Fact or Fiction: Educating skin cancer survivors on risks of tanning bed use could reduce recurrence of melanoma.
Well… it depends on the individual. For more than 20% of skin cancer survivors, the desire to maintain a killer tan overrides the known dangers of tanning bed use and overexposure to sunlight without sunscreen. According to an article published on MDLinx, “Some melanoma survivors still use tanning beds, skip sunscreen,”it’s important to understand that melanoma, although the least common type of skin cancer, is the most dangerous, claiming over 9,000 American lives annually. While the majority of melanoma survivors educate themselves and take precautionary measures to protect themselves from recurrence, reportedly over 20% do not.
Major risk factors for melanoma include:
- Overexposure to ultraviolet (UV) light, commonly due to sunlight and tanning beds/lamps on unprotected skin
- Fair skin and Freckles
- Immune suppression
At the most recent annual meeting of the American Association for Cancer Research, a study found that 27% of melanoma survivors still do not use sunscreen, 15% rarely stayed in the shade when outdoors and 2% still use tanning beds.
Many medical professionals find it disturbing that after surviving skin cancer, patients continue their pre-cancer perilous behavior by not implementing the recommended skin protection practices and ignoring the risk of recurrence. Tthere is clearly a need for more effective intervention and education on the part of healthcare providers to reduce the use of tanning beds/lamps and exposure to the sunlight, especially when educating patients who have already survived a bout with skin cancer. The question remains: Can better outcomes be achieved in time to save lives?
Find more articles about skin cancer at mdlinx.com/oncology:
Cervical cancer screening: What’s new and what’s coming?
Cleveland Clinic Journal of Medicine, 03/19/2013
JIN X.W. et al.- In their 2012 guidelines for cervical cancer screening, several organizations call for less-frequent but more-effective screening that incorporates testing for human papillomavirus (HPV). This article will review the newest screening guidelines and the evidence supporting these recommendations for primary care providers. They also review the potential role of novel biomarkers, newer HPV tests, and possible future strategies for cervical cancer screening. Advances in our understanding of the pathogenesis of cervical cancer, new tests for human papillomavirus (HPV), and the development of HPV vaccines in the last decade are transforming the way we screen for cervical cancer. As a result, screening guidelines are evolving rapidly, requiring clinicians to keep up-to-date with the evidence and rationales supporting the latest guidelines to properly convey best practices to patients.
- The new guidelines still recommend starting screening with cytologic (Papanicolaou) testing at age 21, but now recommend repeating the test less often, ie, every 3 years rather than every 2 years for women age 21 to 29.
- Women age 30 and older who are screened by combined cytologic and HPV testing should be rescreened every 5 years if both tests are negative (instead of every 3 years, as previously recommended). Alternatively, they can be screened by cytology alone every 3 years.
- We can stop screening women at age 65 if they have had adequate screening until then and no history of cervical intraepithelial neoplasia grade 2 or worse (CIN2+) in the past 20 years. Once screening is discontinued, it should not resume, even if the patient has a new sexual partner.
- Screening should not change after HPV vaccination.
- When women have negative cytology but positive HPV results, tests for the HPV 16 and 18 genotypes can help to identify those at higher risk of developing CIN2+.
- These guidelines apply to the general population only. They do not apply to women at high risk who may require more intensive screening, such as those who have a history of cervical cancer, are immunocompromised (eg, positive for human immunodeficiency virus [HIV]), or were exposed in utero to diethylstilbestrol.
Risk factors for second screen-detected or interval breast cancers in women with a personal history of breast cancer participating in mammography screening
Cancer Epidemiology, Biomarkers & Prevention, 03/25/2013 Clinical Article
Read more: http://www.mdlinx.com/oncology/news-article.cfm/4527459/
Houssami N et al. – Our models identify risk factors for interval second BC in PHBC women.
- Screening mammograms from women with history of early-stage BC at Breast Cancer Surveillance Consortium-affiliated facilities(1996-2008) were examined. Associations between woman-level, screen-level, and first-cancer variables and the probability of a second BC were modeled using multinomial logistic regression for three outcomes (screen-detected invasive BC, interval invasive BC, or DCIS) relative to no second BC.
Is it an effective method for screening for Prostate Cancer?
Prostate Cancer is the most frequently diagnosed cancer in men and one of the leading causes of cancer related deaths. According to The American Cancer Society about 238,590 new cases of prostate cancer will be diagnosed and about 29,720 men will die of prostate cancer in 2013. It’s primarily detected in men over the age of 40 and it is the second leading cause of cancer-related death in African American men. Although prostate cancer is an extremely life-threatening disease, the survival rate is over 90%. The most commonly used screenings for Prostate Cancer are: Digital rectal exam (DRE) and Prostatic Specific Antigen (PSA) testing. A PSA test measures the blood level of PSA, which is a protein produces by the prostate gland. Since the 1980’s doctors have been using this test to screen men between the ages of 40-75 for prostate cancer.
Recently many professional organizations are beginning to question the effectiveness of PSA testing. They feel the benefits of the screening do not outweigh the risks. When higher PSA levels are detected, it alerts doctors that cancer may be present. “False positives” are common with PSA test and many times the tumors detected by PSA screening may not develop into life threatening tumors. There are also situations when PSA test produce “false negatives” due to rapidly growing prostate cancers not producing sufficient PSA.
Men who choose to be treated (better safe than sorry) and undergo one of many Prostate Cancer treatments are exposed to side-effects such as: Urinary dysfunction, Bowel dysfunction, erectile dysfunction, hormonal changes and infertility that can last up to 10 years after treatment. The severity of the side-effects depends significantly on the individual and his state of health.
Although controversial for “over diagnosis” and “overtreatment”, “diagnosis and treatment of prostate cancer were radically improved after the discovery of the prostatic-specific antigen”, as noted in the MDLinx article on “screening for Prostate Cancer”. Currently most insurance companies as well as Medicare will cover annual PSA screenings. If a PSA screening detects elevates PSA levels, it’s important to get a biopsy done before starting treatment to accurately determine whether or not Prostate Cancer is evident. Researchers are currently trying to improve the PSA Test. To learn more about the developments in PSA testing visit http://www.mdlinx.com/oncology/.
Interesting article addressing this question is now available as "Full Free Text" from Clin Cancer Res Published OnlineFirst April 29, 2011.
Original summary on MDLinx:
Holdhoff M et al. –Mutant tumor-specific DNA can be detected beyond the visible tumor margin, but never beyond 4 mm, even in patients whose tumors were larger prior to chemotherapy. These data provide a rational basis for determining the extent of surgical excision required in patients undergoing resection of liver metastases.
- Evaluated 88 samples of tumor margins from 12 patients with metastatic colon cancer who each underwent partial hepatectomy of one to 6 liver metastases
- Punch biopsies of surrounding liver tissue obtained at 4, 8, 12 and 16 mm from the tumor border
- DNA from these biopsies analyzed by sensitive PCR-based technique, called BEAMing, for mutations of KRAS, PIK3CA, APC, or TP53 identified in corresponding tumor
- Mutations were identified in each patient's resected tumor and used to analyze the 88 samples circumscribing the tumor-normal border
- Tumor-specific mutant DNA was detectable in surrounding liver tissue in five of these 88 samples, all within 4 mm of the tumor border
- Biopsies 8, 12, and 16 mm from macroscopic visible margin were devoid of detectable mutant tumor DNA as well as of microscopically visible cancer cells
- Tumors with significant radiologic response to chemotherapy were not associated with any increase in mutant tumor DNA in beyond 4 mm of main tumor
Read the full article here