Knowledge is Power

Yesterday, the MRF hosted a live webinar focusing on how to manage melanoma treatment in a rapidly changing landscape. As we prepared for the webinar, I heard disturbing stories of many patients receiving care that is sloppy, outdated, or just wrong:

• Botched biopsies: A key factor in evaluating melanoma is the thickness of the tumor from the surface of the skin. This thickness is an indicator of the likelihood for recurrence and a host of other outcomes. The best way to determine thickness is through what is called a punch biopsy—essentially a hollow needle pushed into the skin so as to remove a tiny cylinder of tissue. I learned that a lot of patients are given shave biopsies, in which the doctor slices away a section of skin. Shave biopsies have their place, but only in the hands of someone very knowledgeable, and only under certain circumstances. When the doctor’s shave biopsy is too thin, it cuts through the middle of the tumor. This means the depth of the tumor can never be known, and staging of the cancer is impossible.
• Outdated treatments: In 2011, two new drugs were approved for treating metastatic melanoma. Since then, many promising clinical trials have opened up, offering people with melanoma even better treatments. Despite this, a lot of patients are still be treated with the old, ineffective therapies or, even worse, are being told that nothing works in melanoma so any treatment is futile. 

In the webinar, a few people asked how they can be sure they are receiving the right treatment. The response of the panelists was very helpful:

• Anyone with metastatic melanoma should get a second opinion.
• At least one opinion should come from someone who sees a lot of melanoma.
• Look for centers that have a true melanoma team, with experts in surgery, oncology, radiology, etc.
• Look for academic settings or places with strong ties to academic settings.

As new and better treatments become available, where you are treated for melanoma becomes more and more important. It can mean the difference between receiving the newest or best treatment options but also receiving the most up to date and comprehensive information available. Now, more than ever before, patients who are well educated and well supported will definitely live longer and better.

Written by Tim Turnham, the MRF's Executive Director.