Montefiore in the News
Montefiore Establishes Multidisciplinary Team of Experts to Treat Patients with Melanoma
May is National Melanoma/Skin Cancer Awareness Month
New York City, NY (May 5, 2011) -- The Montefiore Einstein Center for Cancer Care (MECCC) has established a new multi-disciplinary team specializing in the treatment of skin malignancies including melanoma, the most aggressive and deadly form of skin cancer. The multidisciplinary team includes specialists in medical oncology, radiation oncology, and surgical oncology, as well as dermatology, thoracic surgery, plastic surgery, radiology and pathology who work together to provide care, support and a customized treatment plan for each patient.
Melanoma is the fastest growing cancer in men and the second fastest in women in the U.S. According to the Skin Cancer Foundation, melanoma is the number one cause of cancer in people ages 20-25. If detected early, there is a 95 percent cure rate. A dermatologist can identify and remove any suspicious-looking moles, and a pathologist determines whether they are malignant. When caught in an early stage, melanoma can be successfully treated with surgery alone. But the outlook changes dramatically if melanoma goes undetected.
"Melanoma can be more aggressive than other forms of skin cancer because it is invasive and can spread to other parts of the body if not caught early. At that stage it can be life threatening," says Steven K. Libutti, MD, Vice Chairman of Surgery and Director of the MECCC. "It is critical for patients with melanoma, particularly those with advanced disease, to have access to a range of specialists who can work together to develop individualized treatment plans."
The MECCC"s multidisciplinary melanoma team holds a clinic for patients every Wednesday and collaboratively reviews cases to develop and monitor treatment plans for each patient. The team is committed to providing patients access to novel therapies and clinical research trials.
Among the melanoma treatment options at the MECCC are traditional chemotherapy as well as FDA-approved immunotherapies such as ipilimumab and Interleukin-2 (IL-2), which have been shown to improve survival for some patients. B-RAF inhibitors, which are linked to suppressing the activity of tumors, are available to patients through research protocols.
Approximately half of newly diagnosed cases of melanoma are isolated to the upper or lower limbs, and in up to 10 percent of these cases recurrence takes place in the same limb where the primary diagnosis was made. For patients with recurrent melanoma that is confined to a limb and can not be cured by surgical means, a procedure called Isolated Limb Perfusion (ILP) can be offered. ILP provides an alternative to amputation. This method allows for large doses of chemotherapy to be delivered to the limb only, leaving the rest of the body unaffected. The chance that the tumors will completely go away is about 50 percent after ILP.
"With ILP, patients' response rates are much higher than can be achieved with any other form of therapy currently available," says Katia Papalezova, MD, surgical oncologist, MECCC. The MECCC is among a select group of centers nationwide to offer ILP and isolated limb infusion (ILI), a simplified, minimally invasive procedure offered for poor surgical candidates as an alternative to ILP. State-of-the-art radiation oncology treatments ranging from stereotactic radiosurgery, intensity modulated radiation therapy (IMRT) and image-guided radiotherapy (IGRT) are also available at the Center.
"Individuals diagnosed with melanoma need to be followed closely and educated about their disease, regardless of its stage," says Petra Rietschel, MD, PhD, director of the Melanoma/Sarcoma Program at the MECCC. "As this cancer progresses, treatment options become extremely limited. Our program is among a select few in the country that provides access to investigational treatments that can increase the odds of these patients doing better over time."
While cutting-edge treatments are provided by the MECCC team, its members emphasize that early detection of melanoma is essential. "There is a direct correlation between the thickness of the melanoma and survival rate," says Karthik Krishnamurthy, DO, Chief Dermatology Consultant, MECCC. "We strongly recommend a yearly total body exam by a dermatologist, and monthly self-examinations, to detect any changing or suspicious moles or blemishes. If anything unusual is seen, the patient should be examined by a dermatologist as soon as possible."
The Center's staff coordinates convenient scheduling of appointments so patients can see multiple specialists during one visit, rather than having to come in on several days. In addition, cancer support specialists offer patients and families valuable education and assistance in areas such as nutrition, genetics, rehabilitation and supportive counseling.