examine lesions at the cellular level for a more accurate diagnosis.
Advances in treatment The treatment of skin cancer de- pends on a variety of factors, includ- ing the type and stage of the cancer, its size and location, and the patient’s overall health. Basal-cell carcinomas usually are removed surgically, often via a procedure known as Mohs sur- gery, in which the tumor is excised in layers until completely eliminated. “Mohs surgery has a very high cure rate,” says Duvic, “and is often used to treat basal cells on the face, where they can be very destructive.” Squamous-cell carcinomas also typically are removed via surgery. Epidermal growth-factor receptor inhibitors, which initially were de- veloped to treat other types of can- cer, might be used to treat inoperable squamous-cell carcinomas. Melanoma in its early stages is
excised with clear borders. To delay a
A Navy lieutenant commander examines a sailor’s back during a skin can- cer screening at Naval Amphibious Base Coronado, Calif., in October 2008.
recurrence, high-risk patients might be placed on a yearlong regimen of in- terferon. “Once melanoma spreads, it’s very hard to control,” warns Duvic. For melanomas more than a mil- limeter in thickness, it now is recom- mended patients receive a sentinel- node biopsy prior to surgery. In this process, radioactive dye is injected to determine whether a lymph node is af- fected. If yes, other regional nodes also might be surgically removed. “People who have nega- tive sentinel-node biopsies have a bet- ter prognosis than those who don’t,” notes Duvic.
A Marine sprays on sunscreen be- fore work at Camp Lejeune, N.C., in June 2010.
PHOTOS: ABOVE, CPL. JO JONES, USMC; TOP, PETTY OFFICER 2ND CLASS DOMINIQUE M. LASCO, USN According to Wang, some new
therapies have created optimism re- garding the treatment of advanced melanoma. Improved immuno- therapies and compounds known as BRAF inhibitors disrupt the growth pathways for melanoma. One promis- ing BRAF inhibitor is PLX4032 by Plexxikon, which was approved by the FDA for the treatment of late-stage melanoma in August 2011. In prelimi- nary tests, PLX4032 shrank tumors in more than 80 percent of advanced melanoma patients. By comparison, less than 20 percent responded to pre- viously used medications. Skin cancer is a serious disease,
but there are ways to protect your- self, dermatologists say. Foremost, al- ways wear sunscreen and protective clothing when out in the sun, and reapply sunscreen every hour or so if you’re sweating. If your sunscreen is more than a year old, throw it away. “Sunscreen loses its effectiveness over time,” Duvic says.
MO
— Don Vaughan is a North Carolina- based freelance writer. His last feature article for Military Officer was “Proving Their Mettle,” May 2012.
JU NE 2012 MILITARY OFFI C ER 67
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