Expect Questions About Preventing Melanoma


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A recent report from the Centers for Disease Control and Prevention (CDC) stated that the incidence of melanoma “doubled between 1982 and 2011, but comprehensive skin cancer prevention programs could prevent 20% of new cases between 2020 and 2030.”1,2 That report should serve to increase interest in strategies to reduce exposure to ultraviolet radiation. Augmenting that interest is the strong summer sun and national media coverage of the CDC findings, including reports by CBS News and the Los Angeles Times.

The CDC Vital Signs report included standard advice on protecting against ultraviolet radiation exposure by wearing a hat and clothes that cover the skin, applying broad-spectrum sunscreen, and seeking shade. In addition, the report called on policymakers and members of the community to “restrict the availability and use of indoor tanning by minors.”2

Lynn M. Schuchter, MD, told The ASCO Post, “There is a lot of concern that the rising increase in young females is related to tanning salon use.” Dr. Schuchter is the University of Pennsylvania Willard Robinson Professor of Hematology/Oncology, Chief of the Hematology/Oncology Division, and Program Leader for the Abramson Cancer Center’s National Cancer Institute approved and funded Melanoma Research Program. She is also Chair of ASCO’s Cancer Research Committee and served as an ASCO expert at this year’s Annual Meeting.

Nicotinamide Does Not Work for Melanoma

A study presented at the 2015 ASCO Annual Meeting found that two daily doses of nicotinamide, a form of vitamin B3, reduced the incidence of skin cancers by 23% in high-risk persons but only for those with nonmelanoma skin cancers.3 “That prevention strategy is not for melanoma,” Dr. Schuchter confirmed.

While press materials concerning that study noted that nicotinamide is safe, inexpensive, and “ready to go straight to the clinic,” reports of its efficacy seem to have curtailed its availability. “Locally, patients have tried to get it and said that the drugstores and vitamin stores are sold out,” Dr. Schuchter noted.

“I would not say that I am recommending it in my practice,” she added. The research does not indicate that everyone should be taking nicotinamide, “but I think one could certainly discuss it with some patients who are at a very high risk and have had multiple nonmelanoma skin cancers—for these patients, it could be considered in addition to sunscreen and seeing a dermatologist.” ■

Disclosure: Dr. Schuchter reported no potential conflicts of interest.

References

1. Centers for Disease Control and Prevention: Preventing melanoma. CDC Vital Signs, June 2015. Available at cdc.gov/vitalsigns/melanoma. Accessed June 17, 2015.

2. Centers for Disease Control and Prevention: Rates of new melanoma —deadly skin cancers—have doubled over last three decades. Available at cdc.gov/media/releases/2015. Accessed June 17, 2015.

3. Martin AJ, Chen A, Choy B, et al: Oral nicotinamide to reduce actinic cancer: A phase 3 double-blind randomized controlled trial. 2015 ASCO Annual Meeting. Abstract 9000. Presented May 30, 2015.



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