a single hospital (Memorial Sloan-Kettering in New York). This makes it inherently less convincing than a larger, double-blinded, multi-institution, placebo-controlled study -- all characteristics of larger clinical trials that are designed to minimize potential biases and distinguish between what's due to random chance and what's real. Unfortunately, most phase I trials like this one end in failure and the drug is never approved.
So, cautious optimism is warranted for PLX4032; thinking that it's a "cure" is not. Let's hope that it will prove to be a real breakthrough for patients that desperately need one.