Original Articlerisk Of Second Primary Cancer In Survivors Of In Situ Melanoma
Survivors of invasive melanoma have an increased risk of developing second primary cancers however, similar risks associated with in situ melanoma have not been established. We evaluated 39,872 survivors of first primary in situ melanoma diagnosed from 1982 through 2012 in Queensland, Australia. Relative risk of second nonmelanoma primary cancers was estimated from standardized incidence ratios with 95% confidence intervals. A total of 4,823 in situ melanoma survivors developed a second primary cancer. A small increased risk compared with the general population was found. In those younger than 50 years, risk was increased by 14% for all cancers combined. In situ melanoma survivors had significantly increased risks of developing lip, thyroid, pancreatic, and brain cancers and decreased risks of head and neck, and lung cancers. Male in situ melanoma survivors had a significantly increased risk of prostate cancer female survivors had an increased risk of thyroid cancer and lymphoid leukemia. Findings indicate that in situ melanoma may predict the diagnosis of certain second primary cancers. This altered risk may be due to biological, behavioral, or genetic factors or increased medical surveillance, and it requires further investigation, particularly among people younger than 50 years.
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Guidelines For Avoiding The Sun And Uv Radiation
The following are some specific guidelines for avoiding excessive sun exposure:
- Properly use sunscreens that block out both UVA and UVB radiation with at least SPF 30. DO NOT rely on sunscreen alone for sun protection. Also wear protective clothing and sunglasses.
- Avoid sun exposure, particularly during the hours of 10 a.m. to 4 p.m., when UV rays are the strongest.
- Use precautions, even on cloudy days. Clouds and haze do not protect you from the sun, and in some cases may intensify UVB rays.
- Avoid reflective surfaces such as water, sand, concrete, and white-painted areas.
- UV intensity depends on the angle of the sun, not heat or brightness. The dangers are greater closer to the start of summer.
- Skin burns up to 4 times faster at higher altitudes than at sea level.
- Avoid sun lamps, tanning beds, and tanning salons. The machines use mostly high-output UVA rays.
How Can Melanoma Spread To The Brain
While melanoma normally begins in the skin, cancer cells sometimes grow and break away from the place where the cancer began. The cells that break away often travel to nearby:
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Blood vessels
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Lymph nodes
Once in the blood or lymph , the melanoma cells often travel to the lungs, liver, spleen, or brain.
Cancer cells growing bigger than normal cells
Cancer cells can grow, break off, and spread.
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Causes Risk Factors & Symptoms Of Melanoma
Although some people are predisposed to develop melanoma at some point in their life, this type of cancer can strike anyone.
Risk factors include: Green or blue eyes, light-colored skin, freckles Family history of skin cancer Personal history of skin cancer Immune deficiencies Age risk of melanoma increases with age Gender women are more likely to develop melanoma before the age of 40, after the age of 40 this statistic reverses and men are more likely to develop this cancer
Symptoms of Melanoma a new mark or spot on the skin a mole or spot that changes size, shape, color or height a mole or spot that doesn’t look like other spots on your skin a mole or spot where one side of the spot does not match the other, it is uneven a mole or spot that doesnt have a well-defined border a mole or spot that has varying colors or has changed color. The coloring may be shades of brown, black, pink, white, red or blue. a mole or spot that is more than 6 mm wide a sore that will not heal a change in sensation of a mole or spot, such as itching, tingling, tenderness or pain a mole or spot that is crusted or bleeding spread of pigment from the border of a spot to surrounding skin new moles that grow around or in close proximity to an existing mole redness or a new swelling beyond the border of a spot or mole a growth under a fingernail or toenail or a new pigmented line in a nail
Symptoms If Cancer Has Spread To The Brain
You might have any of the following symptoms if your cancer has spread to your brain:
- headaches
- weakness of a part of the body
- fits
- personality changes or mood changes
- eyesight changes
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J Tobias and D HochhauserJohn Wiley and Sons Ltd
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TNM Staging ChartsLippincott Williams and Wilkins, 2009
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Improving supportive and palliative care for adults with cancerNational Institute for Clinical Excellence , 2004
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Oxford Textbook of Palliative MedicineEds D Doyle and othersOxford Universty Press, 3rd edition 2005
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Cancer and its Management J Tobias and D HochhauserWiley Blackwell, 2015
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Lymph Nodes As A Stopover On A Cancer Cells Journey
Movement of melanoma cells into lymph nodes is not necessarily an endpoint, but rather a stopover on the cells journey elsewhere, wrote Barbara Grüner, Ph.D., of University Hospital Essen in Germany, and Sarah-Maria Fendt, Ph.D., of the Leuven Center for Cancer Biology in Belgium, in .
These results provide a first step towards understanding the protective environment of lymph, Drs. Grüner and Fendt wrote. To what extent findings apply to tumor types other than melanoma, and to humans, remains to be determined. If the results are relevant to human disease, innovative ways must be found for them to have a therapeutic impact.
Dr. Morrisons team is already looking into existing drugs that might make cancer cells more vulnerable to ferroptosis and block the protective effects of lymph, he said. The idea would be to see if such a drug could be given early in the disease course of melanoma to prevent it from spreading.
If we can find a therapy that blocks disease progression in mice, then we would go into clinical trials to see if it works in humans, he added.
Dr. Salnikow said multiple approaches will likely be needed to prevent the spread of melanoma, because different biological factors may be important for metastasis in different people.
One of the interesting questions to answer is whether MCT1 is also helping to protect these melanoma cells metastasizing through lymph, and were doing those experiments now, Dr. Morrison said.
What About Other Treatments That I Hear About
When you have cancer you might hear about other ways to treat the cancer or treat your symptoms. These may not always be standard medical treatments. These treatments may be vitamins, herbs, special diets, and other things. You may wonder about these treatments.
Some of these are known to help, but many have not been tested. Some have been shown not to help. A few have even been found to be harmful. Talk to your doctor about anything youre thinking about using, whether its a vitamin, a diet, or anything else.
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Complementary And Alternative Treatments
It’s common for people with cancer to seek out complementary or alternative treatments. When used alongside your conventional cancer treatment, some of these therapies can make you feel better and improve your quality of life. Others may not be so helpful and in some cases may be harmful.
It is important to tell all your healthcare professionals about any complementary medicines you are taking. Never stop taking your conventional treatment without consulting your doctor first.
All treatments can have side effects. These days, new treatments are available that can help to make many side effects much less severe than they were in the past.
Symptoms If Cancer Has Spread To The Bone
You might have any of the following symptoms if your cancer has spread to the bones:
- pain from breakdown of the bone the pain is continuous and people often describe it as gnawing
- backache, which gets worse despite resting
- weaker bones they can break more easily
- raised blood calcium , which can cause dehydration, confusion, sickness, tummy pain and constipation
- low levels of blood cells blood cells are made in the bone marrow and can be crowded out by the cancer cells, causing anaemia, increased risk of infection, bruising and bleeding
Cancer in the spinal bones can cause pressure on the spinal cord. If it isn’t treated, it can lead to weakness in your legs, numbness, paralysis and loss of bladder and bowel control . This is called spinal cord compression. It is an emergency so if you have these symptoms, you need to contact your cancer specialist straight away or go to the accident and emergency department.
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Skin Cancer Linked To Higher Risk Of Other Cancers
23 April 13
People who have had common skin cancers may be at an increased risk of getting cancer again in their life, according to a new study.
The study found that women with nonmelanoma skin cancers were 26 percent more likely to later develop another form of cancer, compared with women who didn’t have these skin cancers. In men, the risk increased by 15 percent, the study found.
The study included more than 150,000 people who were followed for more than 20 years, so the findings strongly add to the growing evidence of a link between skin cancer and later development of other cancers, said Anthony Alberg, a professor of epidemiology at the Medical University of South Carolina.
The increased risk of cancer seen in the study isn’t high enough to warrant recommending that people with nonmelanoma skin cancers undergo cancer screening tests earlier or more often than generally recommended, said Alberg, who was not involved in the new study. It does, however, raise the question of whether more screening might be beneficial for this group, and future studies might look at this, he said.
Nonmelanoma skin cancers are “so common we can’t even count them,” so the findings have public health significance, Alberg said. A 2006 study showed there were 2.1 million cases of non-melanoma skin cancer in the U.S.
The link may also help researchers to better understand cancer biology, he said.
The new study is published today in the journal PLOS Medicine.
How cancer risk increases
How Dna Changes Can Lead To Cancer
Genes are short segments of DNA found in chromosomes. DNA contains the instructions for building proteins. And proteins control the structure and function of all the cells that make up your body.
Think of your genes as an instruction manual for cell growth and function. Changes or mistakes in the DNA are like typographical errors. They may provide the wrong set of instructions, leading to faulty cell growth or function. In any one person, if there is an error in a gene, that same mistake will appear in all the cells that contain the same gene. This is like having an instruction manual in which all the copies have the same typographical error.
There are two types of DNA changes: those that are inherited and those that happen over time. Inherited DNA changes are passed down from parent to child. Inherited DNA changes are called germ-line alterations or mutations.
DNA changes that happen over the course of a lifetime, as a result of the natural aging process or exposure to chemicals or sunlight in the environment, are called somatic mutations.
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Tests That May Be Done
The doctor will ask you questions about when the spot on your skin first showed up and if it has changed in size or the way it looks or feels. The rest of your skin will be checked. During the exam your doctor will check the size, shape, color and texture of any skin changes. If signs are pointing to skin cancer, more tests will be done.
Skin biopsy
In a biopsy, the doctor takes out a small piece of tissue to check it for cancer cells. A biopsy is the only way to tell for sure if you have skin cancer and what kind it is.
There are many types of skin biopsies. Ask your doctor what kind you will need. Each type has pros and cons. The choice of which type to use depends on your own case.
In rare cases basal and squamous cell skin cancer can spread to the nearby lymph nodes Ask your doctor if your lymph nodes will be tested.
Basal and squamous cell cancers dont often spread to other parts of the body. But if your doctor thinks your skin cancer might spread, you might need imaging tests, such as MRI or CT scans.
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Common Skin Cancer Can Signal Increased Risk Of Other Cancers
Frequent skin cancers due to mutations in genes responsible for repairing DNA are linked to a threefold risk of unrelated cancers, according to a Stanford study. The finding could help identify people for more vigilant screening.
Basal cell carcinomas are common. More than 3 million cases a year are diagnosed nationwide.jax10289/Shutterstock.com
People who develop abnormally frequent cases of a skin cancer known as basal cell carcinoma appear to be at significantly increased risk for developing of other cancers, including blood, breast, colon and prostate cancers, according to a preliminary study by researchers at the Stanford University School of Medicine.
The increased susceptibility is likely caused by mutations in a panel of proteins responsible for repairing DNA damage, the researchers found.
We discovered that people who develop six or more basal cell carcinomas during a 10-year period are about three times more likely than the general population to develop other, unrelated cancers, said Kavita Sarin, MD, PhD, assistant professor of dermatology. Were hopeful that this finding could be a way to identify people at an increased risk for a life-threatening malignancy before those cancers develop.
Sarin is the senior author of the study, which was published online Aug. 9 in JCI Insight. Medical student Hyunje Cho is the lead author.
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Facts That You Should Know About
Further to which, it should be noted that almost 98% of the skin cancers finally turn out to be basal cell carcinoma or squamous cell carcinoma and are completely treatable. Contrary to which, melanoma skin cancers are much less common contributing to only about 1% of the total skin cancers.
However, considering the increasing evidence of other less common types of cancers scientists are trying to evaluate whether having basal skin carcinoma increase the risk for melanoma. Various studies in this regard are ongoing, suggesting a possible link between basal skin cancers and melanoma and colon cancer risk.
Skin Cancer: Half Of People Surviving Advanced Melanoma
Health and science correspondent, BBC News
More than half of patients can now survive a deadly skin cancer that was considered untreatable just a decade ago, say UK doctors.
Ten years ago only one-in-20 patients would live for five years after being diagnosed with late-stage melanoma. Most would die in months.
But drugs to harness the body’s immune system mean 52% now live for at least five years, a clinical trial shows.
Doctors said it was an extraordinary and rapid transformation in care.
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Biological Therapies And Melanoma
Biological therapies are treatments using substances made naturally by the body. Some of these treatments are called immunotherapy because they help the immune system fight the cancer, or they occur naturally as part of the immune system.
There are many biological therapies being researched and trialled, which in the future may help treat people with melanoma. They include monoclonal antibodies and vaccine therapy.
How Serious Is My Cancer
If you have skin cancer, the doctor will want to find out how far it has spread. This is called staging.
Basal and squamous cell skin cancers dont spread as often as some other types of cancer, so the exact stage might not be too important. Still, your doctor might want to find out the stage of your cancer to help decide what type of treatment is best for you.
The stage describes the growth or spread of the cancer through the skin. It also tells if the cancer has spread to other parts of your body that are close by or farther away.
Your cancer can be stage 0, 1, 2, 3, or 4. The lower the number, the less the cancer has spread. A higher number, like stage 4, means a more serious cancer that has spread beyond the skin. Be sure to ask the doctor about the cancer stage and what it means for you.
Other things can also help you and your doctor decide how to treat your cancer, such as:
- Where the cancer is on your body
- How fast the cancer has been growing
- If the cancer is causing symptoms, such as being painful or itchy
- If the cancer is in a place that was already treated with radiation
- If you have a weakened immune system
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Mouse Models Mimic Metastasis Of Human Melanoma
Metastasis is a highly inefficient process in that the vast majority of cancer cells that try to migrate die before they ever have an opportunity to form a tumor, Dr. Morrison said.
Dr. Morrisons team found previously that one factor limiting the survival of melanoma cells circulating in the blood is that the cells experience a high level of oxidative stress. Oxidative stressan imbalance between free radicals and antioxidants in the bodycauses chemical reactions that can damage proteins, DNA, and lipids in cells and disrupt normal cell processes. However, precisely how oxidative stress kills circulating melanoma cells was not known.
For their studies, the team used a mouse model of metastasis created by transplanting melanoma cells from humans beneath the skin of specially bred mice with weakened immune systems. These mice were used to avoid having the transplanted human cells seen as foreign and attacked by the immune system. The team also used a second mouse model created by transplanting mouse melanoma cells into mice with normal immune systems.
Comparing these two mouse models let the researchers control for potential effects of the immune system on the spread of melanoma, Dr. Salnikow explained.
The study was supported in part by NCIs Patient-Derived Models of Cancer program, which promotes the development of animal models that more closely mirror how tumor cells behave in humans.