What do you know about melanoma?

Skin cancers account for 80 percent of all new cancers diagnosed each year. That means 430,000 people will be told they have it in 2012. But what you don't know about skin cancer could end up killing you.

It's time to play-mole madness. First question-where does skin cancer not occur; between your toes, on your palms, under your fingernails, or on your lips?

The answer- skin cancer can happen in all of these places. Next question-simply staying in the shade can protect you from getting skin cancer?

Shade alone can reduce your exposure to ultra-violet rays by 75 percent. But you should still use a sunscreen of at least SPF 30 at all times. This is a tough one. Which mole is not melanoma?

Trick question. All of them are melanoma. Detecting and diagnosing it can be tricky. The only way is through a biopsy, but even then, Cornell Dermatologist Johanthan Zippin says it's not that easy.

"The problem is, this grey area, is a controversial area,” says Dr. Jonathan Zippin, MD, PhD, Assistant Professor of Dermatology at New York Presbyterian Hospital, Weill Cornell Medical Center. “A lot of people don't know how to define it."

Once the mole is tested, pathologists agree on just 60 to 75 percent of the cases. That's why Doctor Zippin has created a new diagnostic test that helps eliminate this 'grey' area.

"It's a test that looks for a certain protein in the melanoma or mole," explains Dr. Zippin.

The protein, called sAC is expressed in all cells.

"It's not a question of whether it's there or not, it's a question of where it is," says Dr. Zippin.

The red in the cell is the sAC protein. The blue is the cell nucleus. When the red is next to the blue, things are normal. If the red is on top of the blue, the mole is cancerous.

"If it's in this area it's bad and if it's in this area it's good,” describes Dr. Zippin. “It's much simpler and much more consistently interpreted."

Doctor Zippin says his protein test is still in the research phase, but doctors can send their biopsies to Cornell and his team will run the test for them.

Also, don't leave your mole health just to your doctor. Experts say you should check your moles each month.


REPORT: MB # 3492

BACKGROUND: Melanoma is the fastest growing cancer in the U.S. Melanoma is caused by changes in cells called melanocytes, which produce a skin pigment called melanin. Melanin is responsible for skin and hair color. A scary fact about melanoma is that it can appear on normal skin or start as a mole. Some moles that have been there since birth can turn into melanoma.

Myth #1: A diagnosis of melanoma means that I have months to live.
There are four stages of melanoma, five if you include a form known as melanoma in situ, which is the earliest form of the disease and affects only the top layer of skin. The depth of the original melanoma is critical to determining how it will be treated and how patients are likely to fare. Although more melanomas are being diagnosed, the largest portion are made up of Stage 1 melanomas.

Myth #2: There is no difference between SPF 30 and SPF 100 sunscreen.
Although the baseline protection from SPF 30 and SPF 100 is not vastly different, the higher number provides longer coverage. One way to think of SPF is by time. If it normally takes you 10 minutes in the sun to burn, an SPF 30 sunscreen protects you for 300 minutes. An SPF 100 should, in theory provide 1,000 minutes of coverage.

Myth#3: If it is a cloudy day, I do not need to wear sunscreen.
About 80 percent of ultraviolet radiation reaches the earth even through clouds. Use a moisturizer with sunscreen daily, especially for areas such as your face that have high exposure.
Myth#4: If I am low in vitamin D levels, I must get some sun exposure.
Although the skin is the most efficient site of vitamin D production, adequate amounts can be obtained from your diet and from supplements. Vitamin D helps you absorb calcium and build strong bones, so we frequently recommend supplements that include vitamin D and calcium. ( Source: The Brigham and Women's Hospital)

NEW TECHNOLOGY: The new test is based on the soluble adenylyl cyclase (sAC) expression pattern and provides objective results: Melanoma is present if sAC appears in the nucleus of cells from a skin biopsy; the lesion is benign if the nucleus is negative. Most diagnostic stains highlight a particular cell in the biopsy, and if the stain is more intense, the cell tends to be melanoma. However, the meaning of "intense" is somewhat subjective. Investigators say the sAC stain should be used together with other diagnostic tests, such as light microscopy and three other stains currently available. They add that the new stain has the potential for expanded use across all cancers. (Source: http://dermatologytimes.modernmedicine.com)

Jonathan Zippin MD PhD
Assistant Professor of Dermatology
New York Presbyterian Hospital - Weill Cornell Medical Center

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