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Stopping cancer before it starts

Petr Kratochvil
Excessive sun exposure can result in cancerous skin lesions.

A UC Irvine Health program to track skin lesions helps monitor people at high risk of dermatological cancer

Each year, millions of Americans develop cancerous skin lesions. The vast majority of these are easily treated and highly survivable, but some are — or could become — melanomas, which can be aggressive and potentially deadly.

The causes of skin cancer vary, ranging from excessive sun exposure to family genetics. People who have numerous moles or compromised immune systems — as seen in patients with HIV/AIDS or who have undergone organ transplantation — are also more susceptible.

UC Irvine Health dermatologists, surgeons, oncologists and pathologists have created a pigmented lesion program for at-risk patients. It is the first in Orange County to encompass research, training and patient care related to suspicious lesions and moles.

“Generally, it’s difficult for people at high risk of skin cancer to receive comprehensive care,” says Dr. Janellen Smith, a UC Irvine dermatologist and co-director of the program based at the Melanoma Center, which is part of the UC Irvine Health Chao Family Comprehensive Cancer Center. “Our team has many years of expertise, knowing which moles and lesions need to be treated and which need to be left alone. We watch them pretty carefully.”

Among the sophisticated equipment used is a SIAscope, one of the most advanced melanoma imaging systems in the world. UC Irvine Medical Center is the only medical facility in California currently using the device for melanoma detection, according to Dr. James G. Jakowatz, a surgical oncologist and director of the Melanoma Center.

The noninvasive SIAscope records the pathological pattern of each mole. Subsequent scans flag pattern changes, letting doctors monitor multiple lesions simultaneously.

“For patients with many moles, this computer imaging can make a big difference,” Smith says. “It decreases the number of biopsies needed, so they won’t look like a pincushion.”

“This is essential for people who have lots of atypical moles,” says Dr. Kenneth G. Linden, co-director of the pigmented lesion program and co-director of the Melanoma Center. “It helps with overall management of melanoma risk.”

That risk continues to grow. Melanoma was diagnosed in about 68,000 Americans last year, Smith says, and the percentage of people who develop it has more than doubled in the past three decades.

If not treated early, melanoma can turn deadly. Its cells penetrate more deeply into the skin and can enter the bloodstream and lymph node channels, dispersing cancer throughout the body. According to Linden, one person dies of melanoma every hour in the United States.

“We believe our comprehensive program is vital to keeping on top of melanoma risk,” he says. “We want to see patients with precursors to this form of skin cancer and catch it before it spreads.”

In addition to caring for patients, doctors with the pigmented lesion program conduct research and host clinical trials of promising new treatments. The program also sponsors monthly multidisciplinary conferences for area internists, oncologists, dermatologists, radiologists and family medicine physicians to discuss the latest advances in the field.

For more information about the program or to request a consultation, call 949-824-0606.