Good news and bad news: new cases of melanoma diagnosed in Italy every year are increasing by 7% among both men and women. But not among the under 35 obviously more sensitive to prevention issues. The picture of the trend of the most dangerous skin cancer is drawn by the specialists of IMI, Intergruppo Melanoma Italiano, who will meet in Florence, from 30 September to 2 October, for their XXVIII National Congress.
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by Dario Rubino
Under 35 less at risk
According to recent studies by the Italian Cancer Registries Association supported by IMI (Italian Melanoma Intergroup), among people born from the mid-1970s onwards, the risk of cancer has decreased after years of constant growth. The merit is to be found in prevention and above all in a more correct exposure to the sun, also due to greater awareness. But according to IMI specialists, “there is still a long way to go and there is no real educational campaign at national level on the model of those recently conducted in Australia or the USA”.
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Survival on the rise
Prevention is even more valuable when you consider that melanoma could be less scary today than in the recent past. “Thanks to the combination of a continuous improvement in therapeutic strategies and a growing increase in early diagnosis – he highlights Emanuele Crocettiepidemiologist and past-president of the Italian Cancer Registries Association – five-year survival has reached 87% and the figure rises to over 90% among the Italian population under 45. However, it remains a particularly insidious tumor that affects every more than 14,900 men and women year “.
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Surgery and targeted therapies
How is melanoma treated? “Today we are able to guarantee good prospects for our patients – he replies Corrado Caracò, of the SC Surgery Melanoma and Skin Tumors of the INT “Pascale Foundation” of Naples. Surgery remains the treatment of choice for melanoma, especially in the early stages of the disease. We are able to carry out targeted and less invasive interventions than in the recent past “. But also in terms of therapies, great strides have been made. “New treatments such as immunotherapy and target therapies have brought long-term benefits to more than half of those affected by this advanced form of cancer and a significant reduction in the risk of relapse in high-risk radically operated patients – points out Mario MandalàProfessor of Medical Oncology at the University of Perugia S. Maria della Misericordia Hospital ”.
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If you are 50 in, visit once a year
It is essential not to skip check-ups because prevention also begins with an early diagnosis. “We recommend everyone a check-up with a dermatologist specialist – he highlights Ignazio Stanganelli, IMI president, professor at the University of Parma and director of the Skin Cancer Unit Irccs IRST Istituto Tumori Romagna. In particular, those who have about fifty moles on their skin should check them periodically, at least once a year. Not necessarily a mole turns into a cancer but its evolution must be monitored to eventually arrive at an early diagnosis of the disease. For this reason it is necessary to intervene on the family doctor to help him in the selection of the population at risk and of the suspicious lesions to be sent to the dermatologist ”.
Telemedicine to train doctors
The latest tele-dermatology projects promoted by IMI are also presented at the Florence congress. “We recently started MelaMed (Melanoma Multimedia Education) – he continues Stanganelli. It is a national initiative that aims to train the general practitioner in the primary and secondary prevention of cutaneous melanoma. It also wants to provide the relative knowledge of the essential bases of the patient’s entire diagnostic and therapeutic pathway “. It makes use of the online platform www.imi-melamed.it, which presents an area of educational activities and a course in Distance Learning, with ECM credits, sponsored by the National Federation of Orders of Surgeons and Dentists (FNOMCeO).
The collaboration between doctor and specialist travels online
The platform also constitutes a virtual library, with a quick-access and easily consultable multimedia atlas, complete with all the fundamental chapters on the pathology ”. Telemedicine has now largely shown how valuable it can be in every area of health. “The telematic sharing of images in dermatology such as the one promoted with the Melamed project is useful in the collaboration between general practitioner and specialist”, underlines Patrizia Re, general practitioner of the Romagna AUSL. The asynchronous FAD of the project will also contribute to an in-depth professional training that will lead to improving the diagnostic appropriateness and quicker management of the patient with onco-dermatological suspicion ”.
IMI is also promoting the genetic teleconsulting project. “With the coordination of Paola Ghiorzo of the University of Genoa – he explains Giuseppe Palmieri of the University of Sassari and Director of Cancer Genetics of the National Research Council (CNR) – we provide specialists with an online path in order to identify patients with access criteria to genetic tests for the diagnosis of hereditary melanoma or conditions syndromic in which the neoplasm may be an associated clinical oncological sign “. “Finally, we have launched an experimental histopathological diagnostic consultancy project – he concludes Daniela Massi of the University of Florence and Director of the Pathological Anatomy Service of the Careggi University Hospital. Through our Second Opinion platform we offer clinicians in the IMI network a decision support tool for atypical melanocytic tumors and rare forms of melanoma aimed at making the treatment path homogeneous in cases of high complexity and rare observation, taking into account the specificity of the individual patient. “.