During the COVID-19 pandemic, people will still get a devastating diagnosis of melanoma. As cancer patients or for those of us that have recovered but still have suppressed immune systems, the last few months have been particularly challenging. In our cancer community, it has created issues we have never faced before. Now, along with the trauma of cancer diagnosis there is increased anxiety because of the challenges posed by COVID-19. Many patients have had appointments postponed or procedures deemed “elective” or delayed. Patients can’t always meet with their doctor in person. Clinical trials may have been shut down. We also know our medical centres are doing their utmost in the face of this crisis and we thank them from the bottom of our hearts.
We do know that cancer doesn’t take a break. I was reminded of this as I trekked down to my cancer centre for a brain scan and felt first hand the anxiety of the potential risks of delaying diagnosis vs. exposure to this relentless virus. It adds a new layer to what is already considered enough. I get it. My heart goes out to all of you who are dealing with this new reality. Reach out – we have many resources available online and a friendly ear to lend support through our office – through our peer support and Mary, who is there to help.
May is international melanoma awareness month. We challenge you and yours to practice safe sun behaviours and encourage you to let others know of the risks. While we are all tired of the requirement to stay home and isolate, the temptation of the change in the weather is going to bring us outdoors – and we need it, mentally and physically. However, I can’t say it enough – beware of the strong UV rays, even on cloudy or cooler days. UV ratings over level 3 require protection – hats, cover up, sunglasses and sunscreen. We all need a break but let’s do it wisely.
At our recent melanoma conference in February, we had such incredible speakers and presenters. I had the opportunity to talk about our initiatives for sun safety, for physician education and for patient needs. I was impressed with so many physicians and researchers who presented data on the correlation of sun damage and UV exposure to skin cancers and melanoma. While I have seen these stats and research results in many cases before, I thought it worth sharing with you. The science behind this is compelling and demonstrates so very clearly, that sun safety can, in the majority of cases, prevent cutaneous melanoma and other forms of skin cancer. We should be shouting it from the rooftops! While these graphs may be a bit difficult to read, what they point to is the damage at the DNA level that ultra violet radiation from sun and artificial sources does to our skin, potentially leading to cancer. I find them so compelling that I wanted to share.
‘…aged, sun-exposed skin is a patchwork of thousands of evolving clones with over a quarter of cells carrying cancer-causing mutations while maintaining the physiological functions of epidermis.’(1)
Table B below shows the level of mutations in normal skin vs. sun damaged cutaneous squamous cell carcinoma, basal cell carcinoma and melanoma, vs. mutations in other forms of cancer. It is easy to see that there is a significant challenge with the number of mutations in skin cancers – which also contributes to the difficulty we experience in finding successful treatments.
‘In some cancer types, a substantial proportion of somatic mutations are known to be generated by exposures, for example, tobacco smoking in lung cancers and ultraviolet light in skin cancers.’ (2)
There is so much more that demonstrates clearly the link between these environmental factors and skin cancers. I know that most of you are clearly convinced, but please help us get the word out and prevent more cases in the future. Support our efforts in education, awareness and prevention.
The conference produced some interesting results in triple combination trials that are ongoing. As well, there continues to be clinical trials with oncolytic viruses in combination with existing immunotherapies. New immunotherapy trials are also continuing and we are hopeful for even better options and results in the future. While waiting, let’s work on prevention.
There may be those hesitating to having their skin checked for something suspicious. Many dermatologists are offering virtual sessions and arranging to see patients in need in person to prevent delays in diagnosis. We applaud their efforts and want to thank our own Board member – Dr. Julia Carroll, for being one of those amazing dermatologists who is continuing to make melanoma a priority. Stay safe. Be kind to yourself and stay in touch.