Real World Health Care Blog

Tag Archives: skin cancer

New Real World Health Care Series: Melanoma Research and Treatment

“Have you heard from mom and dad recently?” My sister’s question caught me off-guard.  Without realizing it, I hadn’t actually heard from my parents in a while.  She had already asked my brother the same question and he reported not hearing from them lately either.  With no imminent trips back to Michigan from our respective homes in Colorado, Maryland, and North Carolina, all three of us started calling and emailing our parents with some urgency to make sure things were well.

Krista Zodet, President, HealthWell Foundation

My mom’s email came back quickly, bringing us up to speed: “Dad went to the dermatologist about a troublesome spot on his cheek and the doctor did a full body check too.  He found a spot on the back of his thigh and did a biopsy.  Diagnosis: melanoma.  Treatment: surgery.” They removed a patch of skin from my dad’s leg – an area he couldn’t see and for the most part was covered by shorts or pants year-round.  It had been malignant and they got all of it.

That was early 2001, and my dad had just retired (talk about timing).  Because of early detection and annual check-ups since, he has been melanoma-free for 16 years.  We learned a lot about melanoma back then: It is the most dangerous form of skin cancer; and we also understand – thankfully – if it is recognized and treated early, it is almost always curable.

May is Melanoma Awareness Month

Since HealthWell opened its melanoma fund, I have learned even more about this devastating disease: Without early detection, the cancer can advance and spread to other parts of the body, where it becomes hard to treat and can be fatal. According to the Skin Cancer Foundation, melanoma kills an estimated 10,130 people in the U.S. annually.

Treatment typically begins by surgically removing the melanoma. Surgical treatments have advanced over the past decade, and most can be done in the doctor’s office or as an outpatient procedure under local anesthesia. In recent years, Mohs Micrographic Surgery has become popular as an alternative to standard surgery for certain melanomas. This procedure spares as much of the normal tissue (known as the margins) as possible while allowing the surgeon to pinpoint the cancer’s location when it is invisible to the naked eye.

When melanoma cells spread to the lymph nodes (stage III) or more distant parts of the body (stage IV), the disease is considered advanced and additional therapy usually follows surgical removal of the original skin tumor. Thanks to an array of treatment options, patients with metastatic melanoma can extend their lives by months or years. A rising number of patients go into long-term remission.

The HealthWell Foundation, sponsor of Real World Health Care, is proud to have supported the melanoma patient community in recent years with copayment and premium assistance. We have helped more than 2,230 melanoma patients afford their treatments since approving our first Melanoma grant in 2011 — thanks to the generous support of our corporate partners. Due to high patient volume, our melanoma fund is temporarily closed until we receive additional funding. We invite corporations and individuals to help us meet this demand by contributing to our Melanoma-Medicare Access Fund, so nobody goes without essential medications because they cannot afford them.

 

 

Categories: General, Melanoma

UV Safety Month: Shedding Light on Melanoma Treatment and Prevention

In 2014, an approximate 77,000 Americans will be diagnosed with melanoma, culminating in nearly 10,000 deaths. Every eight minutes, an American is diagnosed with melanoma, and every hour, an American dies from it. Despite accounting for only four percent of all skin cancer cases, melanoma results in 80 percent of all skin cancer-related deaths. In observance of UV Safety Month, Real World Health Care is examining what’s working and what’s new in the prevention and treatment of melanoma.

photo (1)

Nathan Sheon

If detected early, melanoma is easily treated with surgery. If a tumor in the epidermis – the upper-most layer of skin – is removed before it deepens into the skin or spreads to other parts of the body, the likelihood of completely curing melanoma is high. When melanoma spreads, other treatment options include chemo- and radiation therapy.

Once melanoma has progressed to its later stages, however, treatment of the disease becomes much more difficult. For these patients, treatment options usually focus on extending life expectancy and improving quality of life.

Within the last few years, developments in melanoma research have provided promising leads on how to increase a patient’s lifespan beyond the capabilities of existing treatments. Certain activation immunotherapies – drugs that activate the immune system’s ability to fight disease – are showing potential in their ability to combat the spread of melanoma by killing tumors. Though these treatments do not work in all melanoma patients, in some cases they have been associated with unprecedented increases in lifespan.

“All of these trials involve late stage cancer patients. Suddenly we’re seeing those same patients getting two years or more survival time,” said Ashani Weeraratna of the Wistar Institute, the nation’s first independent institution devoted to medical research and training. “Enhancing the immune system such that it can effectively target and destroy your tumor has been a goal for many years. That’s [the field’s] big advance.”

Melanoma is almost always curable when detected and treated early on. Monthly self-examinations and yearly visits to the dermatologist are highly advised, even for those not predisposed to skin cancers. More information on how to perform a self-examination can be found online in guides from the Skin Cancer Foundation and the Melanoma Research Foundation.

Among other important measures like self-examinations and avoiding tanning booths, the American Academy of Dermatology (AAD) advises that wearing sunscreen when spending time outdoors is vital, especially during peak daylight hours between 10 AM to 2 PM. The AAD suggests using sunscreen with a sun protection factor (SPF) of 30 or above. With a range of sunscreen products on the market, choosing the right one can be difficult. Different products are more effective for different people depending on skin type. Visit the Skin Cancer Foundation’s guide for more information on choosing the right sunscreen product for you. For more information and tips on preventing and detecting melanoma, visit the AAD’s online guide.

How do you stay safe in the sun? Let us know in the comments section.

*Jamie Elizabeth Rosen, editor of Real World Health Care, contributed to this piece.

Companion Diagnostics Target Therapy to the Patients Most Likely to Respond

What cancer patient would want to use trial and error with various chemotherapies when he or she could know first from a diagnostic that one agent in particular would result in the most successful outcome?

David Sheon

David Sheon

A new field has emerged, companion diagnostics, to help predict a patient’s compatibility with chemotherapy or other cancer treatments.  This is a game changer to help ensure drugs are given only to the patients most likely to respond to them. 

According to the Food and Drug Administration (FDA), companion diagnostics already play an important role in determining which therapies are the safest and most effective for a particular patient.  By identifying treatments that work best for specific patients, less money is spent on those that do not work because patients no longer have to endure multiple treatments to find the one that is right for their case. Companion diagnostics, usually created in combination with targeted therapy, not only reduce cost and waste, but also reduce side effects for the patient.

Over the past several years, the FDA has approved the following five companion diagnostics: 

  • Zelboraf and the Cobas Test: The drug Zelboraf specifically treats the melanoma of patients whose tumors express a gene mutation called BRAF V600E. Alberto Gutierrez, Ph.D., Director of the Office of In Vitro Diagnostic Device Evaluation and Safety in the FDA’s Center for Devices and Radiological Health, said that approval “is a great example of how companion diagnostics can be developed and used to ensure patients are exposed to highly effective, more personalized therapies in a safe manner.”
  • Vysis ALK Break Apart FISH Probe Kit: Developed along with the targeted therapy drug Xalkori for patients with late stage, non-small lung cancer who express the abnormal anaplatic lymphoma kinase gene. The test determines if a patient possesses that gene to ensure that the correct treatment is applied.
  • therascreen KRAS RGQ PCR Kit: For those with colorectal cancer who are determining whether the drug Erbitux is right for them. This provides information about the KRAS gene mutation in patients whose colorectal cancer has spread to other parts of the body. If the test shows that the patient does not have the gene mutation, this demonstrates that Erbitux is the correct choice, but not the right one for those with the gene mutation.
  • EGFR Mutation Test: Administered in conjunction with the targeted therapy drug Tarceva, which detects the epidermal growth factor receptor gene mutation in patients with lung cancer. If the patient has the genetic mutation that Tarveca targets, then they are “candidates for receiving Tarceva as first line therapy,” Dr. Gutierrez says. Because this gene is present in approximately 10 percent of patients who have non-small lung cancer, it would go far to help improve the treatment and success rate among these patients.
  • THxID BRAF: Approved alongside two drugs (Tafinlar and Mekinist) – which treat the most dangerous type of skin cancer – this detects the BRAF V600E or V600K gene mutations associated with the disease. If the tumor of the patient contains either of these genes, both drugs are effective. 

Have you – or someone you know – ever been treated with one or more companion diagnostics? What was the experience like and would you recommend it for someone else?

Categories: Cost-Savings