December 29, 2011
It’s no surprise that a new study has found that among both new and established patients, dermatologists are better, overall, at detecting melanomas. I should hope so! After all, they are trained professionals. But more interestingly, the research also found that "established" patients -- those who had been seeing a dermatologist for at least three months -- were just as good as their dermatologists at detecting thin (early-stage) melanomas, in particular. That’s hopeful news, since early detection can make all the difference with this aggressive type of cancer.
At Memorial Sloan-Kettering Cancer Center’s Pigmented Lesion Clinic (PLC) in New York City, researchers reviewed 394 patient records dated from January 1998 to December 2008, which included men and women ages 17 to 91 (average age about 62). The PLC sees patients at high risk for melanoma. Patients are given total body skin exams at least annually and are also given brochures and a personal lesson on how to perform a skin self-exam. The researchers split the patients into two groups: New and established. Then they compared melanoma detection by dermatologists with detection by each group of patients.
Overall, the majority of melanomas (63% to 82%) were missed by patients and discovered by dermatologists during office exams. But there was one area, in particular, where certain patients did measure up -- which provides a glimmer of hope. Established patients (those who were taught how to inspect their own skin and did) were just as successful as their dermatologists in detecting thin, early-stage melanomas (lesions less than 1 millimeter thick). So learning how to perform a proper self-exam certainly isn’t useless information. These study results appeared in the July 18, 2011, edition of the Archives of Dermatology.
To find out more, I called Stephen Dusza, DrPH, a research epidemiologist and member of Memorial Sloan-Kettering’s Melanoma Disease Management Team and a coauthor of the study.
THE SKINNY ON SKIN CANCER
The fact that established patients were able to detect thin melanomas just as well as dermatologists is wonderful news, said Dr. Dusza, because the survival rate for melanoma is much higher -- 95% -- when lesions are detected at that stage. In contrast, with lesions detected at 1.01 mm to 2.00 mm, five-year survival is about 88%... and at greater than 4 millimeters thick, the survival rate is only about 57%. In other words, with guidance from our dermatologists and by practicing self-exams, we can become more skilled at detecting thin melanomas -- and catching them at their earliest, most beatable stage.
The bottom line is that both physician screening and self-examination are essential and work in concert, said Dr. Dusza. So ask your dermatologist to teach you how to perform a thorough skin exam that looks specifically for thin lesions. And make sure that you also visit him or her at least once a year (more often if you’re at high risk for skin cancer), since you can’t see your whole body. For more information on how to do a skin exam, check out Daily Health News, July 12, 2007.
Source:
Stephen Dusza, DrPH, research epidemiologist, Melanoma Disease Management Team, Memorial Sloan-Kettering Cancer Center (MSKCC), New York City.
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