Genetic testing can help increase early detection of melanoma among patients and their family members, according to a presenter at HemOnc Today New York.
However, the approaches toward genetic testing and counseling must be tailored depending on the cancers observed in a particular family.
“Knowledge is power, and this is about knowing genetic background,” Sancy Leachman, MD, PhD, professor and chair of the department of dermatology and director of the melanoma research program at Knight Cancer Institute at Oregon Health & Science University, said during her presentation. “This isn’t testing of the tumor, this is genetic testing of the individual to see if they are predisposed.”
A new way of identifying hereditary melanoma is an expanded “Rule of Threes,” which helps determine which patients have at least a 10% probability of being positive.
The expanded Rule of Threes, completed in 2017, includes three or more invasive melanomas among blood relatives, three or more melanomas for one individual, and three or more cases of melanoma, pancreatic cancer or astrocytoma among an individual or blood relatives.
“You don’t want to be testing everyone, but you want to test enough people to make a difference,” Leachman said.
Screening management should be tailored and follow a plan that includes a personal cancer history, a family cancer history, education on UV protection and self-skin exams, and biopsy threshold reduction.
For patients who are not predisposed, Leachman said she is launching the “War on Melanoma” program in Oregon. This will include health care providers, skin care services, hair dressers, massage therapists, acupuncturists and other members of the community.
The grassroots effort will be designed to help discover suspicious lesions, provide screening and biopsies if needed, and perform early-stage removal if needed through education on melanoma and the cost of treatment.
“If we really want to have an effective early detection program, the people we need to reach are the people who have no idea they need to care about this at all,” Leachman said. “We need to reach the people who don’t care. We want to use melanoma as a model by moving it from something that is deadly to something that is controlled with early detection.” – by John DeRosier
Leachman S. Early detection of melanoma: From genetic testing to technology-driven educational campaigns. Presented at: HemOnc Today New York; March 21-23, 2019; New York.
Leachman reports honoraria from Castle Biosciences and Myriad Genetics.