Author Interviews, Biomarkers, Melanoma, Ophthalmology / 15.11.2019

MedicalResearch.com Interview with: Dr. Mitchell Stark, B.App.Sc (Hons), PhD NHMRC Research Fellow The University of Queensland Diamantina Institute Woolloongabba, QLD MedicalResearch.com: What is the background for this study? Response: Uveal nevi (moles) mimic the appearance of uveal melanoma and their transformation potential cannot be definitively determined without a biopsy. Moles or naevi in the eye are common but can be difficult to monitor because changes to their shape or colouring can’t always be seen as easily as on the skin. As naevi are difficult to biopsy, they are usually “monitored” at regular intervals. If there is a melanoma in the eye, then outcomes are poor for people if their cancer spreads to the liver. This study aimed to identify a “biomarker” that could be measured in patients’ blood that could be used as an early indicator of melanoma formation (from a mole) or progression to other body sites.  (more…)
Author Interviews, Cancer Research, JAMA, Melanoma, Surgical Research, Weight Research / 30.10.2019

MedicalResearch.com Interview with: Magdalena Taube, PhD Institute of Medicine, Dept of Molecular and Clinical Medicine Sahlgrenska Academy at Gothenburg University Wallenberg laboratory Gothenburg Sweden  MedicalResearch.com: What is the background for this study? Response: Obesity is a cancer risk factor, and bariatric surgery in patients with obesity is associated with reduced cancer risk. However, evidence of an association among obesity, bariatric surgery and skin cancer is limited. In this study we used data from the Swedish Obese Subjects (SOS) study– a prospective controlled intervention trial examining bariatric surgery outcomes – to analyze the impact of bariatric surgery on skin cancer incidence. (more…)
Author Interviews, Dermatology, JAMA, Melanoma, Technology / 21.10.2019

MedicalResearch.com Interview with: https://skin-analytics.com/about-us/ Dr. Helen Marsden PhD Skin Analytics Limited London, United Kingdom MedicalResearch.com: What is the background for this study? Response: In this technology age, with the explosion of interest and applications using Artificial Intelligence, it is easy to accept the output of a technology-based test - such as a smartphone app designed to identify skin cancer - without thinking too much about it. In reality, technology is only as good as the way it has been developed, tested and validated. In particular, AI algorithms are prone to a lack of “generalisation” - i.e. their performance drops when presented with data it has not seen before. In the medical field, and particularly in areas where AI is being developed to direct a patient’s diagnosis or care, this is particularly problematic. Inappropriate diagnosis or advice to patients can lead to false reassurance, heightened concern and pressure on NHS services, or worse. It is concerning, therefore, that there are a large number of smartphone apps available that provide an assessment of skin lesions, including some that provide an estimate of the probability of malignancy, that have not been assessed for diagnostic accuracy. Skin Analytics has developed an AI-based algorithm, named: Deep Ensemble for Recognition of Malignancy (DERM), for use as a decision support tool for healthcare providers. DERM determines the likelihood of skin cancer from dermoscopic images of skin lesions. It was developed using deep learning techniques that identify and assess features of these lesions which are associated with melanoma, using over 7,000 archived dermoscopic images. Using these images, it was shown to identify melanoma with similar accuracy to specialist physicians. However, to prove the algorithm could be used in a real life clinical setting, Skin Analytics set out to conduct a clinical validation study. (more…)
AACR, Author Interviews, Melanoma / 20.10.2019

MedicalResearch.com Interview with: Qing Chen, M.D., Ph.D. Assistant Professor, Immunology, Microenvironment & Metastasis Program Scientific Director, Imaging Facility The Wistar Institute MedicalResearch.com: What is the background for this study? Response: We are focusing on how a specific type of brain cells, astrocytes, helps the cancer cells from melanoma and breast cancer to form metastatic lesions.  (more…)
Author Interviews, Environmental Risks, Global Health, Melanoma / 10.10.2019

MedicalResearch.com Interview with: Suzanne Dobbinson, PhD Senior Research Fellow Centre for Behavioural Research in Cancer Behavioural Science Division Australia MedicalResearch.com: What is the background for this study? Response: Skin cancer prevention programs, such as the SunSmart program in Victoria, have been implemented in Australia over 30 years with the aim of reducing the population’s exposure to ultraviolet radiation (UV), the main cause of skin cancer. A recent reduction in melanoma rates among younger Australians has led to this paper which examines the extent of behaviour change in Melbourne, Australia, and the potential contribution of prevention programs to the decline in melanoma rates. Previous population-based studies assessing the impact of these programs have focused on measuring the change in the prevalence of individual sun protection behaviours, and thus have largely overlooked the use of sun avoidance and composite sun protection behaviours. The focus on tracking individual behaviours may have underestimated the behaviour change associated with these programs. We analysed data from a series of cross-sectional surveys conducted in Melbourne during summer months between 1987 and 2017. These data include the summer before the SunSmart program commenced (1987-88) and across summers in three subsequent decades. (more…)
Author Interviews, Dermatology, Environmental Risks, General Medicine, JAMA, Melanoma, Stanford / 07.10.2019

MedicalResearch.com Interview with: Eleni Linos MD MPH DrPH Professor of Dermatology and Epidemiology Stanford University  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: We know that tanning beds are harmful: people who use tanning beds are more likely to get skin cancer. Sexual minority men are much more likely to use tanning beds and also more likely to get skin cancer. In a separate study we discovered that one reason sexual minority men use tanning beds is if it is convenient: e.g. if close to home, cheap, and easy. (https://onlinelibrary.wiley.com/doi/abs/10.1111/bjd.17684). Recent research showed that tobacco retailers cluster in LGB neighborhoods: https://sph.unc.edu/sph-news/more-tobacco-retailers-in-lgbt-neighborhoods-may-explain-smoking-disparities/. This made us wonder if tanning salons also cluster in neighborhoods with more gay men.  (more…)
Author Interviews, Dermatology, Melanoma, Technology / 19.09.2019

SkinVision   MedicalResearch.com Interview with:  Andreea Udrea, PhD Associate Professor University Politehnica of Bucharest   MedicalResearch.com: What is the background for this study? The skin cancer incidence rate is increasing worldwide. Early diagnosis and prevention can reduce morbidity and are also linked to decreased healthcare costs. During the last years, efforts have been made in developing smartphone applications for skin lesion risk assessment to be used by laypersons. In parallel, as machine learning (ML) is on the rise, and medical image databases are increasing in size, a series of algorithms have been developed and compared in clinical studies to dermatologists for skin cancer diagnosis. The accuracy of the algorithms and experts were comparable. One drawback of these clinical studies is that they use images acquired by professionals in standardized conditions. So, there is little knowledge of what the accuracy will be when including an ML algorithm in an app and testing it in a non-clinical setup where the image quality may be lower, and the variability in image taking scenarios is higher as images are acquired by non-professionals using the smartphone camera. This study is one of the first that evaluates the accuracy of an app (SkinVision) when being used for risk assessment of skin lesions in the general population. (more…)
Author Interviews, Melanoma, Vaccine Studies / 11.08.2019

MedicalResearch.com Interview with: Prof. Ronit Satchi-Fainaro, PhD Head, Cancer Research and Nanomedicine Laboratory Department of Physiology and Pharmacology, Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv 69978, Israel Prof. Helena Florindo, PhD Head, BioNanoSciences – iMed.ULisboa Faculty of Pharmacy, University of Lisbon Lisbon, Portugal    MedicalResearch.com: What are the main findings? Response: The war against cancer in general, and melanoma in particular, has advanced over the years through a variety of treatment modalities, such as surgery, chemotherapy, radiation therapy and immunotherapy. The immune checkpoint inhibitors brought a breakthrough solution for advanced melanoma patients, but only a low percentage of those respond to this therapy, developing resistance and being affected by severe side effects. Despite the success of several vaccines against viral diseases, this success has not been materialized yet against cancer. This study led by my lab at Tel Aviv University, and Helena Florindo’s lab at the University of Lisbon, describes the development of an effective nano-vaccine against melanoma, that also sensitizes the immune system to immunotherapies. This nano-vaccine prevented melanoma, and also led to remarkable tumor inhibition and prolonged survival in mice already affected by this disease.  (more…)
ASCO, Author Interviews, Biomarkers, Melanoma, NYU / 02.06.2019

MedicalResearch.com Interview with: David Polsky, MD, PhD Dermatologist and Director of the Digmented Lesion Service Mahrukh M. Syeda, MS Research Associate Ronald O. Perelman Department of Dermatology NYU Langone Health MedicalResearch.com: What is the background for this study? Response: Several studies of metastatic melanoma patients have demonstrated that measuring circulating tumor DNA (ctDNA) associates with their disease burden and survival.  Generally, patients with detectable pre-treatment ctDNA levels and/or detectable ctDNA at various time intervals after starting treatment have shorter survivals than patients with lower pre-treatment or on-treatment ctDNA levels.  Studies have varied in their methods to detect ctDNA, the thresholds chosen to call a sample positive or negative, and the follow up time point for measurement, if any. In this study, we examined pre-treatment and week 4 on-treatment plasma samples from patients enrolled in Combi-D, the Phase III, randomized, double-blind trial of the BRAF and MEK inhibitors Dabrafenib and Trametinib, which led to FDA approval of the combination therapy for patients with unresectable stage III/IV melanoma. Only patients with BRAF V600E or V600K mutations identified from tumor genotyping were enrolled in the clinical trial. (more…)
Author Interviews, Melanoma, Pediatrics, Race/Ethnic Diversity, Stanford / 18.04.2019

MedicalResearch.com Interview with: Susan M. Swetter, MD Professor of Dermatology Director, Pigmented Lesion & Melanoma Program Physician Leader, Cancer Care Program in Cutaneous Oncology Stanford University Medical Center and Cancer Institute MedicalResearch.com: What is the background for this study? What are the main findings?  Response: The Stanford Pigmented Lesion and Melanoma and Program and Pediatric Dermatology Division participated in the long-term management of children, adolescents and young adults (<25 years of age) with melanoma and atypical melanocytic neoplasms, including atypical Spitz tumors (ASTs) that may be histopathologically challenging to differentiate from true melanoma. Over a 23-year period, we have observed increased racial-ethnic diversity in young patients with these diagnoses, especially in the presentation of young individuals with darker skin phenotypes and more clinically amelanotic (nonpigmented) lesions compared to patients with lighter skin.  (more…)
Author Interviews, Dermatology, JAMA, Kidney Disease, Melanoma, Transplantation / 11.02.2019

MedicalResearch.com Interview with "Kidney Model 9" by GreenFlames09 is licensed under CC BY 2.0. To view a copy of this license, visit: https://creativecommons.org/licenses/by/2.0Donal JSextonMD, PhD Department of Nephrology and Kidney Transplantation Beaumont Hospital Royal College of Surgeons in Ireland Dublin, Ireland MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Patients who receive a kidney transplant as treatment for end stage kidney disease are at risk of malignancy due to immunosuppression. In contrast to other solid organ transplant types, when kidney transplants fail it is possible for recipients to return to dialysis. Immunosuppression is usually reduced or completely stopped when  the allograft fails due to the risk of infection on dialysis. We decided to investigate what the trajectory of risk for non-melanoma skin cancer and invasive cancers overall (composite group) looked like for patients who have received multiple consecutive kidney transplants with intervening periods of graft failure. We compared cancer risk during periods of allograft failure and periods of functioning kidney transplants.   (more…)
Author Interviews, Cancer Research, Dermatology, Global Health, Melanoma / 08.02.2019

MedicalResearch.com Interview with: Dr. Catherine M. Olsen Associate Professor Cancer Control Group QIMR Berghofer Medical Research Institute MedicalResearch.com: What is the background for this study? Response: Melanoma incidence and mortality rates are increasing globally. Public health campaigns aiming to reduce sun exposure and use of sunbed have been implemented in many parts of the world, but there is significant variability in terms of the history and reach of these campaigns across countries. We examined melanoma incidence rates in eight different countries with different patterns of sun exposure and varying approaches to melanoma control. (more…)
Author Interviews, Environmental Risks, JAMA, Melanoma / 24.11.2018

MedicalResearch.com Interview with: Reza Ghiasvand, PhD Oslo Centre for Biostatistics and Epidemiology Faculty of Medicne University of Oslo Oslo, Norway  MedicalResearch.com: What is the background for this study? Response: Melanoma is the most dangerous type of skin cancer. It is estimated that about 288,000 individuals will be diagnosed and about 61,000 will die from it in 2018, with the majority of patients in Australia, New Zealand, Europe and North America. Ultraviolet (UV) exposure (from both the sun and tanning beds) is the most important preventable risk factor for melanoma. However, the association between UV exposure and melanoma is complex and does not accord with a simple model in which risk increases directly with exposure. An individual risk of melanoma also depends on personal characteristics such as skin color and skin sensitivity to the UV exposure, hair color, number of moles, and age. It has been hypothesized that the pattern of UV exposure may play a role in melanoma development in different body sites. For example, melanoma on the trunk (chest and back) has been linked to the recreational UV exposure such as sunbathing and frequent sunburns in people with high number of moles on their body. In contrast, melanomas on the head and neck have been linked to constant sun exposure such as occupational UV exposure, mainly in older people. Epidemiologic and molecular evidence in support of this hypothesis has been published based on analyses of small datasets. Also, melanoma on legs and arms is less studied under this hypothesis. In our study, we examined UV exposure (sunbathing, sunburn and sunbed use) and pigmentary factors (skin, eye, and hair color, freckling, and number of moles), and risk of melanoma on different body sites. We used information from the Norwegian Women and Cancer Study, a population-based cohort study that started in 1991, and includes more than 161,000 Norwegian women followed for an average of 18 years. (more…)
Author Interviews, Brigham & Women's - Harvard, JAMA, Melanoma / 14.10.2018

MedicalResearch.com Interview with: Caroline C. Kim, M.D. Associate Professor, Department of Dermatology Harvard Medical School Director, Pigmented Lesion Clinic Associate Director, Cutaneous Oncology Program Beth Israel Deaconess Medical Center Boston, MA 02215 MedicalResearch.com:  What is the background for this study?  What are the main findings? Response: Atypical/dysplastic nevi have been identified as risk factors for melanoma, however the majority of melanomas arise as new lesions on the skin. Unlike other models of dysplasia having a clear trajectory towards cancer as seen in cervical dysplasia, dysplastic nevi are not proven to be obligate precursors for melanoma.  However, there is little evidence to guide the management of biopsied dysplastic nevi with positive margins, with much clinical variation in the management of moderately dysplastic nevi in particular. In this multi-center national study of 9 U.S. academic centers, we examined outcomes of 467 moderately dysplastic nevi excisionally biopsied without residual clinical pigmentation but with positive histologic margins with at least 3 years of clinical follow-up.  We found that no cases developed into a same-site melanoma with a mean follow-up time of 6.9 years. However, 22.8% of our patients went on to develop a future separate site melanoma. (more…)
Author Interviews, Dermatology, Environmental Risks, JAMA, Melanoma / 15.09.2018

MedicalResearch.com Interview with: Lori A. Crane, PhD Department of Community and Behavioral Health Colorado School of Public Health University of Colorado Anschutz Medical Campus, Aurora CO  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Nevi, which are commonly called “moles”, are brown or black spots on the skin that are usually raised.  Moles are the number one risk factor for malignant melanoma, the most dangerous kind of skin cancer.  About 9,000 people die of melanoma each year in the U.S. The more moles a person has, the higher their risk for melanoma.  Sun exposure is a major factor in the development of moles, and in order to prevent melanoma, it is important to better understand how moles are formed on the skin. Most moles are formed during childhood and adolescence.  We studied non-Hispanic and Hispanic white children age 3-16 and found that non-Hispanic children developed many more moles than Hispanic children.  Overall, boys developed more moles than girls, but there were some important differences.  For parts of the skin that are often covered by clothing but sometimes exposed to the sun, such as the chest and back, upper arms and upper legs, girls developed more moles than boys, especially among Hispanic children.  In contrast, for parts of the skin that are usually exposed to the sun, such as the face, boys developed many more moles than girls.  The development of moles leveled off by age 16 for parts of the skin usually exposed to the sun, while for the less often exposed skin, children continued to develop moles to age 16. (more…)
Author Interviews, Biomarkers, Cancer Research, Immunotherapy, Melanoma, Nature / 11.09.2018

MedicalResearch.com Interview with: Dr. Noam Auslander PhD National Cancer institute and the Center for Bioinformatics and Computational Biology University of Maryland, College Park MedicalResearch.com: What is the background for this study? Response: Immunotherapy – specifically immune checkpoint blockage (ICB) therapy – has been shown to be very effective in treating melanoma. However, only some patients with advanced tumors currently benefit from ICB therapies, while others are completely resistant and hence can be spared from the associated side effects and costs. Hence, predicting which patients are most likely to respond is an important challenge that can have great clinical benefits.   (more…)
Abuse and Neglect, Dermatology, Leukemia, Lymphoma, Melanoma / 15.08.2018

MedicalResearch.com Interview with: Clive S. Zent MD Professor of Medicine Director of Lymphoma/CLL Program Wilmot Cancer Institute University of Rochester Medical Center Rochester NY MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Patients with chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL) have an increased risk of all skin cancers including malignant melanoma. This study in a stable population of CLL patients managed by a regional referral center confirmed that melanoma was over 6 times more common in than in an age and sexed matched general population. Because of the proactive skin screening program at the University of Rochester Medical Center’s Wilmot Cancer Center, most melanomas (77%) were detected at earlier stages and were treated surgically with curative intent. One patient with CLL and metastatic melanoma had a sustained remission of both diseases on treatment with ibrutinib and pembrolizumab. (more…)
Author Interviews, Dermatology, Environmental Risks, JAMA, Melanoma / 19.07.2018

MedicalResearch.com Interview with: “Sunscreen” by Tom Newby is licensed under CC BY 2.0Dr Caroline Watts  PhD Post-doctoral Researcher The University of Sydney. MedicalResearch.com: What is the background for this study? What are the main findings?  Response: The study analysed data collected from nearly 1700 young Australians who participated in the Australian Melanoma Family Study, a population-based case-control-family study that focused on people who had a melanoma under 40 years of age and compared them with people the same age who did not have a melanoma. We examined sunscreen use during childhood and adulthood and its association with melanoma risk and found that compared to people who did not use sunscreen, regular sunscreen use during childhood reduced melanoma risk by 30-40 per cent.  (more…)
Abuse and Neglect, Author Interviews, Dermatology, Environmental Risks, Melanoma, Occupational Health / 18.07.2018

MedicalResearch.com Interview with: “Brad at Santa Monica Pier on Ferris Wheel” by Brad Cerenzia is licensed under CC BY 2.0Sonia Duffy, PhD, RN, FAAN Professor, College of Nursing The Ohio State University MedicalResearch.com: What is the background for this study? Response: Prior to conducting a tobacco cessation study with Operating Engineers, I conducted a survey of 498 Operating engineer and found that many of them were at risk for sun burning, which can lead to skin cancer.  So as a follow up study, I conducted a study to prevent sun burning, which randomized 357 Operating Engineers to were randomized to four interventions: education only; education and text message reminders; education and mailed sunscreen; and education, text message reminders, and mailed sunscreen. (more…)
Author Interviews, Melanoma / 26.06.2018

MedicalResearch.com Interview with: Eugene R. Semenov, MD, MA Washington University School of Medicine MedicalResearch.com: What is the background for this study? Response: Melanoma is an aggressive type of skin cancer which has traditionally carried a poor prognosis. Over the past decade, many new therapies have become available that have improved long-term survival rates in patients with metastatic melanoma. However, these drugs have been associated with serious side effects, such as pancreatitis and hepatitis. Our goal was to study how melanoma diagnosis, disease stage, and treatment status impact patient quality of life (QoL). (more…)
AACR, Aging, Author Interviews, Cancer Research, Immunotherapy, Melanoma / 21.06.2018

MedicalResearch.com Interview with: Ashani Weeraratna, Ph.D. The Ira Brind professor and Co-program leader of the Immunology, Microenvironment and Metastasis Program The Wistar Institute Member of Wistar’s Melanoma Research Center Philadelphia  MedicalResearch.com: What is the background for this study? What are the main findings?  Response:  This study shows for the first time that older patients, especially those who have had prior MAPKi therapy fare better than younger patients when treated with anti-PD1. We found that tumors in younger patients and younger mice have higher levels of Tregulatory cells, the cells that regulate other immune cells. This is not true systemically, only within the tumor microenvironment. We were surprised because we expected that, as with targeted therapy, older patients would have a poorer response to immunotherapy, given what we perceive as a poorer immune system in older patients.  (more…)
Author Interviews, Brigham & Women's - Harvard, Dermatology, Environmental Risks, Melanoma, Transplantation / 08.06.2018

MedicalResearch.com Interview with: “Sunscreen” by Tom Newby is licensed under CC BY 2.0Rebecca Ivy Hartman, M.D Instructor in Dermatology Brigham and Women's Hospital Boston MA 02115 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Organ transplant recipients (OTR) are at 100-fold higher risk to develop certain skin cancers compared to the general population due to immunosuppression, and thus preventing skin cancer in this population is critical. Our study found that in a high-risk Australian OTR population, only half of patients practiced multiple measures of sun protection regularly. However, after participating in a research study that required dermatology visits, patients were over 4-times more likely to report using multiple measures of sun protection regularly. Patients were more likely to have a positive behavioral change if they did not already undergo annual skin cancer screening prior to study participation. (more…)
ASCO, Author Interviews, Dermatology, Melanoma, Merck, University of Pittsburgh / 05.06.2018

MedicalResearch.com Interview with: Dr. Diwakar Davar, MD Assistant Professor of Medicine Division of Hematology/Oncology University of Pittsburgh  MedicalResearch.com: What is the background for this study? What are the main findings? Response: The optimal surveillance strategy to detect recurrence in cutaneous melanoma remains elusive. Risk of recurrence increases with higher stage, and is especially high for patients with stage IIIC disease. Although consensus guidelines agree on surveillance imaging for high-risk (stage IIB-IIIC) MEL, there is no consensus regarding optimal frequency/modality in these patients. NCCN guidelines suggest chest radiography (CXR) at 6- to 12-month intervals for stage IA-IIA melanoma  patients; although this is controversial. There exists a great deal of practice variation in the surveillance of these patients. (more…)
Author Interviews, JAMA, Melanoma, UCLA / 24.05.2018

MedicalResearch.com Interview with: Joann G. Elmore, MD, MPH Professor of Medicine David Geffen School of Medicine at UCLA Director of the UCLA National Clinician Scholars Program Affiliate Professor of Medicine, University of Washington School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings?  Response: In a recent study published in 2017 in the British Medical Journal, our team found that pathologists disagreed on their diagnoses of some melanocytic skin biopsy lesions and early stage invasive melanoma more than 50% of the time. This concerning level of disagreement was particularly true for diagnoses in the middle of the disease spectrum, such as atypical lesions and melanoma in situ.  For example, Figure 1 from this paper shows the diagnoses of 36 pathologists who interpreted the same glass slide of a skin biopsy using their own microscopes; the diagnoses ranged from a benign lesion to invasive melanoma. Since that study, the American Joint Committee on Cancer has released new guidelines for melanoma staging. Given this change, we wanted to examine whether the updated guidelines improved the reliability of melanoma diagnosis. We found that using the new guidelines improved the accuracy of pathologists’ diagnoses for invasive melanoma (Elmore J, et al, JAMA Network Open 2018).  (more…)
Author Interviews, Dermatology, Environmental Risks, Melanoma / 22.05.2018

MedicalResearch.com Interview with: “Sunscreen” by Tom Newby is licensed under CC BY 2.0Carla Burns, M.S. Environmental Working Group She is one of the coauthors of the 2018 Guide to Sunscreens.  MedicalResearch.com: What is the background for the EWG report?  Response: Environmental Working Group (EWG) published its first Sunscreen Guide in 2007. When we first started the guide, many sun protection products sold in the U.S. were not as safe and used misleading marketing claims. Throughout the years, EWG has continued to find that a common sunscreen ingredient, oxybenzone, poses a hazard to human health and the environment. Despite EWG’s efforts to draw attention to the health hazards associated with this ingredient over the last 12, oxybenzone remains widely used in chemical-based sunscreens. So, this year, we are ramping up our efforts to rid the market of this ingredient by launching a campaign to urge companies and consumers to go oxybenzone-free by 2020. (more…)
Author Interviews, Dermatology, Education, JAMA, Melanoma / 17.05.2018

MedicalResearch.com Interview with: Michael SKolodneyMD, PhD Section of Dermatology, Department of Medicine West Virginia University MedicalResearch.com: What is the background for this study? What are the main findings? Response: Melanoma is easily curable if recognized early.   Dermatologists are good at spotting melanomas because they develop an innate sense of how melanomas appear after examining thousands of malignant and benign lesions.  In contrast, most medical students are relatively disadvantaged by their limited dermatology exposure. We felt that too little experience, rather than lack of knowledge of the rules, is the primary barrier to development of pattern-recognition and intuition as a reliable tool for melanoma diagnosis in non-experts.  To remedy this problem, we developed a novel web-based application to mimic the training of a dermatologist by teaching medical students intuitive melanoma diagnosis in a highly condensed period of time. Our application, which we call Skinder, teaches intuitive visual diagnosis of melanoma by quickly presenting the learner with thousands of benign and malignant skin lesions.  The user makes rapid binary decisions, by swiping right for benign or left for malignant, and receives instant feedback on accuracy. With this application, the learner can amass a mental repository of diagnostic experience in a short amount of time. To determine if intuitive visual diagnosis training is superior to a traditional rule-based approach, we compared our web-based application to a rules based approach, the publicly available INFORMED Skin Education Series. Medical students were tested on the ability top differentiate melanomas from benign pigmented lesions before and after training with either Skinder of the Informed Skin Education Series. The pre-test mean for the Skinder group was 75% correct, compared to 74.7% correct for the INFORMED group. The post-test mean for the skinder application group was 86.3% correct, compared to 77.5% correct for the INFORMED group which was highly signifcant. (more…)
Author Interviews, Cancer Research, Dermatology, JAMA, Melanoma, Primary Care, University of Pittsburgh / 18.04.2018

MedicalResearch.com Interview with: Laura K. Ferris MD, PhD Associate Professor, University of Pittsburgh Clinical and Translational Science Institute Director of Clinical Trials, UPMC Department of Dermatology University of Pittsburgh MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Dermatology is one of the greatest utilizers of physician extenders, including physician assistants (PAs) in medicine. The scope of practice of PAs has also expanded over time from a role in assisting the dermatologist to taking a more independent role and many PAs now do skin cancer screening examinations and make independent decisions about which lesions are suspicious for skin cancer and need to be biopsied. Our main findings were that, overall, in comparison to board-certified dermatologists, PAs were more likely to perform biopsies of benign lesions. For every melanoma that they found, PAs biopsied 39 benign lesions whereas dermatologists biopsied 25. In addition, PAs were less likely than dermatologists to diagnose melanoma in situ, the earliest and most curable, but also hardest to identify and diagnose, form of melanoma. However, PAs had a similar rate of diagnosing the more clinically-obvious forms of skin cancer, including invasive melanoma, basal cell carcinoma, and squamous cell carcinoma. (more…)
AACR, Author Interviews, Cancer Research, Melanoma / 24.03.2018

MedicalResearch.com Interview with: Gao Zhang, Ph.D. Staff scientist in the Herlyn Lab The Wistar Institute MedicalResearch.com: What is the background for this study? Response: The past 7 years have witnessed the great success in treating patients with unresectable or metastatic melanoma. Despite the breakthrough of molecularly targeted therapies and immune checkpoint blockade therapies, a majority of patients have experienced the rapid tumor recurrence and progression, following the dramatic regression. There is an urgent and unmet need to treat therapy-resistant tumors. (more…)
Author Interviews, Cancer Research, Dermatology, Environmental Risks, JAMA, Melanoma / 23.03.2018

MedicalResearch.com Interview with: John W. Epling, Jr., M.D., M.S.Ed., Task Force Member Dr. Epling is is a professor of Family and Community Medicine at the Virginia Tech Carilion School of Medicine in Roanoke, VA. He is also the Medical Director of Research for Family and Community Medicine, Medical Director of Employee Health and Wellness for the Carilion Clinic, and maintains an active clinical primary care practice.  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Skin cancer is the most common type of cancer in the U.S., affecting millions of people every year. The Task Force looked at the latest research to see if clinicians can help people prevent skin cancer by providing counseling about ways to reduce risk, including using sunscreen, wearing protective clothing, and avoiding sunlight during peak hours. Based on our review of the evidence, we found that counseling younger patients with a fair skin type and their parents is effective at encouraging these sun protective behaviors. By helping reduce their patients’ exposure to harmful UV rays, clinicians can decrease their risk for skin cancer. As such, we recommend that clinicians provide counseling to people who are six months to 24 years old and have a fair skin type. For adults over 24 with a fair skin type, clinicians should consider the individual’s risks for skin cancer when deciding whether or not to provide counseling.  (more…)
Author Interviews, Dermatology, JAMA, Melanoma / 11.03.2018

MedicalResearch.com Interview with: Aimilios Lallas, PhD First Department of Dermatology, School of Medicine Aristotle University Thessaloniki, Greece MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Our goal today is to recognize melanoma at the earliest stage, ideally before it invades the dermis and acquires metastatic potential. Melanoma-specific dermoscopic criteria have been tested mainly in the context of invasive melanoma. Although they were proven valid melanoma predictors, the question still remains if they are strong enough to diagnose melanoma in situ (MIS). Our aim was to investigate the diagnostic accuracy of dermoscopic criteria for the diagnosis of melanoma in situ. We identified 5 main positive dermoscopic indicators of MIS: atypical network, regression, irregular hyperpigmented areas, prominent skin markings and angulated lines.  (more…)