Skin cancer lecture focuses on prevention, treatment

Focusing on preventing, treating and improving skin cancer treatment, Lee Cranmer, M.D., Ph.D. and assistant professor of the Melanoma/Sarcoma Program at the Arizona Cancer Center, spoke at the West Center last week.

Cranmer told the audience of about 200, that like Australia, Southern Arizona has among the highest incidence of skin cancer cases in the world.

“It’s the most common form of cancer with a higher incidence than all other kinds of cancer combined,” he said.

Lightheartedly, he added, “We didn’t move here to stay in all the time” and named the basic tenets of the Centers for Disease Control for preventing skin cancer.

They aren’t new, haven’t changed and are still advised—avoid direct exposure to the sun; wear a hat, protective clothing, sunscreen and sunglasses; avoid using sunlamps and tanning beds—and perform frequent skin self exams.

As some skin cancers are more dangerous than others, Cranmer spoke in depth about malignant melanomas that have a tendency to spread and metastasize. In 2007, there were 59,940 such cases in the United States and 8,110 deaths.

In Arizona, between 1995 and 2000, there were 765 invasive cases and 120 deaths; in 2004, the number in Arizona rose to 1,080 invasive cases and 148 deaths.

“It’s a type of cancer that disproportionately affects younger patients,” Cranmer said. Typically patients have an 80 percent chance of being cured by surgery if the cancer is caught early and hasn’t spread.

Speaking of the treatment program at AZCC, Cranmer said, “One goal of the Cutaneous Oncology Program at the Arizona Cancer Center is to provide patients with access to clinical trials… we also sustain close communication between treating physicians and individual patients. Problems can be talked about and resolved right then.”

The audience viewed graphic illustrations of different types of skin cancer lesions and were told about the common “ABCDE” signs of melanoma:

Asymmetry— Half the lesion doesn’t match the other half;

Border — Edges are ragged, notched or blurred;

Color — Different shades of brown, tan and black; a “spotty” look with dashes of red, white or blue;

Diameter — The width is larger than a pencil eraser. Be concerned about any growth of a mole;

Evolving — Spots that show any of these changes over time: size, shape, shades of color, itching or tenderness, surface bleeding.

Cranmer then added his own “F” for Friend.

“If a friend tells you to have that looked at, you should do it.”

He gave an overview of the importance of Sentinel Lymph Node biopsies when a patient has surgery to remove a skin cancer lesion.

Using a radioactive dye the surgeon will test a sentinel lymph node under the armpit.

If it is found to be negative or free of cancer cells, the surgeon doesn’t look farther. If the sentinel node shows the presence of cancer, more nodes are tested and removed if needed.

“Sentinel Lymph Nodes are proven sites of early metastases,” Cranmer said.

In closing, he reviewed these main points. “Sun exposure remains a major risk factor; early diagnosis is important, Sentinel Lymph Node biopsies are central to future care and clinical trials are improving. Most important, he said, “At least once a year have a dermatologist exam with clothes off.”

To help avoid skin cancer in Southern Arizona, the SHADE Foundation of America offers a simple way to remember the basics:

Sunglasses and sunscreen;

Hats with wide brims;

Avoid midday sun;

Dress to cover and protect;

Examine skin regularly.

Ellen Sussman is a freelance writer in Green Valley. Contact her at ellen2414@cox.net.