Just how early can melanoma be detected? First of all, some exciting news: The chief reason why melanoma cells are so resistant to chemo has been discovered by researchers at UC Irvine’s Chao Family Comprehensive Cancer Center.
However, researchers are a long way off from applying this discovery to melanoma treatment. In the meantime, those who fear this skin cancer and/or are at elevated risk need to seriously take measures towards the earliest detection possible.
And how is the earliest detection of melanoma possible? Through serial digital dermoscopy. My HMO doctor would not authorize coverage for this because I do not have unusual or a high number of moles, nor previous skin cancer. But for peace of mind, I wanted serial digital dermoscopy, so I paid out of pocket for the procedure last year, and recently had my follow-up.
The reason melanoma is so resistant to chemotherapy has to do with a genetic pathway that prevents the cancer cell from detecting damage to it caused by chemotherapy. Instead of acting damaged, the cancer cells continue to thrive.
“If we can find a way to turn off the pathway responsible for this resistance, melanoma tumors would suddenly become sensitive to therapies we’ve been using for the last 20 years,” explains UCI dermatologist Dr. Anand Ganesan.
Once melanoma spreads, it’s very difficult to get it to respond to treatment. Dr. Ganesan explains, ” …this blunting of DNA damage response allows melanoma cells to mutate and proliferate.” The next step is to figure out a way to suppress the genes that prevent recognition of the DNA damage from chemotherapy.
This next step isn’t in the near future, so people must be super vigilant with self- and clinical skin exams. Malignant lesions can be missed by the layperson and even by a dermatologist, simply because the naked eye cannot always detect changes. Changes can also be missed by a handheld lens that a dermatologist may use, called a dermoscope.
However, the technology of serial dermoscopy is amazing, in that this procedure can detect melanoma earlier than any other type of screening. A dermatologist will examine your skin and then select the moles for the serial dermoscopy.
In my case, I requested that the moles on my back get imaged since I can’t easily inspect them. If you have a lot of atypical moles or large moles, you are a good candidate for serial digital dermoscopy. Last year I had three small moles imaged (I thought I’d have more imaged).
This year I requested that all the moles on my back get into the database, and that I didn’t understand why only three were selected originally. This time I had a different dermatologist as well as resident who was also part of the exam. They were more accommodating to my desires, and I ended up having six additional moles imaged.
Selected moles are indicated with a marker so that the nurse knows which ones to image. She squirted ink on each one, then held a little camera up and took their image. Soon after, the dermatologist sat with me at the computer and reviewed the magnified images: the three original moles and compared them to last year’s images; and the six new images.
Serial digital dermoscopy involves comparing the images to a database of images of normal and melanoma moles. The computer than rates the images according to a color spectrum. The dermatologist doesn’t rely on solely the dermoscopy; clinical observations are also part of the plan.
To find out more about how serial digital dermoscopy can detect melanoma super early and yield peace of mind to patients, read my interview with a dermatologist who performs the procedure on her patients.
Source: http://www.sciencedaily.com/releases/2012/09/120917132351.htm
