Thursday, 30 June 2011

My Thoughts on the Save Your Skin Patient Information Symposium in Vancouver

Well, I certainly can't believe where the time went this week! I attended the symposium Saturday and then enjoyed Vancouver and area Sunday and haven't had a minute to blog the rest of the week. So I'd like to post my thoughts and share some info. These are only my impressions and what I got out of it.
There were fabulous speakers:
Dr. Joel Claveau, dermatologist at the Melanoma and Pigmented Lesions Clinic, CHUQ Hôtel-Dieu de Québec spoke via video conference. He was very dynamic and was easily understood by everyone there. He gave the latest stats: Melanoma is increasing at a rate of 2-3% per year. It's the fastest increasingly diagnosed cancer. Estimated 1/59 in 2010 and 1/50 by 2015. This is a worldwide phenomena. In Canada in 2011 - 5,500 cases/year and 950 deaths. It appears Melanoma diagnoses are under reported. In July 2009, WHO (World Heath Organization) stated UV is an official carcinogen. I'm hoping my numbers are correct - I was writing so fast. Any errors are mine. Some of the other things he mentioned was that people are still getting burned using sunscreen because: people were under applying sunscreen, you need to put it on thicker; people are using a poor quality sunscreen, and they weren't reapplying. The worse things people do is forget to use other methods to protect themselves against too much UV exposure: hats, UV protectant clothing and umbrellas, staying out of the sun during the highest UV times etc.
Dr. Sasha Smiljanic, medical oncologist at Lion's Gate Hospital North Vancouver BC. He spoke more medicalese and spoke about studies. He explained Interferon - saying it is a naturally occurring cytokine that has a role in activation of the immune system. It's used as a treatment in high risk melanoma after surgery - Stage III. The treatment is for a year. Improves survival rates 5-10%. He also spoke about Ipilimumab (Yervoy). He said it downregulates T-cell activation - in layman's terms - T-cell activiatin turns the brakes off the immune system and then Yervoy turns the immune system on again. I didn't really understand it thoroughly - sorry. Yervoy is the first agent to show overall survival benefit in Melanoma when compared to standard of care (chemo/radiation). It cranks up the immune response. Long-term (>3 years) - control of Melanoma in 25% of patients - Yervoy vs standard chemotherapy - Dacarbazine (DTIC).
Dr. Michael Smylie, medical oncologist at the Cross Cancer Institute Edmonton, Alberta. I was looking forward to hearing Dr. Smylie as I've heard so much about him. He started off saying that he's been working with Melanoma patients for 17 years and that he's been depressed for 16 of those years because there hasn't been a significant improvement in Melanoma therapies. He spoke about chemo not being really effective in Melanoma especially metastatic. He mentioned that tumor vaccines have failed to date. He spoke a bit about Interleuken II, Targeted Therapies - BRAF. He said that Melanoma had something called BRAF mutation in 50% of patients. There is immune activation with no turn off system. From what I understand BRAF is a protein that is involved in cell division, differentiation and secretion. When there is a mutation, it can cause cancer. Then he mentioned Vemurafenib which works in BRAF patients - response rate >50%. Decreasing death by 63%. In the BRIM3 study there was a median 6 months shrinkage in tumors.
Following these talks there was a panel that included the 3 above speakers to answer questions from the audience. Some of the things I took away from this was answers to my questions which were about follow up after Surgery and for my Stage II. They said I should be going to the dermatologist yearly, the oncologist every 4 months and family doctor 2-3 times/year. They weren't pro having a CT or any other radiological test for baseline unless there was something that definitely needed to be checked out. They said a CT scan had 2,200 times the radiation of a chest X-ray. They said the risk of that causing problems outweighed the benefit of a baseline CT scan. I was surprised about that. I also don't know if it will change my mind about having a baseline CT scan. We'll see.
Another thing I took away from the panel discussion was that 30 SPF was a minimum for sunscreen but higher than 50 SPF didn't give exponentially more protection - it gives a false sense of security.
They mentioned that Melanoma was radiation resistant and that radiation was only effective paliatively for comfort.
Also there was a fellow there that was speaking about his pregnant wife having Melanoma and he was worried that the baby would be at risk. The panel believed that there was a risk to the baby and the doctors would have to be vigilant in checking over the baby and monitoring it for signs of Melanoma. Who knew that Melanoma can be passed through pregancy.

So to wrap up what I learned, basically if you have Stage I and II Melanoma, your prognosis is pretty good, but there still wasn't a lot promising for treatments during Stage III and IV. There is still a lot of research going on and the new clinical trials are showing good results with Yervoy and Vemurafenid. I sure hope they come up with new stuff fast.This is all that is available in Canada anyways. I know things are different in the USA.

Like I said, any errors are mine and so are any opinions. If you have any questions, please feel free to email Kathy Barnard at the Save Your Skin Foundation:

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