Teaming Up Against Melanoma
by Catherine House

Melanoma has the fastest growing incident rate of all cancer types in the United States. It is also one of the most treatable forms of cancer if caught in its early stages. 

"That is why it is so important to get any suspicious moles checked out," says Lisa May, a dermatologist in the School of Medicine. "The thinner the melanoma, the better the survival rate." 

But it's often difficult for people to judge on their own if a mole has grown or changed in appearance. Sometimes it's troublesome for doctors to tell, even when they take careful notes on the appearance and size of the mole. "When you're dealing with millimeters," May says, "there's a lot of room for error." 

That's one of the reasons physicians in the School of Medicine have teamed up and started a new multidisci-plinary melanoma clinic—to help manage everything from examining a mole to treating metastatic melanoma. 

To reduce the chance of error, the clinic offers the latest technology for monitoring changes in the shape and size of a pigment lesion. With help from the Medical Illustration and Photography department, dermatologists use digital cameras to take a series of 36 images of each patient—covering most of the body. These images are then stored on a compact disc for future comparisons. 

Doctors can look at these images on a computer screen and zoom to a specific spot on the body, enabling them to compare minute changes in a mole from one visit to another. They can also determine if new lesions have developed. 

"For those patients with hundreds of moles," May says, "this technology helps to relieve some anxiety. It makes it easier to keep track of new developments." 

While this procedure may sound high-tech and expensive, it only costs $76 for each patient—a lot less, for example, than a set of dental X-rays. But because this technology is so new and not yet used in many clinics, insurance companies aren't willing to pay for the procedure. 

"The way we see it," May says, "prevention is the key. We're proving that this is good preventative medicine. Hopefully, insurance companies will be quick to take notice. It's a lot less expensive to treat skin cancer at this stage than at the melanoma stage." 

Once patients are diagnosed with melanoma, treatment includes surgery and drug therapy. Patients often have to take a toxic drug such as interferon that causes a lot of side effects—nausea and other flu-like symptoms. But researchers in the clinic are hoping that a new melanoma vaccine, which stimulates the patient's own immune system to fight melanoma cells, will prove to be as effective as or better than interferon without the side effects. 

UNC-CH is one of several international centers participating in a final clinical trial that is testing the melanoma vaccine's effectiveness. David Ollila, a surgeon in the department of surgical oncology, says, "The results of this trial are important because if this drug proves to be as successful as or better than interferon, then it will mean a less toxic treatment option for melanoma patients." 

"And that's why we started this clinic," says May, "to offer the melanoma patient the best preventative and treatment options available."