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Melanoma Q&A with Dr. Bremer, Ph.D.

What? We asked Facebook fans to submit questions about melanoma prevention, diagnosis and/or treatment. We received a great response.

Why? May is Melanoma Awareness Month and we know how important it is to protect your skin.

Who? Dr. Edwin Bremer Ph.D., the recipient of the SkinCeuticals-Melanoma Research Alliance Young Investigator Award, was invited to respond on this important topic.


About Melanoma

Did you know that 1 person in the US dies every hour of melanoma? Melanoma is the deadliest form of skin cancer and is one of the fastest growing cancers in this country. Through the MRA’s and Dr. Bremer’s efforts a cure for melanoma is hopeful within our lifetime. However, there are no guarantees so education of this deadly disease is even more important.


Q: I am low on vitamin D and can your body absorb vitamin D while using sunscreen?

A:  Vitamin D comes in two forms (vitamin D2 and vitamin D3). Only one of these forms, vitamin D3 is produced by the body upon exposure to sunlight/UV radiation. Since sunscreen will block UV radiation, the production of vitamin D3 by the body will be blocked while using sunscreen. However, D3 can also be obtained via your diet. Some examples of foods containing vitamin D3 are oily fish (salmon, sardines), egg yolk, fortified dairy products and cereals. In addition, there are many over-the-counter vitamin D supplements available. In other words, there is no real need for unprotected sunlight exposure in order to take up vitamin D!


Q: Does Melanoma ever first develop on parts of the body that are not exposed to the sun? If so, is there anything to prevent that?

A:  Melanoma can indeed develop on parts of the body that are not or not often exposed to the sun. For instance, scratching or continuous irritation of a mole by elastic bands in e.g. underpants or bras can trigger damage and formation of melanoma. Perhaps the best solution for a mole which is frequently irritated is careful monitoring of appearance and/or preventive removal.


Q: Why melanoma is the deadliest form of skin cancer vs other types of skin cancer?

A:  Compared to other skin cancers, melanoma is a particularly deadly cancer since it is fast-growing and can spread/metastasize at a rapid speed, creating malignant cancer cells in other parts of the body. Other common types of skin cancer grow and spread more slowly. For instance, squamous cell carcinoma most of the time spreads so slowly that it is not very dangerous. Furthermore, basal cell carcinoma almost never spreads, so even in advanced cases treatment is almost always successful.


Q: Can Melanoma develop on a person’s scalp?

A:  Melanoma can indeed develop on the scalp. This is usually referred to as a hidden melanoma, since the lesion is often hidden by hair and the scalp is difficult to self-examine.


Q: What does metastatic mean?

A:  The word metastatic is derived from the Greek word ‘methistanai’, which means ‘to change’. Metastatic melanoma cells have indeed undergone changes compared to melanoma cells of the original lesion. Metastatic melanoma cells can survive in the bloodstream, can invade other organs and, once there, can form new tumours. In short, they have acquired changes that allow them to spread and develop new tumours.


Q: Have you ever heard about a “clear” or colourless melanoma?

A:  While uncommon, colourless melanoma does occasionally occur. Colourless means that the malignant cells do not produce melanin, which accounts for the typical brown colour of melanoma cells. Examples are rare cases of nodular melanoma (NM), which while most often being darkly pigmented can be light brown or even colourless and non-pigmented. In addition, some uncommon melanoma subtypes can appear colourless. For instance, amelanotic melanoma usually appears as a pink or red nodule, whereas Desmoplastic neutrotrophic melanoma (DNM) usually looks like a non-pigmented scar.


Q: What do you think the future of melanoma treatment will be?

A:  In my opinion, the future of melanoma treatment lies in so-called immunotherapy, in which the aim is to induce and enhance an immune response against melanoma cells. Some very promising results have been obtained with immunotherapy in melanoma. For instance, in a recent clinical trial in which people were treated with so-called autologous T-cells, approximately 20% of advanced melanoma patients experienced a complete response. In another example, treatment with an antibody that was designed to block a negative signal on T-cells prolongs survival for most patients by 2 years and is virtually curative in a small percentage of patients. This antibody has actually recently received FDA approval for advanced melanoma.


Q: Is it easier to treat or do surgery for men or for women?

A: Men and women are affected alike by melanoma and treatments are not significantly different. The major denominator for difficulty of treatment/surgery is the location of the tumour. More important still for is the question as to how advanced the melanoma is, in other words, whether the melanoma has spread and metastasized.


We encourage everyone to educate your friends & family and follow these simple steps to protect your skin!

  1. Use a broad-spectrum sunscreen and wear protective clothing.
  2. Never use an indoor tanning bed.
  3. Know your skin and examine it regularly
  4. Visit a Dermatologist regularly, recommended twice a year.

If you’d like to have some worrying moles checked out by our dermatologist, in May we’ll be giving away a limited number of FREE consultations. Book quickly, since appointments will be given on a first-come, first-serve basis. Call us on 21 340 366 or send an email to info@persona.com.mt