It was considered a rare tumor, while today it is among the top six most frequent cancers in Western countries. We are talking about melanoma, the most dangerous skin cancer, whose incidence has doubled in just 10 years. With a gender difference, because men get sick more. In fact, between 2015 and 2020, the increase was 37% among men and 24% among women. Another important difference is the geographical one: in the Center-North you get twice as sick as in the South. These are data that it is important to remember especially in this period of the year, when the first exposure to the sun begins, which are the factor of major environmental risk for melanoma.
Prevention was discussed today during a new meeting on the disease in the countryside Mela Talk Connected, a national information project now in its second edition, in which citizens – patients, caregivers and others – meet with oncologists, dermatologists and psycho-oncologists. The webinar, which is sponsored by the main patient associations (AIMa.Me. – Italian Association of Melanoma Patients, APaIM – Italian Melanoma Patients Association, Associazione Melanoma Italia Onlus and Emme Rouge Onlus) is made with the unconditional contribution of Bristol Myers Squibb .
“In Italy, the differences found are partly attributable to a greater tendency on the part of women to protect themselves from the sun’s rays, to check their skin and, in the event of a suspected lesion, to go to a dermatologist for a check”, she points out. Paola Queirolo, Director of the Melanoma, Sarcoma and Rare Tumors Division at the European Institute of Oncology in Milan: “It is important that men do not underestimate the risks of excessive sun exposure. The increase in incidence we are observing is partly linked to the absence of prevention campaigns before 2015 ”. Avoiding exposure when the sun is higher, using sunscreen and clothing that shields UV rays (not just cotton) are habits that can reduce the chances of getting sick. The main risk factor for this neoplasm, in fact, is burns, especially those that occur during childhood and adolescence. “We need to raise the level of awareness and raise awareness among young people, who still too often use tanning lamps or do not use sunscreen at the sea or in the mountains”, he adds Monica Forchetta, patient and president of APaIM. More generally, there is a need for information on this disease. Very often, for example, it is thought that a melanoma develops from an existing mole, while in 80% of cases it is new formations. “Whether it is a pre-existing or newly formed mole, there are some signs to watch out for”, explains Queirolo: “A mole that continues to grow must always be checked quickly by a specialist, as well as the presence of reddish-purplish areas “.
Melanoma and the new possibilities of treatment
In our country, 14,900 new cases were recorded last year (8,100 among men and 6,700 among females). In total, over 169,900 people live in Italy after a diagnosis of melanoma (80,100 males 89,800 females). It affects a relatively young age group: the average age at diagnosis is 57, and one in five cases is diagnosed among people under the age of 40. However, the information regarding the treatments is very positive: “75% of male patients and 83% of females manage to recover from the disease after 8-10 years from the moment of diagnosis”, continues Queirolo: “Traditional treatments against cancer such as chemo or radiotherapy are not very effective in this case, and are therefore only used in a few specific cases. The revolution in the fight against melanoma took place after the introduction of molecularly targeted therapies and immuno-oncology. Thanks to these treatments, more than 50% of patients with metastatic cancer can have a long-term benefit ”.
10 years of immunotherapy
Immunotherapy, in particular, which turns 10 this year, has fundamentally changed the clinical history of melanoma and other innovations are on the way. Studies presented at the American Congress of Medical Oncology (ASCO) show, for example, that the combination of two immunotherapy molecules, nivolumab and ipilimumab, brings a distinct advantage in survival in patients with advanced melanoma never treated before. 49% of patients treated with the combination are alive at 6.5 years and the median overall survival was 72.1 months – the longest reported in advanced melanoma to date. “A really important result if we consider that, before immunotherapy, the life expectancy of patients with metastatic melanoma was about 6 months, and less than 10% were alive at five years”, comments Queirolo: “This must make us understand how important follow-up is today, because getting to diagnose metastatic disease early can make a difference. In patients with a high risk of relapse, checks should be every 4 months “.
Communication is the basis of care
Finally, in the treatment path, the role of the psycho-oncologist is becoming increasingly important. “There are data – continues the oncologist – which show how help and a positive attitude of the patient also improve the prognosis”. And here the doctor-patient relationship also comes into play, one of the central themes of the webinar: “Communication is essential for patients who continually need to be updated on the disease”, concludes Forchetta: “We get many questions about the new treatments available but also on aspects of everyday life such as diet, rehabilitation or physical activity. Initiatives such as Mela Talk are therefore welcome, which give patients and caregivers the opportunity to dialogue directly with medical specialists ”.
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