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Topical Cream Studied as Way to Treat Skin Cancer without the Knife
April 29, 2009In a case study of a type of melanoma skin cancer typically found on chronically sun-exposed skin, Saint Louis University researchers found that imiquimod, a topical cream, produced good results for patients when used together with surgery to treat the cancer, potentially helping doctors cut less.
The study, published in Dermatologic Surgery, looked at two cases of the most common type of melanoma of the head and neck, lentigo maligna (LM), a type of "melanoma-in- situ", the earliest stage of melanoma. This early form, known as LM, precedes the more invasive form, lentigo maligna melanoma (LMM), and the progression of LM to LMM typically occurs after 10 to 15 years. Though surgical removal of LM is most often used to treat the non-invasive form of the cancer, it can have high local recurrence rates.
In two patients who had both LM and LMM, investigators used imiquimod in conjunction with surgery. In both patients, surgery was first done to remove the area of known invasive disease, followed by the topical cream to the outer area of LM. This approach was chosen with patients who did not want extensive surgery due to the large size of the melanoma on their scalp and face. These cases, along with other recent studies, suggest that imiquimod may help to reduce the area needing surgery, manage the LM and hopefully minimize its recurrence.
"As we're seeing melanoma in younger and younger people, in their 30s and 40s, there is a longer window for the cancer to return and a greater desire to avoid disfiguring surgery," said Scott Fosko, M.D., chairman of the department of dermatology at Saint Louis University School of Medicine and lead study investigator.
Researchers hope that topical treatments like imiquimod may be used to lower the seriousness and the cost of treating the disease, as well as limit scars from surgery, and, most importantly, improve patient care.
"This subtype of melanoma is becoming more and more common, and can be one of the more challenging melanomas to manage," said Fosko, who is also director of the melanoma and cutaneous oncology section of the Saint Louis University Cancer Center.
"While more study is needed to understand how the drug works and which patients are likely to benefit from it, we are optimistic that the drug may prove to be a good option for some patients," said Fosko. "This may be an effective first line treatment."
Doctors stress that the best way to catch skin cancer early is through screenings. Patients seem to be hearing the message, as upcoming free cancer screenings hosted by the Saint Louis University department of dermatology and Saint Louis University Cancer Center filled up quickly.
While this year's May 2 screenings are full at both the Anheuser Busch Institute and DesPeres SLUCare locations, you may be placed on a waiting list or schedule a regular screening with a SLUCare dermatologist by calling 314-977-4440 or 1-866-977-4440.
Regular skin screenings are recommended for everyone, especially those over 40 years of age, and individuals at higher risk for skin cancer, those with a fair complexion, sunburn easily, have numerous moles, a personal or family history of skin cancer, and by occupation, recreation or use of tanning salons, get significant sun or ultraviolet rays exposure, regardless of age or race.
During a screening, a dermatologist will check moles, birth marks and other pigmentations for signs of cancer, which include abnormal size, color, shape or texture.
Skin Cancer Facts:
According to the American Cancer Society, more than 1 million new cases of skin cancer will be diagnosed in the United States this year. As many one in five Americans will develop skin cancer during their lifetime. Yet many people continue to tan both indoors and out.
Melanoma is the most deadly form of skin cancer and is the leading cancer in young adults, 25-29 years old. It is characterized by the uncontrolled growth of pigment-producing cells and may appear on the skin suddenly without warning or develop on an existing mole. There are several warning signs of melanoma.
Identifying these signs is as easy as ABCDE:
Asymmetry - one half is unlike the other half
Border - irregular, scalloped or poorly defined border
Color - varied from one area to another; shades of tan and brown, black; sometimes white, red or blue
Diameter - while melanomas are usually greater than 6 mm (the size of a pencil eraser) when diagnosed, they can be smaller
Evolving - a mole or skin lesion that looks different from the rest or is changing in size, shape or color
Established in 1836, Saint Louis University School of Medicine has the distinction of awarding the first medical degree west of the Mississippi River. The school educates physicians and biomedical scientists, conducts medical research, and provides health care on a local, national and international level. Research at the school seeks new cures and treatments in five key areas: cancer, liver disease, heart/lung disease, aging and brain disease, and infectious disease.
Saint Louis University
"As we're seeing melanoma in younger and younger people, in their 30s and 40s, there is a longer window for the cancer to return and a greater desire to avoid disfiguring surgery," said Scott Fosko, M.D., chairman of the department of dermatology at Saint Louis University School of Medicine and lead study investigator.
Researchers hope that topical treatments like imiquimod may be used to lower the seriousness and the cost of treating the disease, as well as limit scars from surgery, and, most importantly, improve patient care.
"This subtype of melanoma is becoming more and more common, and can be one of the more challenging melanomas to manage," said Fosko, who is also director of the melanoma and cutaneous oncology section of the Saint Louis University Cancer Center.
"While more study is needed to understand how the drug works and which patients are likely to benefit from it, we are optimistic that the drug may prove to be a good option for some patients," said Fosko. "This may be an effective first line treatment."
Doctors stress that the best way to catch skin cancer early is through screenings. Patients seem to be hearing the message, as upcoming free cancer screenings hosted by the Saint Louis University department of dermatology and Saint Louis University Cancer Center filled up quickly.
While this year's May 2 screenings are full at both the Anheuser Busch Institute and DesPeres SLUCare locations, you may be placed on a waiting list or schedule a regular screening with a SLUCare dermatologist by calling 314-977-4440 or 1-866-977-4440.
Regular skin screenings are recommended for everyone, especially those over 40 years of age, and individuals at higher risk for skin cancer, those with a fair complexion, sunburn easily, have numerous moles, a personal or family history of skin cancer, and by occupation, recreation or use of tanning salons, get significant sun or ultraviolet rays exposure, regardless of age or race.
During a screening, a dermatologist will check moles, birth marks and other pigmentations for signs of cancer, which include abnormal size, color, shape or texture.
Skin Cancer Facts:
According to the American Cancer Society, more than 1 million new cases of skin cancer will be diagnosed in the United States this year. As many one in five Americans will develop skin cancer during their lifetime. Yet many people continue to tan both indoors and out.
Melanoma is the most deadly form of skin cancer and is the leading cancer in young adults, 25-29 years old. It is characterized by the uncontrolled growth of pigment-producing cells and may appear on the skin suddenly without warning or develop on an existing mole. There are several warning signs of melanoma.
Identifying these signs is as easy as ABCDE:
Asymmetry - one half is unlike the other half
Border - irregular, scalloped or poorly defined border
Color - varied from one area to another; shades of tan and brown, black; sometimes white, red or blue
Diameter - while melanomas are usually greater than 6 mm (the size of a pencil eraser) when diagnosed, they can be smaller
Evolving - a mole or skin lesion that looks different from the rest or is changing in size, shape or color
Established in 1836, Saint Louis University School of Medicine has the distinction of awarding the first medical degree west of the Mississippi River. The school educates physicians and biomedical scientists, conducts medical research, and provides health care on a local, national and international level. Research at the school seeks new cures and treatments in five key areas: cancer, liver disease, heart/lung disease, aging and brain disease, and infectious disease.
Saint Louis University
Melanoma Current Events and Melanoma News RSSLaser therapy can aggravate skin cancer
High irradiances of low-level laser therapy (LLLT) should not be used over melanomas.
Quarter of a million children in England at risk of skin cancer from sunbeds
An estimated quarter of a million 11-17 year olds in England are being put at increased risk of developing malignant melanoma by using sunbeds, warn researchers in a letter to this week's BMJ.
Hundreds of genes distinguish patients likely to survive advanced melanoma
Although the chances of surviving advanced melanoma aren't very good with current therapies, some patients can live for years with cancer that has spread beyond the skin to other organs.
New Notre Dame study provides insights into the molecular basis of tumor cell behavior
A new study by a team of researchers led by Crislyn D'Souza-Schorey, associate professor of biological sciences at the University of Notre Dame, sheds light on the molecular basis by which tumor cells modulate their surroundings to favor cancer progression.
Switching immunosuppressants reduces cancer risk in kidney
Switching to a newer type of immunosuppressant drug may reduce the high rate of skin cancer after kidney transplantation, according to research being presented at the American Society of Nephrology's 42nd Annual Meeting and Scientific Exposition in San Diego, CA.
Cancer survivors may not be getting the help they need to stop smoking
More than a quarter of cancer survivors who still smoke have not been advised to quit smoking by their health care providers in the last year, according to a study published by researchers at Fox Chase Cancer Center in the current issue of the Journal of General Internal Medicine.
Melanoma treatment options 1 step closer
A targeted chemotherapy for the treatment of skin cancer is one step closer, after a team of University of Alberta researchers successfully synthesized a natural substance that shows exceptional potential to specifically treat this often fatal disease.
Resident physicians seldom trained in skin cancer examination
Many resident physicians are not trained in skin cancer examinations, nor have they ever observed or practiced the procedure.
New findings on the formation of body pigment
The skin's pigment cells can be formed from completely different cells than has hitherto been thought, a new study from the Swedish medical university Karolinska Institutet shows. The results, which are published in the journal Cell, also mean the discovery of a new kind of stem cell.
Studying cancer in pet dogs to find new treatments for human patients
A team of scientists at the National Cancer Institute (NCI) in Bethesda, USA, says that studying pet dogs with cancer could yield valuable information on how to diagnose and treat human cancers.
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