Why do a Skin Self Exam?

Melanoma Review

Reviewed October 2014-February 2015

Video 1: Metastatic Melanoma (lives in a different section of website than skin cancer, markets Mount Sinai School of Medicine)

1. Not the most common form of skin cancer –https://www.aad.org/media-resources/stats-and-facts/conditions/skin-cancer
2. (0:57) In situ easily treated – 96-99% survival rate in 5-10 years (5 year survival is similar to that of the general population)
   1. <1mm: 5-year survival is 95-100%, melanoma research foundation
   2. survival is similar to that of general population http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3228223/
3. Deeper than 1 mm – broad resection and check lymph nodes (http://www.melanoma.org/understand-melanoma/diagnosing-melanoma/stages-of-diagnosis)
4. (1:20) 10 year survival rate of metastatic melanoma under 10% (video cited national institute of cancer statistics 2008)  -> is slightly better than 10%
   1. http://www.cancer.org/cancer/skincancer-melanoma/detailedguide/melanoma-skin-cancer-survival-rates
      1. Stage IV: The 5-year survival rate is about 15% to 20%. The 10-year survival is about 10% to 15%. The outlook is better if the spread is only to distant parts of the skin or distant lymph nodes rather than to other organs, and if the blood level of lactate dehydrogenase (LDH) is normal (2014) - ACS
   2. most sites talk about 5 year survival
5. there are newer protein directed therapies that are effective in some patients - http://www.melanoma.org/understand-melanoma/melanoma-treatment/targeted-therapy

Video 2: What is skin cancer?

1. (0:22) >1 million americans every year find out they have skin cancer -> true but more like 2 million
   • more than two million people in the US are develop over 3.5 million non-melanoma skin cancers every year http://www.skincancer.org/skin-cancer-information/skin-cancer-facts/nonmelanoma-skin-cancer-incidence-jumps-by-approximately-300-percent
   • and AAD - https://www.aad.org/media-resources/stats-and-facts/conditions/skin-cancer
2. (0:31) estimated 70,000 people will learn they have melanoma –
   • The American Cancer Society estimates that at present, more than 120,000 new cases of melanoma in the US are diagnosed in a year. In 2014, an estimated 76,100 of these will be invasive melanomas http://www.skincancer.org/skin-cancer-information/melanoma
   • cdc 2011 - 70k
   • ACA - about 76,100 new melanomas will be diagnosed (about 43,890 in men and 32,210 in women). http://www.cancer.org/cancer/skincancer-melanoma/detailedguide/melanoma-skin-cancer-key-statistics
3. (2:21) basal cell ¾ cases of skin cancer (can change it to approximately or greater than)
   • More than one out of every three new cancers are skin cancers, and the vast majority are BCCs. http://www.skincancer.org/skin-cancer-information/basal-cell-carcinoma
   • About 8 out of 10 these are basal cell cancers. Squamous cell cancers occur less often. org http://www.cancer.org/cancer/skincancer-basalandsquamouscell/detailedguide/skin-cancer-basal-and-squamous-cell-key-statistics
4. (3:02) squamous cell more likely to spread than basal cell-http://www.cancer.org/cancer/skincancer-basalandsquamouscell/detailedguide/skin-cancer-basal-and-squamous-cell-what-is-basal-and-squamous-cell

Video 3: Skin Cancer: Prevent and Treat

1. (2:13) 20-40% of melanomas arise from atypical mole – can’t find
   1. Individuals with dysplastic nevi and no personal and family history of melanoma have a risk 7 to 27 times greater of developing melanoma. - See more at: http://www.aimatmelanoma.org/en/aim-for-answers/risk-factors/moles.html#sthash.LQKiL1sX.dpuf
   2. About 30% of melanomas develop from pigmented moles (about half each from typical and atypical moles); http://www.merckmanuals.com/professional/dermatologic_disorders/cancers_of_the_skin/melanoma.html
   3. Approximately 10 to 20 percent of diagnosed melanomas arise within atypical nevi. Uptodate - Screening and early detection of melanoma

Video 4:  How to do a skin self exam

1. (2:57) 60% of melanomas in African americans occur on the feet (-> should read more than 70% of African Americans do not develop melanoma in sun exposed areas)
   1. only 33% of African-American patients developed melanoma in sun-exposed areas. - See more at: http://www.aimatmelanoma.org/en/aim-for-answers/risk-factors/melanoma-in-people-of-color.html#sthash.73XhDjRp.dpuf
   2. Melanomas in African Americans, Asians, Filipinos, Indonesians, and native Hawaiians most often occur on non-exposed skin with less pigment, with up to 60-75 percent of tumors arising on the palms, soles, mucous membranes and nail regions. http://www.skincancer.org/skin-cancer-information/skin-cancer-facts#ethnicity
   3. Gloster HM, Neal K. Skin cancer in skin of color. J Amer Acad Dermatol 2006; 55:741-60. http://www.jaad.org/article/S0190-9622(05)02730-1/abstract

Video 5: Why do a self skin exam?

1. (1:02) skin cancer is the most common type of cancer - http://www.skincancer.org/skin-cancer-information/skin-cancer-facts
2. Should perform every month – Skin Cancer Foundation (“If you can spot it you can stop it”)
3. Video is similar to “how to do a self-skin exam”

Video 6: True Life Story Melanoma

1. n/a

References:

1. American Academy of Dermatology - Schaumburg, IL
   18. “Skin Cancer” – Downloaded November 18. 2014 https://www.aad.org/media-resources/stats-and-facts/conditions/skin-cancer
2. Mocellin S and Nitti D. Cutaneous Melanoma in Situ: Translational Evidence from a Large Population-Based Study. Oncologist. 2011 Jun; 16(6): 896–903
3. Melanoma Research Foundation. Washington DC. 
   2015. Stages of Melanoma Diagnosis. http://www.melanoma.org/understand-melanoma/diagnosing-melanoma/stages-of-diagnosis Redownloaded February 9, 2015.
   2016. Melanoma Treatment: Targeted Therapy. http://www.melanoma.org/understand-melanoma/melanoma-treatment/targeted-therapy Redownloaded February 9, 2015.
4. American Cancer Society
   2013. What are the survival rates for Melanoma Skin Cancer by Stage. November , 2013. http://www.cancer.org/cancer/skincancer-melanoma/detailedguide/melanoma-skin-cancer-survival-rates  Downloaded November 12, 2014.
   2014. What are the key statistics about basal and squamous cell skin cancers? October, 2013.  http://www.cancer.org/cancer/skincancer-basalandsquamouscell/detailedguide/skin-cancer-basal-and-squamous-cell-key-statistics  Downloaded November 18, 2014.
   2015. What are basal and squamous Cell Skin Cancers? October 2013.  http://www.cancer.org/cancer/skincancer-basalandsquamouscell/detaile…/skin-cancer-basal-and-squamous-cell-what-is-basal-and-squamous-cell  Downloaded November 17, 2014.
5. Nonmelanoma Skin Cancer Incidence Jumps by Approximately 300 Percent. Skin Cancer Foundation.  NY, New York    http://www.skincancer.org/skin-cancer-information/skin-cancer-facts/nonmelanoma-skin-cancer-incidence-jumps-by-approximately-300-percent.  Downloaded November 17, 2014
6. Skin Cancer Statistics.   Atlanta, GA.  September, 2014. http://www.cdc.gov/cancer/skin/statistics/  Downloaded November 17, 2014.
7. Melanoma: Cancers of the Skin: Merck Manual Professional. Merck Manual. November 2014. http://www.merckmanuals.com/professional/dermatologic_disorders/cancers_of_the_skin/melanoma.html Downloaded February 6, 2015.
8. Risk Factors: Moles. Aim at Melanoma Foundation. Plano, Texas. 2012. http://www.aimatmelanoma.org/en/aim-for-answers/risk-factors/moles.html#sthash.LQKiL1sX.dpuf Downloaded November 18, 2014.
9. Melanoma in People of Color. Aim at Melanoma Foundation.  Plano, Texas. 2012 http://www.aimatmelanoma.org/en/aim-for-answers/risk-factors/melanoma-in-people-of-color.html Downloaded November 18, 2014.
10. Gloster HM, Neal K. Skin cancer in skin of color. J Amer Acad Dermatol 2006; 55:741-60.
11. Geller AC and Swetter S. Uptodate: Screening and early detection of melanoma. Updated October 2014.  Downloaded November 18, 2014.
12. If you can spot it, you can stop it. Skin Cancer Foundation.  New York, NY. 2015.  http://www.skincancer.org/skin-cancer-information/early-detection/if-you-can-spot-it-you-can-stop-it Downloaded February 27, 2015.

Note: These are all the sources used for every video in this series, not every source listed was used in this specific video.