By Abby S. Van Voorhees, MD, May 01, 2013
Dermatologists have long been thinking about skin cancers.
Despite our efforts, the number of cases of these malignancies has continued to grow at alarming levels. Over the past few years, happily, we’ve seen an explosion in our knowledge and our ability to treat these patients. Understanding the good and the bad, the benefits as well as the possible risks and limitations are key to guiding patients facing treatment decisions. In our supplement this month we take a look at each of these hot areas.
Let’s take non-melanoma skin cancer. Mohs surgery has been developed by dermatologists to aid in the care of those with more high-risk basal cell cancers. But does this technique translate into a benefit for all BCCs? In an era of cost cutting where every dollar spent will come under scrutiny, it is critical that we establish when this type of procedure truly benefits patients. In our piece on Mohs we highlight the conclusions of the Academy’s appropriate use criteria efforts. They clearly spell out when Mohs is truly recommended, and when alternatives are considered reasonable. An important first step for the Academy; you will definitely want to read this.
New drugs for treating melanoma seem to be popping up every time I read my journals. However, each comes with its limitations. If one were perfect in stopping this adversary we wouldn’t need others, but boy are we making progress. Therefore, it is important to appreciate the potential advantages of these new agents as well as learn about their limitations both in terms of recurrences and potential unwanted side effects. Again, another must-read.
Like in melanoma, there are also new developments in the squamous cell carcinoma arena. The untoward effects of transplant regimens are now increasingly understood. We are learning which drug protocols put patients at most risk, and we are starting to better educate both patients and transplant surgeons. Shifting from one immunosuppressant to another takes courage, but may have advantages. Again, it requires that we carefully think about the potential benefits as well as the limitations of our well trod paths of treatment.
New discoveries in the realm of photoprotection described in our article are also exciting may even soon allow for better compliance in our patients at most risk. Also read our story on the continuing search for enhanced treatment for actinic keratoses; certainly another important approach.
Benefits and limitations all over in the world of skin cancer. Wonderful to see such progress in these areas. New treatments unimaginable just a few years ago are opening up possibilities for our patients. Hope that you enjoy our pieces summing up the state of things in 2013. Exciting times.
Enjoy your reading.