Cancer Care

A study reveals patients, the public and even practitioners may have erroneous perceptions about cancer. Because patients have taken on an unprecedented role in deciding their course of treatment, their viewpoint has taken on an increased significance, researchers say. Yet, the report published in CA: A Cancer Journal for Clinicians, indicates patients’ perspective on cancer risk may be off the mark.

Even among clinicians, the mind’s eye may not see the risks clearly, the researchers reported. For example, in one study, when doctors were asked whether they would release a psychiatric patient, their answers depended on the way statistical information was presented. When they were told 20 of 100 similar patients would likely commit a violent act, 41 percent refused to discharge the patient. However, when they were given the risk as a percentage — 20 percent — only half as many, 21 percent, declined to release the patient.

Similar biases occur with patients. For example, studies show people are more likely to act when they are cautioned than when they are cajoled. Thus, a woman is more apt to get a mammogram if she’s warned, “If you don’t get screened, you may die,” than if she ‘ s assured, “Getting screened can save your life,” researchers said. These influences are important to understand for both the doctor and the patient if communication between them is to produce meaningful results, the authors said.

Five ways to spot melanoma risk

Specialists have come up with criteria to help gauge an individual’s risk for developing a potentially deadly skin cancer called melanoma. The guidelines, published online in the Journal of the American Academy of Dermatology, were based on an analysis of skin cancer screening information gathered between 2001 and 2005 by the American Academy of Dermatology. Dr. Darrell Rigel, clinical professor of dermatology at New York University Medical Center, and his colleagues came up with five factors that appear to increase the likelihood of melanoma. These included:

— a history of skin cancer;

— age older than 50;

— absence of a regular dermatologist;

— changes in a mole;

— male gender.

While study participants who met four or five of the above criteria comprised less than 6 percent of those surveyed, they accounted for nearly 14 percent of the probable melanoma cases, Rigel said. In addition, they were 4.4 times more likely to be diagnosed with the cancer than were those with none or only one of the risk factors.

Specialists advise everyone to give skin regular, thorough examinations, including on the:

— back;

— scalp;

— soles;

— palms; and

— between the toes.

The following should be reported to a doctor:

— changes in the size, color, shape or texture of a mole;

— appearance of a new mole; or

— unusual changes in the skin.

In addition, dermatologists recommend melanoma screenings.

Indoor tanning carries risks

Dermatologists caution teens against indoor tanning, which they say can be as damaging and dangerous to the skin as the sun’s potentially deadly rays. Up to an estimated 3 million adolescents opt for what they perceive to be a safer way to bronze their skin. A national survey by the American Academy of Dermatology showed 67 percent thought tanning beds are safer than the sun. That is mistaken thinking, the dermatologists warned. Research points to the risks of indoor tanning, they said. A report from the International Agency for Research on Cancer, based on an analysis of seven studies, concluded those who use tanning beds before age 35 face a 75 percent increased risk of developing melanoma. A Swedish study also pointed to a potential link between indoor tanning and increased melanoma risk.

This year, doctors will diagnose more than 1 million new cases of melanoma, said Dr. Arielle Kauvar, a New York dermatologist and chair of the academy’s Council on Communications.

To whittle down those numbers, teens and their parents must take precautions, Kauvar said. To educate adolescents about the risks of indoor tanning, the academy has launched a campaign in a language most familiar to that age group — instant messaging.

Kinder, gentler option for spinal tumors

Research indicates there may be another option besides the traditional surgery and radiation treatment for spinal tumors. Estimates indicate in at least 30 percent of the some 1.4 million new cases of cancer that will be diagnosed in 2007, the malignancy will spread to the spine. Untreated, the expanding cancer will cause the spinal cord to compress, chronic pain to develop, leg function to cease and, ultimately, paralysis and incontinence to set in. In such cases, the current treatment strategy calls for surgery to decompress the spinal cord followed by radiation. Yet, this protocol doesn’t work for all patients, including those unable or unwilling to undergo surgery, doctors said.

Enter a new option that has been undergoing some serious scientific scrutiny: stereotactic radiosurgery, which sends super-high doses of radiation precisely to the target, minimizing harm to the surrounding healthy tissue.

For the past three years, scientists at Henry Ford Hospital in Detroit have been offering the treatment as an alternative to certain patients with spinal cord compression. They reported their results at a meeting of the American Association of Neurological Surgeons in Washington. Based on the findings, “we feel that radiosurgery may be considered as an alternative to surgery when patients with malignant spinal cord compression are ambulatory and especially when the tumor is radiosensitive,” Dr. Ian Lee told the gathering. UPI Consumer Health welcomes comments on this column. E-mail: lwasowicz@upi.com.