The Importance of Skin Cancer Prevention
- Julian Lennon, the 61-year-old son of late Beatles icon John Lennon, was recently diagnosed with an aggressive form of skin cancer called melanoma for a second time. The first time it was found on his head four years ago. His most recent diagnosis was found on either his forearm or his shoulder.
- Lennon underwent surgery to remove the melanoma, however, he is still waiting for his biopsy results to see if all the cancer was taken out.
- Melanoma is a type of skin cancer that starts in the same cells that give your skin, hair, and eyes their color. It is most likely found on sun-exposed skin areas like your face, neck, arms, and legs. However, you might also find them in your feet, eyes, and mouth
- Although Lennon didn’t specify the type of surgery he underwent, it’s likely his doctor performed Mohs surgery, a microscopically controlled surgery where surgeons remove thin layers of skin tissue until they reach clear tissue without cancer.
What You Need to Know About Skin Cancer
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Lennon, who was his late dad’s inspiration for the song “Hey Jude,” then admitted that he prioritized his health and immediately flew back to Los Angeles “to surgery, with a surgeon recommended by Dr Tess, @timneavin – who spent several hours cleaning up and operating on me, with large margins, in the hope that we have, at the end of the day – clear margins, which would mean being free from cancer.”
After praising the operation to be a “success,” Lennon did note that he is still awaiting his biopsy results and he may not get them until after Christmas.
Lennon said he’s keeping his “fingers crossed” until hearing his biopsy results, but he remains hopeful that all the cancer has been removed.
He concluded, “Obviously good news, would be the best Christmas present ever… Which I’m hopeful for… But I just want to say, this is also a timely reminder to all, to please get yourself checked out by your doctor.
“It only takes a short while to do so, and you may just be saving your own life, at the end of the day… so please, for the sake of yourself, your family and friends just go to your Dr and do what must be done… I love life and I want to live for a very long time and this is one way, and a choice, that could determine your future.”
His cancer news comes nearly five years after his previous melanoma journey, which he also took to social media to share photos.
Alongside some images of the spot on his head that needed to be removed, the English musician warned, “The Trouble is… You think you have time.”
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He explained, “A few days ago, I went to visit My dermatologist, here in LA, when she noticed a little bump on My head, that was actually a Mole, that had been there, along with a Birthmark, for the all my life…. But this time, it looked & felt a little different.
“She urged me to have a Biopsy 2 days ago, which I obliged… Only to learn, 24 hrs later, that it was Malignant/Cancerous, and that her recommendation was to get it removed immediately, which is what happened today…. Hopefully We managed to remove all that was cancerous, but the Mole is being sent off again, for a further/deeper analysis, and I’ll have those results next week.”
We’re glad Lennon has continued to spread awareness for skin cancer and the importance of prevention, especially after his mom Cynthia Lennon, passed away after a short battle with cancer in April 2015, as per various news outlets.
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Understanding Melanoma
Melanoma starts in the same cells that give your skin, hair, and eyes their color. In melanoma, the cells change in a way that allows them to spread to other organs.
Changes to a mole you’ve had for a while or a new growth on your skin could be signs of melanoma. However, it’s also possible to get this type of skin cancer without any warning signs.
You’re most likely to find melanoma on sun-exposed skin areas like your face, neck, arms, and legs. Surprisingly, you might also find them in other places as well, like:
- The palms of your hands or soles of your feet
- On your eyes or mouth
- Under your nails
The top way to protect yourself is by staying out of the sun, especially during peak hours, and avoiding unprotected sun exposure because ultraviolet (UV) radiation can lead to melanoma.
According to experts like Dr. Anna Pavlick, an oncologist at NYU’s Perlmutter Cancer Center, tanning beds pose ultraviolet radiation risks for skin cancer and should be avoided completely.
RELATED: How Do I Know My Skin Cancer is Gone?
Dr. Pavlick notes that people who are covered with moles stand a higher risk of developing skin cancer, especially people with dysplastic nevis syndrome, or “atypical” moles.
Atypical moles are those that are unusual-looking and, when seen under a microscope, they have irregular features. Although usually benign, a high number of atypical moles do signal an increased risk for melanoma, according to the Skin Cancer Foundation which says people with 10 or more atypical moles have 12 times higher risk of developing melanoma.
Warning Signs of Skin Cancer – Remember ABDCE
The most important thing to look out for when it comes to finding melanoma is a sudden, new spot on your skin or a spot that is quickly changing in size, shape, or color.
Dr. Cecelia Larocca, a dermatologist at Dana-Farber Cancer Institute, recommends implementing the ABCDE rule to determine if a mole requires further examination.
The ABCDE rule:
- A: Asymmetry of the mole, or when one half of the mole doesn’t match the other
- B: Border irregularity or Bleeding
- C: Color change either lightening or darkening of a mole
- D: Diameter greater than 6mm or enlarging moles
- E: Evolving size, shape or color.
WATCH: Dr. Cecila Larocca on the ABCDEs of checking moles for signs of skin cancer
Melanoma that moves into the body, away from the skin, becomes an entirely different treatment journey for patients.
Treatment options for melanoma that has spread include targeted therapy and immunotherapy, which give people a better chance of living a long and healthy life than ever before. If you’re diagnosed with melanoma, there’s a good chance surgery will be the treatment your doctor recommends.
Expert Melanoma Resources
- Blood Test Could Predict the Best Type of Treatment for Metastatic Melanoma
- Atypical Moles Don’t Necessarily Mean You Have Melanoma
- Am I at High Risk for Melanoma?
- How is Melanoma Treated After Surgery? The Landscape of Therapies Explained
- Examining Your Skin for Melanoma: Remember ABCDE
- There is no “Cookie Cutter Recipe” for Treating Stage Four Melanoma
- ‘A Game Changer’: New Combination Immunotherapy for Advanced Melanoma Offers More Options For Patients
- A Melanoma Vaccine for Metastatic Patients
- Dramatic Improvement in Melanoma Survival Rates– The Treatment Revolution is Working
Cancer removal usually leads to a cure in the early stages of the disease. After surgery, the removed tissue and lymph nodes are examined to measure the melanoma and determine if it has clear margins. Clear margins mean the cells around the area of tissue that was removed don’t contain any melanoma.
When no cancer cells are left around the removed area, your cancer is less likely to return.
The Melanoma Workup
Unlike other diseases, the workup for melanoma is pretty straightforward. For any skin lesions, your dermatologist will give you a head-to-toe visual examination to look for any other atypical moles or suspicious lesions.
If a growth warrants further evaluation, you might get a biopsy. And if advanced melanoma is found, you may need additional imaging and blood tests to help determine the best treatment plan.
Blood tests may include:
Complete blood count (CBC): looks at the number and types of cells in your blood, including red blood cells, white blood cells, and platelets
Comprehensive Metabolic Panel (CMP): measures the blood levels of certain enzymes, proteins, electrolytes, and minerals
Lactate dehydrogenase (LDH): an enzyme that’s increased in many cancers
Imaging tests may include:
CT scan: uses x-rays and a computer to create detailed images of your body
PET scan: uses radioactive materials (called tracers) and a special camera to create pictures of areas inside the body where cancer may be growing
MRI: Uses radio waves and magnets to create images of organs and tissues
A pathologist may also examine your tissue sample under a microscope to look for certain mutations. This is called biomarker testing, which helps determine the best treatment options for you. The BRAF mutation is the most common mutation found in melanoma tumors.
It’s important to remember that many atypical skin lesions are not cancer. So don’t worry if your doctor finds something that looks a bit strange it may just be a benign growth. If you have any concerns about the findings, be sure to talk with your doctor.
Melanoma Treatment Options
Melanoma treatment has come a long way. Survival rates have risen dramatically, thanks to a “treatment revolution,” say SurvivorNet’s experts. With breakthrough treatments like targeted therapy and immunotherapy now available, people who are diagnosed today have a much better chance of living a long and healthy life than ever before.
If you’re diagnosed with melanoma, there’s a good chance surgery is going to be the treatment your doctor recommends. In the early stages of the disease, removing the cancer should lead to a cure. The question is typically not whether you’ll get surgery, but which kind you’ll have.
WATCH: Dermatologic Surgeon Dr. Nima Gharavi, On The “Gold Standard Treatment” For Melanoma
For an early-stage melanoma that is close to the skin surface, Mohs surgery might be an option. This technique removes skin cancer, layer by layer, until all the cancer is gone.
In general, stage I melanoma surgery consists of the simple, in-office removal of the cancerous cells by a dermatologist. If the cancer is thicker, your surgeon will remove it through a technique called wide excision surgery.
The removal of stage II and III melanomas are performed by surgeons or surgical oncologists, not dermatologists. You may also have a sentinel lymph node biopsy to see if the melanoma has spread to the first lymph node where it’s most likely to travel. If your cancer has reached this first lymph node, it may have spread to other neighboring lymph nodes, and possibly to other organs. Where the cancer is will dictate your treatment.
After surgery, the removed tissue and lymph nodes will go to a specialist called a pathologist, who will measure the melanoma and find out if it has clear margins. Having clear margins means the cells around the area of tissue that was removed don’t contain any melanoma. When there aren’t any cancer cells left around the removed area, your cancer is less likely to come back.
Once your cancer spreads, treatment gets a little more complicated, but there are still ways to stop it. New treatments have vastly improved the outlook for people with metastatic, or stage IV, melanoma.
Targeted drugs and immunotherapy have been shown to be more effective than chemotherapy. So, with many more choices, there is no standard treatment. Treatment will vary based on your condition and whether there is recurrent disease.
Research has found that immunotherapy drugs such as Keytruda (pembrolizumab) and Opdivo (nivolumab) helped some people live longer. Combining immunotherapy drugs Yervoy (ipilimumab) and Opdivo (nivolumab) has also extended survival. Opdivo (nivolumab) + relatlimab is a new therapy option added to the National Comprehensive Cancer Network guidelines in 2022. The combination of two immunotherapies is called Opdualag.
For those with the BRAF mutation, targeted drugs which shrink or slow the tumor can be a good option. This could include a combination of drugs, such as:
- Zelboraf (vemurafenib) and Cotellic (cobimetinib)
- Braftovi (encorafenib) and Mektovi (binimetinib)
- Tafinlar (dabrafenib) and Mekinist (trametinib)
- Zelboraf (vemurafenib) and Cotellic (cobimetinib) can also be combined with atezolizumab.
“Every patient is different and every situation is different,” says Dr. Anna Pavlick, medical oncologist at Weill Cornell Medicine. She emphasized that “there is no cookie-cutter recipe,” for treating stage IV melanoma.
There Is No “Cookie Cutter Recipe” for Treating Stage Four Melanoma
Dr. Pavlick also notes the importance of personalized care and treatment. “It really is a matter of looking at the tools we have so that we can pick the right tools to give the patient the best outcome.”
So, while there is no one-size-fits-all approach to treating metastatic melanoma, your doctor will work with you to develop a treatment plan that is tailored to your individual situation. Advances in research and technology are making the fight against metastatic melanoma more hopeful than ever.
What is Mohs surgery?
We’re delighted to see Lennon raising awareness for skin cancer after recently undergoing surgery to remove the cancer. Although he didn’t specify what type of surgery he underwent, it’s likely Mohs surgery —a microscopically-controlled surgery where thin layers of tissue (typically, skin cancer tissue) are removed until the surgeon reaches clear tissue.
“You’re able to remove a very conservative margin around the cancer and study it in essentially real-time,” Dr. Sumaira Aasi, Director of Mohs and Dermatologic Surgery at Stanford, told SurvivorNet in a previous conversation.
If, when the surgeon examines the tissue under the microscope, cancer is found, the surgeon goes back and removes some more tissue.
The idea is that by making the tiniest cuts and evaluating them microscopically, the surgeon knows for certain that all the cancer is out when the last piece of tissue proves to be clear. It is often done as an outpatient procedure with local anesthetic.
“The Mohs surgeon will take a conservative cut circumferentially around the cancer where we’re able to preserve healthy tissue,” Dr. Aasi explained. “We’re able to process the tissue and look at the cancerous tissue and know where there are still tumor cells persisting.
Dr. Aasi continued, “Because as the Mohs surgeon removes the cancer, it’s mapped out, and we can go back specifically to the areas where we see cancer cells and take, again, another conservative margin or amount of tissue.”
Contributing: SurvivorNet Staff
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