Self-Detection Not As Effective As Physician Screening For Spotting Melanoma Early

The Star-Ledger (7/19, Livio) reports that “even high-risk patients have a better chance of beating skin cancer the sooner they see a dermatologist. While the researchers noted many people know enough about the dangers of skin cancer to check their skin periodically, physicians are much better at noticing subtle changes.”

HealthDay (7/18, Dallas) reported, “Melanoma, the most dangerous type of skin cancer, can be found by patients themselves, but new research reveals that self-detection is not as effective as screenings performed by doctors,” according to a study published online July 18 in the Archives of Dermatology. For the study, researchers “found that in addition to higher rates of physician-detected melanomas, doctors also are more likely to detect thinner lesions, or cancers in the earliest stages.”

MedPage Today (7/18, Bankhead) reported that, in a review identifying 527 melanomas detected in 394 patients over the course of a decade, “dermatologists identified 76% of more than 500 primary melanomas, including 84% of lesions in established patients.” Notably, “dermatologists detected almost 80% of in-situ lesions, and the clinician-identified lesions were 40% thinner than patient-detected melanomas.” Nevertheless, the study authors emphasized that self-examination by patients is critical to diagnosing melanomas early. They concluded that “educating patients on recognizing melanoma signs and symptoms by performing skin self-examination can have a notable impact on early diagnosis of melanoma.”


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Heart Transplant Patients At Increased Risk For Skin Cancer

Heart transplant patients are 4 to 30 times as likely to develop skin cancer as healthy people, depending on where they live and other factors,” according to a study published June 30 in the American Journal of Transplantation. The study also found that patients who live nearer the equator and have fairer skin are the most likely to suffer skin cancers and to die from them.  Among those patients, the team identified 228 cases of basal cell carcinoma (3.6% of patients), 289 cases of squamous cell carcinoma (4.6%), 22 cases of melanoma (0.003%) and six cases of other skin cancers (0.001%).”

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Treating Skin Cancer With Mohs Surgery

Mohs surgery has come to be accepted as the single most effective technique for removing Basal Cell Carcinoma and Squamous Cell Carcinoma (BCCs and SCCs), the two most common skin cancers. It accomplishes the nifty trick of sparing the greatest amount of healthy tissue while also most completely expunging cancer cells; cure rates for BCC and SCC are an unparalleled 98 percent or higher with Mohs, significantly better than the rates for standard excision or any other accepted method.
The reason for the technique’s success is its simple elegance. Mohs differs from other techniques in that microscopic examination of all excised tissues occurs during rather than after the surgery, thereby eliminating the need to “estimate” how far out or deep the roots of the skin cancer go. This allows the Mohs surgeon to remove all of the cancer cells while sparing as much normal tissue as possible. The procedure entails removing one thin layer of tissue at a time; as each layer is removed, its margins are studied under a microscope for the presence of cancer cells. If the margins are cancer-free, the surgery is ended. If not, more tissue is removed, and the procedure is repeated until the margins of the final tissue sample examined are clear of cancer. In this way, Mohs surgery eliminates the guesswork in skin cancer removal, producing the best therapeutic and cosmetic results.

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