Managing melanoma, early detection could save your life

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It is a cancer typically originating in melanocytes, a specialised skin cell that produces the protective skin-darkening pigment melanin. While most commonly associated with skin, melanoma is not only a skin disease and can occur anywhere in the body, including in the internal organs.

Advanced melanoma is the fourth stage of melanoma also known as metastatic or advanced melanoma, where the cancer has spread from where it originated to other parts of the body. International research indicates that up to 12% of patients who develop melanoma will progress to develop advanced melanoma.

While melanoma is the most deadly form of skin cancer, a greater insight into the immune system has led to a broadening of the treatment options available. In light of these facts and World Cancer Day coming up on the 4th of February, Bristol-Myers Squibb, would like to shed some light on the disease and assist with creating awareness and education, encouraging an earlier diagnosis.

Most at risk

• People who have a family history of melanoma and atypical moles (with irregular borders, or varying colour and asymmetrical) are more likely to develop into a melanoma.
  
• People who have more than 50 ordinary moles
  
• Those with fair hair and skin, freckles and light coloured eyes, therefore white men are three times more likely to develop melanoma than black men are
  
• People who have had one or more severe cases of sunburn as a child or teenager
  
• People who use a sun-bed frequently
  
• Those with weakened immune systems from other cancers, drugs or HIV/AIDS

Dr Daniel Vorobiof, a medical oncologist and director of the Sandton Oncology Centre, believes that early detection of melanoma is critical. "Skin cancers found and removed early are almost always curable. It is therefore critical that patients consult a dermatologist regarding any skin growth that itches, increases in size or thickness or changes in shape, texture or colour.

"Advanced melanoma is difficult to treat and in most instances it cannot be cured; however there are treatments which can slow its progression. Depending on the patient's condition, the advanced disease in some instances it is treated with chemotherapy combinations, while radiotherapy and surgery are also important therapeutic approaches and considered depending on the melanoma site and number and characteristics of the lesions."

New hope

"In the past decade, we have seen a broadening of treatment options for this stage of the disease. These include immunotherapy treatment options, which have had incredible life-changing results in certain patients with inoperable or metastatic melanoma who have been non-responsive to prior therapy.

Immunotherapy treatment options, some of which are now available in South Africa, do not directly target tumours like traditional chemotherapy but rather help the body's own immune system to attack melanoma cells. They do this by lifting the 'braking' mechanisms that slow down and stop immune responses. These 'brakes' are a necessary part of a healthy immune system, but they may also slow down an immune response before a cancer has been destroyed.

"Immunotherapy drugs are administered intravenously over a period of a few weeks. Some patients have immune pathways that are more sensitive and therefore obtain quicker and prolonged benefits from this treatment.

"It is important to stress that not all patients respond to immunotherapy and it is just not possible to predict who will respond. Each cancer patient's journey and body is different and therefore each treatment plan should be tailored accordingly. In the future, and depending on the results of currently ongoing clinical trials, it might become possible to treat patients at earlier stages in order to prevent progression into a more advanced disease," concludes Dr Vorobiof.

For more information, go to www.melanoma.co.za