New Melanoma Diagnostic Techniques Provide Better Treatment for Patients

Melanoma is the most aggressive form of skin cancer. With early detection and prompt treatment, it is highly curable. Once the disease spreads, it can be difficult to control and potentially lethal. In fact, melanoma accounts for less than 5 percent of all skin cancer cases in the United States, but causes more than 75 percent of all skin cancer-related deaths, according to the American Cancer Society (ACS).

"Melanoma has been a tough nut to crack, but we are making progress," said melanoma expert Mohammed Kashani-Sabet, M.D. A physician and researcher, he directs California Pacific Medical Center’s Center for Melanoma Research and Treatment. "For the first time, there is real promise that individualized approaches are going to offer physicians and their patients better ways to manage this disease."

Moving away from one-size-fits-all treatments, researchers are focusing on molecular medicine to make strides against melanoma. Using genetic maps, they’re working to develop and test more refined strategies for diagnosis, prevention and treatment. Dr. Kashani-Sabet and his colleagues at California Pacific are among those on the forefront, improving melanoma care through collaboration and meeting the challenges inherent in medicine with ingenuity.

Challenges
"Diagnosing melanoma can be very tricky," says Dr. Kashani-Sabet. When a doctor removes a suspicious mole, a pathologist examines the tissue to determine whether it is malignant or a benign growth. That decision isn’t always clear.

"Harmless moles and early melanoma tumors can look similar under the microscope," explains Dr. Kashani-Sabet. "It is not uncommon to have several pathologists rendering different opinions."

Because malignant melanoma is one of the most difficult cancers to treat successfully once it has started to spread, a delayed or missed diagnosis directly affects the person’s chances of survival.

Ingenuity
A new diagnostic technique developed by Dr. Kashani-Sabet and his colleagues could aid in the diagnosis of malignant melanoma. Using gene chip analysis, they discovered that melanomas express certain genes in higher levels than harmless moles. The researchers then developed and tested a multi-marker assay to distinguish between the two lesions. In 2009, the Proceedings of the National Academy of Sciences published their findings. These five markers were accurate in the diagnosis of skin lesions about 92 percent of the time.

In a separate study led by Dr.Kashani-Sabet, researchers explored the use of three different molecular markers to determine the severity of melanoma. According to the study’s findings, published in the journal Clinical Cancer Research, the assay helped predict the patient’s chances of recovery.

"Knowing the severity of a tumor affects treatment decisions. The information helps physicians to identify the sickest patients – those who are at high risk of death," continues Dr. Kashani-Sabet. "If we know how aggressive the melanoma is, we’ll know who would be a candidate for the most aggressive cancer therapies."

Collaboration
The molecular diagnostic technique is not available yet commercially, but Dr. Kashani-Sabet hopes to make it accessible at CPMC’s Center for Melanoma Research and Treatment, which now has some of the best and brightest melanoma experts in the nation.

"We have put together a stellar team of physicians focused on the care of patients with melanoma," said Dr. Kashani-Sabet. "Our goal is to bring research into practice and provide the very best in molecular medicine for the most accurate diagnosis and treatment planning out there."

The Center for Melanoma Research and Treatment brings together specialists from dermatology, surgical and medical oncology, head and neck surgery, pathology and nuclear medicine. Working at one location on the Pacific Campus, they address all stages of melanoma. Through a robust clinical trial program, the team is putting investigational treatments to the test for high-risk skin malignancies.

"Because this is one of the most difficult cancers to treat once it has spread, caring for individuals with melanoma really does require a collaborative and aggressive approach," said Dr. Kashani-Sabet. "Our program provides that multidisciplinary care in a seamless fashion."

Risks
(According to the American Cancer Society)
Even with the best care within reach, it’s always wise to practice prevention and know the factors that increase your chances of getting melanoma.

• Men are at greater risk than women


• Fair hair and skin


• Multiple moles


• Episodes of severe burning in childhood


• A family history of melanoma


• Weakened immune system


• Excessive exposure to the ultraviolet (UV) radiation from the sun

Prevention

• Don’t use indoor tanning beds
  Just last year, the World Health Organization added UV radiation from tanning machines to its list of the most dangerous cancer-causing radiation. That list includes the radioactive element plutonium.


• Inspect yourself for potentially harmful moles


• Be aware of the growths that are on our skin and to monitor them periodically look for a change in the size, shape, color or feel of an existing mole.


• If you find a spot that looks abnormal, it is important to have it checked out in a timely fashion.

Bryan Hemming Cancer Care Center

California Pacific Medical Center

Comprehensive Cancer Services. The Bryan Hemming Cancer Care Center at California Pacific Medical Center in San Francisco features some of the top-rated cancer physicians and best cancer surgeons in the San Francisco Bay Area, Marin county and Northern California. Providing personalized patient care using the most successful cancer treatment options available is what we do best.