Scientists Uncover Gene Variation Linked to Melanoma

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1 in 20 Cases of Melanoma Linked to Tanning Beds: Study

HealthDay – 6 mins ago TUESDAY, July 24 (HealthDay News) -- Those who bronze themselves in tanning beds face a 20 percent increased risk of skin cancer, and that raised risk reaches 87 percent if they start before they are 35 years old, new research indicates.

The European study also estimates that one in every 20 cases (5.4 percent) of the most lethal form of skin cancer, melanoma, can be attributed to tanning bed use.

"Indoor UV tanning devices are real carcinogenic devices, and people should be advised not to attend indoor tanning parlors or to buy them for private use," said lead researcher Philippe Autier, director of the International Prevention Research Institute in Lyon, France.

The U.S. Food and Drug Administration is considering a ban on tanning beds for anyone under the age of 18. Bans are already in place in Brazil and New South Wales and the idea is gaining popularity in France, Autier said.

Study co-author Mathieu Boniol, who is also from the International Prevention Research Institute, added that "as the use of these devices produces no positive effect to health, it is now in the hands of policy makers to decide how to manage, minimize or remove this risk."

The report was published online July 24 in the BMJ.

To determine the relationship between tanning beds and skin cancer, the researchers analyzed 27 studies published between 1981 and 2012. In all, they identified more than 11,000 cases of skin cancer.

This process, called a meta-analysis, attempts to find patterns across several studies to uncover connections between unrelated research.

By pooling the data, the researchers found a 20 percent increased risk of developing cancer for people who regularly used tanning beds, compared to people who never used the devices. The risk rose to 87 percent if one started tanning before 35, and increased almost 2 percent for each additional tanning session noted per year.

Of the almost 64,000 new cases of melanoma in Western Europe each year, more than 3,400 can be blamed on tanning bed use, the researchers calculated. Tanning bed use is also estimated to cause 800 deaths from this deadly cancer annually, the team added.

Since the use of tanning beds is relatively new and there is need for more research, the risk might be even greater, the researchers noted.

Dr. Jeffrey C. Salomon, an assistant clinical professor of plastic surgery at Yale University School of Medicine, said that "this study validates the previous studies and adds new risks to the ever growing knowledge of the downside of tanning beds."

Parents should not only be concerned about their children using tanning beds, they should avoid using these devices themselves, he said.

"Tanning beds are worse than the sun for risk of melanoma based on these results," Salomon said. "The risks from tanning beds are real, the untoward results can be dire, and the ultimate solution may require total prohibition."

Not everyone agrees, however. John Overstreet, executive director of the industry group the Indoor Tanning Association, took exception to the findings.

One cannot compare tanning in Europe to the United States, he said. "Commercial tanning salons in the United States are a different matter altogether," he said.

"The United States Food and Drug Administration has conducted tests to determine the amount of ultraviolet radiation required to burn persons with a variety of different skin types, and requires that all tanning equipment used in the United States carry labels specifying the recommended exposure times for each skin type, which have been calculated to prevent burning," Overstreet explained.

Enforcement of the FDA recommendations is left to the individual states, he noted.

"Most states have strict enforcement, requiring on-site records to be kept of each customer session listing name, date of session, skin type, type of equipment used, and length of exposure, so that state inspectors can assure compliance with regulations. Burning of customers in these states is virtually nonexistent," Overstreet said.

More information

For more information on melanoma, visit the U.S. National Cancer Institute.

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New Guidelines Issued for Biopsy Use in Melanoma Patients

HealthDay – 4 hrs ago MONDAY, July 9 (HealthDay News) -- Sentinel lymph node biopsy -- a minimally invasive surgical technique that lets doctors see whether cancer has spread -- should be performed on patients with melanoma tumors of intermediate thickness and may also be appropriate for thick melanoma tumors, according to new guidelines released Monday.

The American Society of Clinical Oncology (ASCO) and the Society for Surgical Oncology issued the evidence-based recommendations to clarify the use of this type of biopsy, which they said has been inconsistent.

A sentinel lymph node is the first lymph node to which cancer cells are most likely to spread from the original tumor, according to the U.S. National Cancer Institute. There can be more than one sentinel lymph node. During a biopsy, the node is identified, removed and examined for cancer cells.

"When used for the right patients at the right time, sentinel lymph node biopsy is one of our best tools for personalizing melanoma treatment, and for sparing patients from unnecessary procedures or therapies," study lead author Dr. Sandra Wong, co-chair of the guideline panel and an assistant professor of surgery at the University of Michigan, said in an ASCO news release.

The panel of 14 clinical and methodological experts from various disciplines reviewed 73 studies, involving 25,000 patients, that were published over the past two decades. After examining this evidence, the panel made the following recommendations:

The procedure is recommended for all patients with melanoma tumors between 1 millimeter (mm) and 4 mm (intermediate thickness). Sentinel lymph node biopsy detects cancer in the sentinel node in about 18 percent to 26 percent of these patients, the panel noted. Sentinel lymph node biopsy may be beneficial to patients with melanoma tumors greater than 4 mm ("thick"). The panel noted, however, that few studies focus on the use of the biopsy in patients with thick melanomas. The panel found there is not enough evidence to recommend routine sentinel lymph node biopsy for patients with melanoma tumors less than 1 mm ("thin"). The experts added that thin melanomas can usually be cured through surgical removal of the primary tumor. However, the biopsy could be considered in patients with thin melanoma who have certain high-risk factors, such as rapidly dividing cancer cells.

Patients with a positive sentinel lymph node biopsy should undergo complete removal of the remaining lymph nodes, the experts added. This procedure has been shown to prevent the spread of cancer.

The panel also advised doctors to discuss sentinel lymph node biopsy, particularly the procedure's potential risks and benefits, with their patients as part of the treatment-planning process.

"Our rapidly growing understanding of the biology of melanoma is driving development of more effective treatments with fewer side effects for patients," panel co-chair Dr. Gary Lyman, a professor of medicine and director of comparative effectiveness and outcomes research at Duke University School of Medicine and the Duke Cancer Institute, said in the news release.

"But to take advantage of this progress, we need to know the true extent of the disease from the start. This guideline will help ensure that sentinel lymph node biopsy is used appropriately whenever it can provide that vital information while avoiding unnecessary procedures in patients who are unlikely to benefit."

Information on the guidelines was published online by ASCO.

More information

The U.S. National Cancer Institute has more about melanoma.

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GSK melanoma drugs may steal market from Roche

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Melanoma a Big Threat to Older Men

HealthDay – Fri, May 18, 2012 FRIDAY, May 18 (HealthDay News) -- Older men have an increased risk of developing melanoma, but most are careless about sun protection and do not know how to properly check themselves for signs of skin cancer, a new survey reveals.

This is particularly worrisome because nearly 132,000 new cases of melanoma will be diagnosed in 2012, according to the American Academy of Dermatology, which conducted the online poll.

"This survey demonstrates that many men do not protect themselves from the sun when outdoors and that some still believe that sun exposure is good for their health. This is a very troubling combination in light of the fact that the major risk factor for melanoma is exposure to ultraviolet light," dermatologist Dr. Thomas Rohrer, a clinical associate professor of dermatology at Brown University School of Medicine, said in an academy news release.

Just 29 percent of men report always protecting their skin outside, the national survey showed. Meanwhile, 43 percent of women take the necessary precautions.

Moreover, 39 percent of men said they preferred to simply enjoy the sun and not worry about how to protect themselves from its harmful rays, compared with 28 percent of women.

Although 59 percent of women said they know how to examine their own skin for signs of cancer, the study also showed that just 46 percent of the men surveyed knew how this should be done.

"Men need to examine their skin and see a dermatologist if they spot anything changing, bleeding or growing," Rohrer said.

Fortunately, the researchers noted, the five-year survival rate for people whose melanoma is diagnosed and treated before it spreads to the lymph nodes is 98 percent.

"The survey results should serve as a wake-up call to men to be vigilant about protecting their skin from sun exposure and examining their skin regularly for skin cancer," Rohrer concluded. "Loved ones can assist by examining their partners' skin and noting anything suspicious. These exams are vital since the early detection of skin cancer helps save lives."

The academy is distributing public service announcements to television, cable and radio stations nationwide to help raise awareness on how people can protect themselves from skin cancer.

More information

The American Cancer Society has more about skin cancer.

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Two-Drug Combo May Be Safe for Melanoma Treatment

HealthDay – 45 mins ago WEDNESDAY, May 16 (HealthDay News) -- A preliminary, first-stage study funded by a pharmaceutical company shows promising results for an experimental double-drug therapy for melanoma.

The two drugs, known as dabrafenib and trametinib, appeared to delay progression of the potentially deadly skin cancer with fewer side effects than an existing drug called vemurafenib (Zelboraf).

However, the research into the drug combination is only in the first of three phases required before the U.S. government can approve its use. The first phase is designed to test the safety of a medication, not whether it works.

Unlike some other cancers, melanoma has stubbornly resisted advances in treatment. About 70,000 Americans are diagnosed with melanoma each year, and about 8,000 of those will die from the disease.

Researchers tested the drug combo in patients with advanced melanoma and a genetic mutation that exists in about half of all melanomas.

"Not only are the two drugs causing shrinkage of the cancer, but we're seeing that a second anti-cancer therapy may actually suppress the side effects of the first," said Dr. Jeffrey Weber, director of the Donald A. Adam Comprehensive Melanoma Research Center at the H. Lee Moffitt Cancer Center, Tampa, Fla., in a news release from the American Society of Clinical Oncologists.

Vemurafenib, approved last year, aims to prevent progression of the cancer in these patients. But patients' tumors eventually become immune to its effects.

The new analysis looks at 77 patients who took the combination therapy. Their cancer didn't progress for an average of 7.4 months, similar to what was seen in previous research with vemurafenib only. The researchers haven't released statistics about their survival rates.

Skin lesions, a side effect, were much less common in the patients on the combination therapy than in patients who took vemurafenib.

Ashani Weeraratna, an assistant professor in the Molecular and Cellular Oncogenesis Program at the Wistar Institute, Philadelphia, agreed that the combo therapy does seem to reduce the skin lesion side effects.

"This is important for patients that, in addition to battling a deadly disease, also have to deal with the discomfort associated with the secondary lesions," Weeraratna said. "Having said that, I do think most of us would pick getting what is essentially an uncomfortable rash over not receiving a cutting-edge therapy that might eradicate our metastatic melanoma."

Dr. Martin Weinstock, a professor of dermatology and epidemiology at Brown University in Providence, R.I., expressed some caution. "Ideally, what we need is to figure out how to cure most people with a regimen that doesn't have devastating side effects," he said. "We don't have that yet, and it doesn't look like this will be that either."

The results were scheduled for release Wednesday, prior to presentation June 4 at a meeting of the American Society of Clinical Oncologists in Chicago. The data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

The study was funded by the drug company GlaxoSmithKline, and Weber has received financial support from the pharmaceutical company.

More information

For more about melanoma, see the U.S. National Library of Medicine.

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Melanoma Rates On the Rise Among Young Adults: Study

HealthDay – 1 hr 44 mins ago SUNDAY, April 1 (HealthDay News) -- New research highlights a dramatic increase in the rates of melanoma, a potentially fatal form of skin cancer, among young adults, with young women being hit the hardest.

According to the study, the incidence of melanoma increased eightfold among young women and fourfold among young men from 1970 through 2009.

The findings come from a population-based study by Mayo Clinic researchers using records from the Rochester Epidemiology Project, a decades-long database of all patient care in Olmsted County, Minn. The researchers looked for first-time diagnoses of melanoma in patients 18 to 39 from 1970 to 2009.

Dermatologists said these findings mirror what they are seeing in their own practices.

And the study researchers pointed to the rise in the use of indoor tanning beds as one of the main reasons behind the trend, but childhood sunburns and ultraviolet (UV) exposure in adulthood may also contribute to melanoma risk. The findings appear in the April issue of Mayo Clinic Proceedings.

Although the rates of melanoma have increased, the study did show that fewer people are dying from skin cancer. Researchers credit early detection of skin cancer and prompt medical care for the improved survival rates.

"People are now more aware of their skin and of the need to see a doctor when they see changes," Mayo Clinic dermatologist Dr. Jerry Brewer said in a statement. "As a result, many cases may be caught before the cancer advances to a deep melanoma, which is harder to treat."

Dr. Jennifer Stein, an assistant professor at the Ronald O. Perelman department of dermatology at the NYU Langone Medical Center in New York City, said that she is seeing a lot of young people, especially young women, with melanoma.

"Skin cancer awareness is up, and even though there is lots of information about the dangers of tanning beds, people still use them," Stein said.

Other risks for melanoma include a family or personal history of melanoma and large numbers of unusual looking moles. "People who have had a melanoma are at higher risk for having another," she said. "It is important to check your own skin at home and come in to see a skin doctor if you ever see anything you are worried about it."

How can you tell? Look for moles that follow the ABCD rule, said Dr. Alicia Terando, a surgical oncologist at Ohio State University's James Cancer Hospital in Columbus. "'A' stands for asymmetry, meaning that one half of the mole is a different size than the other. 'B' is for border irregularity. 'C' stands for color. Melanomas are often brown, tan and black. The 'D' is for diameter. Most melanomas are greater than 6 millimeters in size. "A melanoma is the mole that stands out," she said. "It's the ugly duckling."

"Prevention is also important," Stein said. "Take precautions when in the sun, including wearing a wide-brimmed hat, sun-protective clothing and applying and reapplying sunscreen that protects against UVA and UVB rays."

Dr. Kavita Mariwalla, director of Mohs and Dermatological Surgery at Beth Israel Medical Center in New York City, is concerned about the rising rates of skin cancer in young women.

"People know they should wear sunscreen and should not get burned, but there is a disconnect between that and tanning bed use," Mariwalla said. Tans are also being glamorized on reality shows like "Jersey Shore," she added.

As it stands, 36 states restrict indoor tanning use by minors. California became the first state to prohibit the use of indoor tanning devices for everyone under the age of 18, and many other states are considering such bans, according to the American Academy of Dermatology.

John Overstreet, executive director of the Indoor Tanning Association, a trade group based in Washington, D.C., said that indoor tanning bed use shouldn't be singled out as a cause for the rise in skin cancer rates.

"The study itself has almost nothing to do with indoor tanning and the links they cite to indoor tanning are nothing but speculation," he said. "They attempt to make indoor tanning the story while ignoring other possible risk factors such as sunburning outdoors, sunscreens that for several decades did not block UVA, the more deeply penetrating ultraviolet wavelength, and more frequent travel to sunny vacations locations over the last decade where severe sunburns are more likely to occur."

More information

Learn more about melanoma at the U.S. National Cancer Institute.

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Study Reveals Trigger That May Speed Melanoma Growth

HealthDay – 39 mins ago WEDNESDAY, March 28 (HealthDay News) -- Growth of the deadly skin cancer melanoma may be triggered by the immune system turning on itself, according to a new study that also identified the mechanism that causes this to happen.

Melanoma accounts for only about 5 percent of skin cancers, but is the cause of most skin cancer deaths, American Cancer Society statistics indicate. The disease is often curable in its early stages but is difficult to treat once it has spread invasively, the authors of the new study noted.

The study, published in the current edition of the journal Science Translational Medicine, focused on a specific immune-inhibiting molecule called B7-H1 in melanoma tumors.

In patients with tumors that expressed B7-H1, suppression of the inflammatory immune response sped the growth and increased the aggressiveness of their tumors, the researchers from Yale School of Medicine and Johns Hopkins Medical Institutions found.

The investigators also found that tumor cells somehow use a component of the immune system itself (interferon gamma) to turn on B7-H1 and suppress the immune system.

"We were surprised to find that aggressive tumors can not only escape or hide from infiltrating immune cells, but can go on the attack -- using interferon gamma as a weapon against the immune system," lead author Dr. Lieping Chen, a professor of immunobiology at Yale School of Medicine and director of the cancer immunology program at Yale Cancer Center, said in a Yale news release.

This mechanism may be responsible for immune suppression and tumor growth in up to 40 percent of melanoma patients, Chen said. The finding may make it possible to develop therapies that block this immune-suppressing ability, he added.

More information

The American Cancer Society has more about melanoma.

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