Melanoma Vets

Hi, Jared,

I think that I would have whatever moles she deems as suspicious removed before I took off for Afghanistan.  That is just my personeal preference. I lost my worlwide mobility status after I had a lesion checked out, but I would have been in a world of doodoo if I had just gone on the deployment.

As for the aspirin, I checked it out, and was very surprised to see some articles about the efficacy of an aspirin a day in treating melanoma! Here is a link:

http://www.msnbc.msn.com/id/43468687/ns/health-cancer/t/daily-aspirin-may-protect-against-melanoma/

Good luck to you, Jared!

Cristy, Stage IV

Hi, Jared,

I think that I would have whatever moles she deems as suspicious removed before I took off for Afghanistan.  That is just my personeal preference. I lost my worlwide mobility status after I had a lesion checked out, but I would have been in a world of doodoo if I had just gone on the deployment.

As for the aspirin, I checked it out, and was very surprised to see some articles about the efficacy of an aspirin a day in treating melanoma! Here is a link:

http://www.msnbc.msn.com/id/43468687/ns/health-cancer/t/daily-aspirin-may-protect-against-melanoma/

Good luck to you, Jared!

Cristy, Stage IV

Hi, Jared,

I think that I would have whatever moles she deems as suspicious removed before I took off for Afghanistan.  That is just my personeal preference. I lost my worlwide mobility status after I had a lesion checked out, but I would have been in a world of doodoo if I had just gone on the deployment.

As for the aspirin, I checked it out, and was very surprised to see some articles about the efficacy of an aspirin a day in treating melanoma! Here is a link:

http://www.msnbc.msn.com/id/43468687/ns/health-cancer/t/daily-aspirin-may-protect-against-melanoma/

Good luck to you, Jared!

Cristy, Stage IV

If you have a lot of atypical looking moles, removal of all of them is just not realistic.  Only about 50% of melanomas arise on existing moles.  Personally, I only remove things that change for the worst.  For my 3 primaries, that was key.  If I were you, I'd probably let the PA remove anything you can't monitor yourself that is suspicious.  Then I'd probably take photos of the rest to watch for change.  As for the old shave biopsy on your back, it's likely that the shave didn't remove everything and some of the original benign mole remained or grew back.  If it was benign before, it most likely is benign now.  I wouldn't really suspect amelanotic melanoma especially if your first melanoma wasn't amelanotic.  But you could request an excisional biopsy to get rid of it all if it bothers you.  That's the problem with shave biopsies, they often don't go deep enough to remove an entire mole.  I refuse shave biopsies now.

My question to you is this:  What moles do YOU want removed and what would make YOU comfortable?  I like my derm, but *I* caught my 3 primaries – no one else.  You know your body better than a PA who sees you on occasion.  If they aren't comparing your existing moles against photos, how is the PA going to remember if anything looks different than before?  Are any of those moles "the ugly duckling"?  Different from all your other moles?  My derm always asks my gut feeling, and we discuss anything that is suspicious after we compare it against existing pictures.  He will remove anything that I really don't like – and that is key with me.  You call the shots – you know your body best!  Do what YOU think will make you comfortable while you're away.  It's still low risk that you'll have another primary, but being vigilant is just smart.

Best wishes,

Janner

If you have a lot of atypical looking moles, removal of all of them is just not realistic.  Only about 50% of melanomas arise on existing moles.  Personally, I only remove things that change for the worst.  For my 3 primaries, that was key.  If I were you, I'd probably let the PA remove anything you can't monitor yourself that is suspicious.  Then I'd probably take photos of the rest to watch for change.  As for the old shave biopsy on your back, it's likely that the shave didn't remove everything and some of the original benign mole remained or grew back.  If it was benign before, it most likely is benign now.  I wouldn't really suspect amelanotic melanoma especially if your first melanoma wasn't amelanotic.  But you could request an excisional biopsy to get rid of it all if it bothers you.  That's the problem with shave biopsies, they often don't go deep enough to remove an entire mole.  I refuse shave biopsies now.

My question to you is this:  What moles do YOU want removed and what would make YOU comfortable?  I like my derm, but *I* caught my 3 primaries – no one else.  You know your body better than a PA who sees you on occasion.  If they aren't comparing your existing moles against photos, how is the PA going to remember if anything looks different than before?  Are any of those moles "the ugly duckling"?  Different from all your other moles?  My derm always asks my gut feeling, and we discuss anything that is suspicious after we compare it against existing pictures.  He will remove anything that I really don't like – and that is key with me.  You call the shots – you know your body best!  Do what YOU think will make you comfortable while you're away.  It's still low risk that you'll have another primary, but being vigilant is just smart.

Best wishes,

Janner

If you have a lot of atypical looking moles, removal of all of them is just not realistic.  Only about 50% of melanomas arise on existing moles.  Personally, I only remove things that change for the worst.  For my 3 primaries, that was key.  If I were you, I'd probably let the PA remove anything you can't monitor yourself that is suspicious.  Then I'd probably take photos of the rest to watch for change.  As for the old shave biopsy on your back, it's likely that the shave didn't remove everything and some of the original benign mole remained or grew back.  If it was benign before, it most likely is benign now.  I wouldn't really suspect amelanotic melanoma especially if your first melanoma wasn't amelanotic.  But you could request an excisional biopsy to get rid of it all if it bothers you.  That's the problem with shave biopsies, they often don't go deep enough to remove an entire mole.  I refuse shave biopsies now.

My question to you is this:  What moles do YOU want removed and what would make YOU comfortable?  I like my derm, but *I* caught my 3 primaries – no one else.  You know your body better than a PA who sees you on occasion.  If they aren't comparing your existing moles against photos, how is the PA going to remember if anything looks different than before?  Are any of those moles "the ugly duckling"?  Different from all your other moles?  My derm always asks my gut feeling, and we discuss anything that is suspicious after we compare it against existing pictures.  He will remove anything that I really don't like – and that is key with me.  You call the shots – you know your body best!  Do what YOU think will make you comfortable while you're away.  It's still low risk that you'll have another primary, but being vigilant is just smart.

Best wishes,

Janner

Most studies I have seen relate to the full strength adult aspirin usage for 5 years or more.  The main activity apparently is believed to be in the anti-inflammatory properties of aspirin.  One item to watch out for is any of the negative side-effects of aspirin if you tend to have them.  I don't seem to have them and my family has had circulatory problems for which aspirin appears to help.

   If not on any Chemo for melanoma, I would also recommend anti-oxidants and Curcumin (Tumeric extract (95%))

Cancers 2011, 3, 927-944; doi:10.3390/cancers3010927

http://bmctoday.net/practicaldermatology/2011/08/article.asp?f=skin-cancer-important-developments-in-treatment-and-prevention

In one of the more promising recent studies of NSAID use and skin cancer incidence, Tori, et al. found NSAID use to be associated with a modestly reduced risk of SCC.⁷ Aspirin use provided the greatest reduction in risk, with the greatest benefit seen among patients taking the drug for six years or less. NSAID use seemed to reduce the risk of SCC tumors with p53 or PTCH mutations,

http://www.mdpi.com/2072-6694/2/2/1178/pdf

2.2.2. Anti-inflammatory Agents
Overexpression of cyclooxygenase-2 (COX-2) and increased prostaglandin biosynthesis are defining features of several malignancies, and correlate with carcinogenesis [23–27]. The SKICAP-AK trial revealed that NSAID use of short duration was more protective against non-melanoma skin cancers than longer duration of use [28]. A few epidemiological studies have examined the association of NSAIDs with melanoma risk and have found conflicting results [29–32] A recent case controlled study examining the association between statins and NSAID use and melanoma, demonstrated that control
subjects were more likely than melanoma subjects to have reported NSAID or aspirin use for 5 years [33]. While NSAIDs have yet to demonstrate sufficient evidence to be recommended for melanoma chemoprevention, their potential role in melanoma may be directed towards adjuvant treatment of metastases rather than prevention [34].

2.2.3. Anti-oxidants
Induction of reactive oxygen species (ROS) in the skin by ultraviolet (UV) radiation is damaging to intracellular organelles, depletes the critical antioxidant glutathione (GSH), and ultimately promotes oncogenic mutations via oxidative DNA damage [35–38]. N-acetylcysteine (NAC), an orally bioavailable antioxidant, replenishes the pool of available GSH [39]. Topical formulations have the potential to decrease UV-mediated GSH depletion and ROS formation [40], and recent human studies support the utility of NAC in pre-UV exposure prophylaxis [41].
2.2.4. Anti-proliferatives
Perillyl alcohol (POH) is a naturally occurring chemical that can slow tumor cell growth by suppressing transcription factor-mediated cell proliferation and transformation [42]. A recent phase IIa study examined reversal of actinic damage following POH vs. placebo in patients with sun-damaged skin, and showed that histopathologic score was reduced with low dose POH and that abnormal nuclei were significantly reduced with high dose POH. These compelling results warrant larger, well-controlled studies of POH as a chemopreventive agent as well as efforts to improve dermal
penetration and bioavailability of POH-based therapeutics.
2.2.5. Diet, Micronutrients and Nutritional Supplements
Diet, micronutrients, and other nutritional supplements may also play a role in melanoma chemoprevention [43]. Vitamins C [44], D [45–48], and E [49–55] each have varying degrees of evidence supporting their use as chemopreventive agents. The same is true with other dietary supplements such as green tea polyphenols [56–61], selenium [62–65], curcumin [66], and lycopene [67–69]. While there are many in vitro and animal studies that indicate a possible benefit in melanoma prevention, human studies are generally lacking and do not suggest a clear clinical
recommendation that physicians should pass on to their patients.

Most studies I have seen relate to the full strength adult aspirin usage for 5 years or more.  The main activity apparently is believed to be in the anti-inflammatory properties of aspirin.  One item to watch out for is any of the negative side-effects of aspirin if you tend to have them.  I don't seem to have them and my family has had circulatory problems for which aspirin appears to help.

   If not on any Chemo for melanoma, I would also recommend anti-oxidants and Curcumin (Tumeric extract (95%))

Cancers 2011, 3, 927-944; doi:10.3390/cancers3010927

http://bmctoday.net/practicaldermatology/2011/08/article.asp?f=skin-cancer-important-developments-in-treatment-and-prevention

In one of the more promising recent studies of NSAID use and skin cancer incidence, Tori, et al. found NSAID use to be associated with a modestly reduced risk of SCC.⁷ Aspirin use provided the greatest reduction in risk, with the greatest benefit seen among patients taking the drug for six years or less. NSAID use seemed to reduce the risk of SCC tumors with p53 or PTCH mutations,

http://www.mdpi.com/2072-6694/2/2/1178/pdf

2.2.2. Anti-inflammatory Agents
Overexpression of cyclooxygenase-2 (COX-2) and increased prostaglandin biosynthesis are defining features of several malignancies, and correlate with carcinogenesis [23–27]. The SKICAP-AK trial revealed that NSAID use of short duration was more protective against non-melanoma skin cancers than longer duration of use [28]. A few epidemiological studies have examined the association of NSAIDs with melanoma risk and have found conflicting results [29–32] A recent case controlled study examining the association between statins and NSAID use and melanoma, demonstrated that control
subjects were more likely than melanoma subjects to have reported NSAID or aspirin use for 5 years [33]. While NSAIDs have yet to demonstrate sufficient evidence to be recommended for melanoma chemoprevention, their potential role in melanoma may be directed towards adjuvant treatment of metastases rather than prevention [34].

2.2.3. Anti-oxidants
Induction of reactive oxygen species (ROS) in the skin by ultraviolet (UV) radiation is damaging to intracellular organelles, depletes the critical antioxidant glutathione (GSH), and ultimately promotes oncogenic mutations via oxidative DNA damage [35–38]. N-acetylcysteine (NAC), an orally bioavailable antioxidant, replenishes the pool of available GSH [39]. Topical formulations have the potential to decrease UV-mediated GSH depletion and ROS formation [40], and recent human studies support the utility of NAC in pre-UV exposure prophylaxis [41].
2.2.4. Anti-proliferatives
Perillyl alcohol (POH) is a naturally occurring chemical that can slow tumor cell growth by suppressing transcription factor-mediated cell proliferation and transformation [42]. A recent phase IIa study examined reversal of actinic damage following POH vs. placebo in patients with sun-damaged skin, and showed that histopathologic score was reduced with low dose POH and that abnormal nuclei were significantly reduced with high dose POH. These compelling results warrant larger, well-controlled studies of POH as a chemopreventive agent as well as efforts to improve dermal
penetration and bioavailability of POH-based therapeutics.
2.2.5. Diet, Micronutrients and Nutritional Supplements
Diet, micronutrients, and other nutritional supplements may also play a role in melanoma chemoprevention [43]. Vitamins C [44], D [45–48], and E [49–55] each have varying degrees of evidence supporting their use as chemopreventive agents. The same is true with other dietary supplements such as green tea polyphenols [56–61], selenium [62–65], curcumin [66], and lycopene [67–69]. While there are many in vitro and animal studies that indicate a possible benefit in melanoma prevention, human studies are generally lacking and do not suggest a clear clinical
recommendation that physicians should pass on to their patients.

Most studies I have seen relate to the full strength adult aspirin usage for 5 years or more.  The main activity apparently is believed to be in the anti-inflammatory properties of aspirin.  One item to watch out for is any of the negative side-effects of aspirin if you tend to have them.  I don't seem to have them and my family has had circulatory problems for which aspirin appears to help.

   If not on any Chemo for melanoma, I would also recommend anti-oxidants and Curcumin (Tumeric extract (95%))

Cancers 2011, 3, 927-944; doi:10.3390/cancers3010927

http://bmctoday.net/practicaldermatology/2011/08/article.asp?f=skin-cancer-important-developments-in-treatment-and-prevention

In one of the more promising recent studies of NSAID use and skin cancer incidence, Tori, et al. found NSAID use to be associated with a modestly reduced risk of SCC.⁷ Aspirin use provided the greatest reduction in risk, with the greatest benefit seen among patients taking the drug for six years or less. NSAID use seemed to reduce the risk of SCC tumors with p53 or PTCH mutations,

http://www.mdpi.com/2072-6694/2/2/1178/pdf

2.2.2. Anti-inflammatory Agents
Overexpression of cyclooxygenase-2 (COX-2) and increased prostaglandin biosynthesis are defining features of several malignancies, and correlate with carcinogenesis [23–27]. The SKICAP-AK trial revealed that NSAID use of short duration was more protective against non-melanoma skin cancers than longer duration of use [28]. A few epidemiological studies have examined the association of NSAIDs with melanoma risk and have found conflicting results [29–32] A recent case controlled study examining the association between statins and NSAID use and melanoma, demonstrated that control
subjects were more likely than melanoma subjects to have reported NSAID or aspirin use for 5 years [33]. While NSAIDs have yet to demonstrate sufficient evidence to be recommended for melanoma chemoprevention, their potential role in melanoma may be directed towards adjuvant treatment of metastases rather than prevention [34].

2.2.3. Anti-oxidants
Induction of reactive oxygen species (ROS) in the skin by ultraviolet (UV) radiation is damaging to intracellular organelles, depletes the critical antioxidant glutathione (GSH), and ultimately promotes oncogenic mutations via oxidative DNA damage [35–38]. N-acetylcysteine (NAC), an orally bioavailable antioxidant, replenishes the pool of available GSH [39]. Topical formulations have the potential to decrease UV-mediated GSH depletion and ROS formation [40], and recent human studies support the utility of NAC in pre-UV exposure prophylaxis [41].
2.2.4. Anti-proliferatives
Perillyl alcohol (POH) is a naturally occurring chemical that can slow tumor cell growth by suppressing transcription factor-mediated cell proliferation and transformation [42]. A recent phase IIa study examined reversal of actinic damage following POH vs. placebo in patients with sun-damaged skin, and showed that histopathologic score was reduced with low dose POH and that abnormal nuclei were significantly reduced with high dose POH. These compelling results warrant larger, well-controlled studies of POH as a chemopreventive agent as well as efforts to improve dermal
penetration and bioavailability of POH-based therapeutics.
2.2.5. Diet, Micronutrients and Nutritional Supplements
Diet, micronutrients, and other nutritional supplements may also play a role in melanoma chemoprevention [43]. Vitamins C [44], D [45–48], and E [49–55] each have varying degrees of evidence supporting their use as chemopreventive agents. The same is true with other dietary supplements such as green tea polyphenols [56–61], selenium [62–65], curcumin [66], and lycopene [67–69]. While there are many in vitro and animal studies that indicate a possible benefit in melanoma prevention, human studies are generally lacking and do not suggest a clear clinical
recommendation that physicians should pass on to their patients.