Waging War on Skin Cancer and Melanoma
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1 Waging War on Skin Cancer and Melanoma The Role of the Esthetician and the Spa Industry Casey Culbertson MD Chair - Melanoma Research Foundation October 9, 2004 San Francisco, California
2 Waging War on Melanoma Overview I Skin Cancer and Tanning: Fact or Myth Skin Cancer & Melanoma Paradigm Skin Cancer & Melanoma Why Be involved Causes of Skin Cancer / Melanoma October 9, 2004 San Francisco, California
3 Waging War on Melanoma Overview II SPA owners Skin Cancer detection Skin Cancer How to Recognize Spa owners Supporting Patients The Melanoma Research Foundation October 9, 2004 San Francisco, California
4 Finally Casey s s Promise The Mind cannot absorb what the butt cannot endure!
5 Tanning Fact or Myth # 1 A Tan is Healthy and will PROTECT your skin from cancer MYTH Tan = SPF 3-4 sunscreen No protection from skin CA People of Color Asian / Black / Hispanic No immunity to melanoma Guess I need some stronger SPF
6 Tanning Fact or Myth # 2 A Tan is NECESSARY for your body to make Vitamin D and strong bones Just drink your milk like me! MYTH Lots of Vitamin D in food Need Minimal Sun exposure min UV exposure
7 Tanning Fact or Myth # 3 Sunscreens will PREVENT you from getting melanoma Guess I need a bigger Sombrero! MYTH High SPF sunscreens Help protect skin when: Applied before exposure Reapplied after swimming Will NOT prevent melanoma
8 Tanning Fact or Myth # 4 Tanning beds only have GOOD UV radiation so can t give you melanoma Bet I am getting a KILLER tan! MYTH Tanning bed -> UVA exposure Use = risk of melanoma (55%) 450% in use since 2000 Biggest user: y.o. females Tanning Industry = $5 billion / yr
9 Tanning Fact or Myth # 5 Children do NOT get melanoma What do you mean if I tan I am toast! MYTH Melanoma affects ALL ages Small study ( 3/2004) Average age = 9.5 years Initial melanoma easily seen 1 peeling sunburn = risk
10 The Cancer Paradigm (Metastatic Melanoma )
11 The Melanoma Paradigm (2004) What are WE up against? Metastatic Melanoma is currently increasing faster than ANY cancer in the United States Risk of Melanoma 52,000+ new cases diagnosed annually 7,800+ deaths annually Lifetime risk = 1/
12 Predicted New Melanoma Cases for 2004 (N=55,100)
13 Why YOU Need to be the Front Line for YOU clients skin health Why do I need to know about skin cancer?
14 Types of Skin Cancer Squamous Cell Basal Cell Melanoma
15 What Your Knowledge can mean for YOUR clients Squamous Cell 5 Year Survival Basal Cell % 90.00% 80.00% 70.00% 60.00% 50.00% 40.00% 30.00% 20.00% 10.00% 0.00% DX 1 Yr 2 Yr 3 Yr 4 Yr 5 Yr Basal Cell Squamous Cell
16 What YOU can save YOUR clients from I Melanoma In situ ( superficial) Stage III disease Found in lymph nodes (only) No organ system involvement % 90.00% 80.00% 70.00% 60.00% 50.00% 40.00% 30.00% 20.00% 10.00% 0.00% 5 Year Survival DX 1 Yr 2 Yr 3 Yr 4 Yr 5 Yr Stage III In situ
17 What YOU can save YOUR clients from II Melanoma 5 Year Survival - Stage IV Stage IV disease Multiple organ system involvement % 90.00% 80.00% 70.00% 60.00% 50.00% 40.00% 30.00% 20.00% 10.00% 0.00% DX 1 Yr 2 Yr 3 Yr 4 Yr 5 Yr
18 What else YOU can save YOUR clients from CT Scan for Advanced Melanoma Staging Side Effects Radiation May need 4-6 scans / year Contrast -> Kidney Damage Allergic Reaction -> Death Psychological Trauma Good Result (NED) Bad Result -> progression of the melanoma
19 What else YOU can save YOUR clients from CT Scan for Melanoma Staging III Other Side Effects?? No changes?? New Tumors?? Bigger Tumors Changes in CT scan More invasive tests Surgery Toxic Therapies
20 What else YOU can save YOUR clients from Interferon (alpha) Gold Standard for Stage III Approved by FDA NO significant change in Long term survival High Dose x 1 month Low Dose x 11 months Side Effects ( F.L.S ) Fever/chills on administration Liver Damage Bone Marrow problems
21 What else YOU can save YOUR clients from Interleukin II (IL-2) Used in Stage IV disease Few Complete Responders IV administration Must be done in ICU Side Effects Severe swelling (edema) Respiratory Distress Ventilator Cardiac Arrest Severe allergic Reaction
22 See why YOU want to know about skin cancer for YOUR clients WOW.. I DO need to know about skin cancer!
23 How Does Skin Cancer Occur UV Radiation Sun Skin Cancer Gene Mutations Genetics
24 What Makes Melanoma BAD Things that melanoma does (prognostic factors) Melanoma Ulcerating Invade through basement membrane Spread to lymph or blood system
25 GOOD Things the SPA Industry can DO Detection of Skin Cancers Client s Sun History Recognition / Suspicion Reasons to suggest referral Prevention / Education Sun safety Yearly Skin Check Support of the Client/Patient Supporting the MEL community Role of the MRF
26 Why the SPA Industry can DO this Therapists / Estheticians Frequent encounters with the skin of YOUR client(s) Face / Scalp Whole Body Detect early skin changes Discuss any skin findings Clients often share body changes with therapist NOT shared with their physician
27 Client s History: Important Risk Factors Melanoma Causes & Associations Multiple sunburns before teen years Multiple moles or freckles (nevi) Family history of melanoma Previous melanoma removed Northern European Background
28 GOOD Things the SPA Industry can DO Protection Recommendations Avoid sunbathing Avoid artificial tanning devices Avoid unnecessary sun exposure between 10 AM - 4 PM Use SPF 15 (or greater) sunscreen Use Protective Clothing (long sleeved shirts / hats etc) Examine YOUR skin - head to toe at least once every 3 months
29 Skin Cancer Recognition - AAD Style Classic ABCD A = Asymmetry 1 side different than the other Color or texture (ulcerated) B = Border Irregular C = Color Variation Dark brown or Black D = Diameter Larger than a pencil eraser
30 Skin Cancer Recognition - Casey Style ABCD Revisited A = A New Lesion Something you/they have not seen before B = Bugs You (or Them) Itchy, bleeding, bumpy etc Ulcerating Its just THERE!
31 Skin Cancer Recognition - Casey Style ABCD Revisited C = Changing Bigger or darker or now bleeding D = Doesn t Go Away When in doubt - send em out advising them to see their dermatologist
32 Skin Cancer Recognition Does it fit any ABCD criteria? Symmetrical, light brown No bleeding or ulceration Uniform color Smaller than an eraser Answer: Mole Does it fit any Casey criteria? A new lesion Bugging the client or you Changing Doesn t Go away
33 Skin Cancer Recognition Does it fit any ABCD criteria? Symmetrical, light brown No bleeding or ulceration Uniform color Smaller than an eraser Answer: Melanoma Does it fit any Casey criteria? A new lesion Bugging the client or you Changing Doesn t Go away
34 Skin Cancer Recognition Does it fit any ABCD criteria? Symmetrical, light brown No bleeding or ulceration Some with non-uniform color Smaller than an eraser Answer: Dysplastic Nevi Melanoma Precursor Does it fit any Casey criteria? A new lesion Bugging the client or you Changing Doesn t Go away
35 Skin Cancer Recognition Does it fit any ABCD criteria? Symmetrical, light brown Irregular Borders Uniform color Smaller than an eraser Answer: Melanoma Does it fit any Casey criteria? A new lesion Bugging the client or you Changing Doesn t Go away
36 Skin Cancer Recognition Does it fit any ABCD criteria? Symmetrical, light brown No bleeding or ulceration Uniform color Smaller than an eraser Answer: Melanoma Does it fit any Casey criteria? A new lesion Bugging the client or you Changing Doesn t Go away
37 Other Things the SPA Industry can DO Sun Protection Education Distribute sun protection literature in salon or spa (AAD or MRF) Distribute sunscreen in salon or spa Display literature / posters about skin cancer prevention / detection Business Opportunities Support MRF / AAD events Booths at AAD or MRF events Promote YOUR business as part of patient wellness
38 The PERFECT Medical SPA (2004) SPA Treatment Support Therapies that promote feeling of wellness during treatment Aroma therapy Facials Massage Therapy Business Opportunities YOUR salon/spa supports classes / support groups Associate with or co -sponsor MRF events
39 The SMART Medical SPA (2004) SPA support after Surgery Localized removal (skin) Facial Surgery (Mohs) Face: make up / hair concerns Lymph nodes dissection Lymphedema Massage therapy Exercise / Range of motion Business Opportunities: Support patient groups / classes One free visit during therapy (or during May) = Melanoma Awareness Month
40 The SPA Industry / MRF Alliance An out -of -this world alliance to fight melanoma!
41 Original Board: either MM patients or family members and all volunteers The MRF - Our Roots Who We Are MRF: Founded October 6, 1996 Diana Ashby (MM patient) 3 year battle with Melanoma Frustrated by lack of research and treatment Collected $15,000 -> MRF 1st Treatment: Betulinic Acid Died: May 2, 1997
42 The MRF - Research Research Grants Diana Ashby Award 6 Research Grants (2003-5) Emory University University of Pittsburg Rutgers University City of Hope Organize Research Meetings Agenda for the Cure Workshop World Congress on Melanoma Phoenix 2004 (2 nd World Congress)
43 The MRF - Education MRF mini-symposiums MM Clinicians / researchers minute talks / Q & A session Food and Fellowship Locations Nationwide LA, Chicago, SLC, Boston, NYC, Daytona Beach, Houston, San Francisco, Washington DC, Seattle, Tampa, Atlanta, Phoenix etc. 2x/ year with MRF board meeting Thanks to Chiron for their generous sponsorship of the MRF Mini-symposia
44 The MRF - Advocacy National Agenda for Melanoma Celebrities with melanoma Prevention and Detection Program NIH funding increase for melanoma National Office in Washington DC Lobby Congress for funding MRF Advocacy Accomplishments 1st Melanoma Foundation -> meet with NIH Partnering with Adovocacy Group Allured Publishing Day Spa Association
45 The MRF and SPA Association Goal Increased Research Education & Advocacy A Cure for Melanoma
46 Thank You Allured and Skin INC Together we can make a significant difference in the lives of those we serve Have a Great Conference!!!!
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