Posts Tagged ‘preventive medicine’

If you are or will be a skin cancer patient: read this

Tuesday, March 2nd, 2010

Neoadjuvant Therapy. Adjuvant Therapy. Learn these words. One or the other may save your life if you get cancer. I am largely alive today because I was one of the first participants in a clinical trial using neoadjuvant therapy to treat my pancreatic cancer in 2002. I will write more about that later.
Neoadjuvant therapy can refer to treatments given to reduce tumor size or improve survival before definitive therapy such as surgery is performed. Adjuvant therapy is the use of drugs or other modalities after surgery to reduce the chance of surviving cancer cells from growing.
Skin cancer is the most prevalent cancer in the world. More than 1 million cases occur every year in the United States. It is the 7th leading cause of cancer death in the United States. It is the biggest single drain on the health care system of all cancers. It is promoted by sunlight and directly caused by suntan parlors. The odds of a patient who has had skin cancer developing another skin cancer is 30% over the next 3 years and 100% over a lifetime.
A patient came to see me today who told me about her husband who had skin cancer and a lot of sun exposure in his earlier life. He sees a dermatologist many times a year and at each visit the dermatologist “zaps” off lesions from his face. Yet no matter how many lesions are removed, at the next visit new ones have arisen. I think even a mule understands that when he is overheating in the sun and does not feel well, moving into shade gives relief. Yet here are millions of patients who go month after month, year after year, to get spots “zapped” with the “understanding” that this might prevent skin cancer. At best this is specious reasoning and between the doctor and the patient I am not sure who benefits most.
It was refreshing at the Orlando Dermatology Meeting last December to hear lectures on neoadjuvant and adjuvant therapy to prevent the onset of new lesions and ultimately to prevent new cancers. Remember these names- adjuvant and neoadjuvant. They are available for you now and will be the primary therapy for your children. The fact is patients have options on how to prevent cancer and what follows is a short list to consider:
• Topical vitamin A or tretinoin. Available as a gel or cream a little dab each night may prevent up to 90% of new cancers from arising. This has been known since 1980, yet few physicians recommend it to patients. Coincidentally it is used to treat wrinkles.
• 5-FU (5-fluorouracil): a known anticancer drug for breast and colon, it has been used for years as a cream to treat precancerous lesions. New evidence suggests using it for one week out of the year may prevent even these precancerous lesions from forming.
• PDT (photodynamic therapy): consists of applying a chemical, aminolevulinic acid, to the skin followed by intense light or laser therapy. With more than 20 years experience in Europe it is very successful in treating precancerous lesions and small cancers and is a very popular skin rejuvenation treatment. Like vitamin A you get two for the price of one: better health and better looks.
• Fractional Laser Resurfacing: While not yet successful as a preventive, this is another 1-2 punch making you look better and removing precancerous lesions.
In the 21st century it is archaic to get lesions “zapped” and do nothing to prevent skin cancer and its precancerous growths. In an age where we look to legislation to reduce health care expenditures it is incumbent upon each of us to utilize preventive measures to treat and prevent skin cancer. Well, the time is here and the methods are available. Are you?