Public Health Clinic

What is effective drug against melanoma side effects
What is Melanoma?
Two new weapons against melanoma
Tips for living with dermatitis

What is effective drug against melanoma side effects

Posted: 31 Jan 2012 07:50 AM PST

Vemurafenib is one of the most prominent and expected to treat metastatic melanoma. Although in Spain this drug is not yet approved in the U.S. can be used from September last year. Although as a side effect, some patients may develop skin carcinomas, the benefits of this therapy are much higher. Especially considering that metastatic melanoma mortality is 90%.

Now a team of researchers from the University of California at Los Angeles (UCLA) has discovered what is the cellular mechanism by which Vemurafenib is able to fight against this type of melanoma, however, allows the development of squamous cell carcinoma.

This happens to one in four people treated with this drug, as recorded by the article published in The New England Journal of Medicine .Furthermore, “can also produce primary melanomas,” argues Susana Puig, research coordinator Melanoma Unit and member of the Dermatology Department of Hospital Clínic (Barcelona). But that, notes, “usually occurs at the beginning of medication during the first weeks and successfully treated by surgical removal.’s Why it’s important to follow up dermatology.”

He adds: “We must not forget that people with metastatic melanoma have a high risk of mortality (90%), so that the benefits outweigh the side effects that also have very little aggressive treatment.” As explained by the Spanish specialist commenting on the U.S. investigation, “ Vemurafenib get that 85% of patients who take it better or at least not feed the tumor. “The rest of the treatment options available, however, work only 10% of cases. “The difference is remarkable. It is a great benefit.”

Maybe now you know the Vemurafenib mecanimo by which encourages the development of squamous cell carcinomas, this side effect can be avoided even in the near future. According to the authors of the study, the drug specifically blocks of the proteins that drive the growth of melanoma (BRAF, present in 50% of patients). But this oncogene is activated by another (RAS). The drug gets to act against BRAF and block it, if the individual has activated RAS (by the sun), favors this mutation.

This was observed after performing a molecular analysis of samples from 21 individuals with metastatic melanoma treated with Vemurafenib.“Our data indicate that RAS mutations are present in 60% of patients develop squamous cell carcinomas and take the drug,” says Antoni Ribas, one of the authors of the research, Spanish oncologist who works at UCLA. “This mutation (RAS) is probably caused by prior damage, sun exposure, and what it does is accelerate Vemurafenib appearance of skin carcinoma.”

Once you know the mechanism, to be seen whether the patient receives while Vemurafenib can block the RAS mutation with another different drug to prevent the development of secondary skin cancer.

Educational attainment and early diagnosis

Although melanoma is the least common skin cancer is highly invasive, with a great capacity to metastasize soon. However, as explained by specialists, thanks to prevention campaigns that are being developed in recent years as technological advances allow better distinguish benign from malignant lesions, the majority of melanomas are detected early states and heal no problem (with removal).

This must be one of the reasons why the U.S. has decreased the mortality rate from this disease, it is diagnosed in early stages. But it is not the only reason. A study published this week in the journal Archives of Dermatology ‘ claims that the death rate is reduced especially in patients with a higher education level.

After examining the melanoma mortality data from 1993 to 2007 in 26 U.S. states, a group of experts from the American Cancer Society realized that the death rate was reduced by 10% in the last 10 years ( both men and women), but only among those with at least 13 years of education. “We need to design prevention strategies aimed at those who do not have some level of training,” they conclude.

What is Melanoma?

Posted: 31 Jan 2012 01:47 AM PST

Skin cancer is a disease caused by the development of cancer cells in any layer of the skin.

There are two types: type non-melanoma and melanoma . The cancer non-melanoma is the most common and is called non-melanoma because it is formed from other skin cells are not accumulating pigment (melanocytes). Within this type are all less skin cancers, malignant melanoma is less common and more malignant and are explained below.

Skin cancer is more common in white skinned people who have spent much time exposed to sunlight, especially when sun exposure took place during infancy and there were numerous sunburn. Although it may appear anywhere on the skin, is more common to occur in the face, neck, hands and arms. This cancer is one of the most common of all cancers, and an estimated two million are diagnosed new cases per year worldwide. In recent years, the incidence of malignant melanoma has increased dramatically, has been multiplied by 3.3 in by 2.5 in men and women in the last twenty years in Spain. Although this represents less than 3% of all tumors and early detection campaigns have helped reduce the mortality by 30% since the seventies.

Two new weapons against melanoma

Posted: 30 Jan 2012 07:44 PM PST

An aide to Congress by consulting the scientific program. | ASCO If diagnosed early, melanoma can be cured in a high percentage of cases. In contrast, when the disease is detected early, the prognosis for the future is usually not good. Oncologists had time trying to find a way to ‘stop’ the progress of this aggressive skin cancer without, so far, would have made great progress. However, after many years ‘drought’ therapeutic, research seems to have begun to bear fruit.

According to data presented at the 47th meeting of the American Society of Clinical Oncology (ASCO), patients could start benefiting from two new pharmacological options that are able to prolong the life of those with advanced melanoma.

“This is a big step forward. The treatment of melanoma has begun to emerge in the deep well that was,” explains Martin Algarra ELMUNDO.es Salvador, a specialist in the University Hospital of Navarra and president of the Multidisciplinary Melanoma Spanish Group , who notes that, until now, the only drug therapy available for these patients was dacarbazine, a chemotherapy treatment developed in 1978 does not offer too good results and is associated with numerous side effects.

The new alternatives, continues the specialist, do not cure cancer, but can be more optimistic for the future if the investigation continues.

One option is ipilimumab, a drug recently approved by the U.S. Food and Drug Administration (FDA its acronym in English) that has already demonstrated its potential in the last edition of the medical conference .

A phase III study has ratified its benefits and demonstrated that, in combination with dacarbazine, the intravenous drug improves survival of patients with metastatic melanoma who had not previously received treatment. According to the findings of this study, after three years of follow-up 20.8% of patients treated with combination therapy were alive, whereas only 12.2% did so only those who had received dacarbazine.

Ipilimumab (developed by Bristol-Myers Squibb) does not directly attack the cancer cells, it activates the immune system so that it is he who fights against the tumor. “It’s like if you teach the body’s defense to reject cancer,” said Michele Maio, a specialist at the University of Siena (Italy) in a press conference organized by the pharmaceutical company.

Against cell proliferation

Nor vemurafenib, the other therapeutic option presented at the conference, fights cancer in a conventional manner. Instead of ‘poison’ the tumor such as chemotherapy does, the Roche drug blocks the intracellular communication pathways to prevent the proliferation of the malignant process, ie, prevents the cancer continues to grow.

The drug is only useful in patients with a mutation (V600E) in BRAF gene, 50% of the cases, because its expression inhibits cell, but its effects are more than remarkable. According to data presented at ASCO, three months, the treatment achieved a 63% lower risk of death for patients taking it compared to the patients who were indicated dacarbazine.

“The results were so good, we interrupted the study for all patients could benefit,” stressed at a press conference Paul Chapman, a researcher at Memorial Sloan-Kettering Cancer Center in New York and principal signer of the work, together with the ipilimumab research have been published this week in the journal ‘The New England Journal of Medicine .

Try the combination

In his meeting with the press, this specialist has underlined the potential for personalized therapy vemurafenib get open if properly combined with other agents that fight advanced melanoma. In that sense, Bristol-Myers Squibb and Roche have announced that they have launched a joint investigation to verify and efficacy of dual therapy with vemurafenib and ipilimumab.

In addition, this research also should consider the safety of the combination of both drugs. Vemurafenib use has been associated with the development of other skin cancers other than melanoma (small and can be successfully treated with surgery), among other adverse effects. While, for its part, has been associated with ipilimumab liver and gastrointestinal problems , although this latest research has been less the observed effects were less pronounced than at other times.

Melanoma is one type of cancer whose incidence is increasing faster. In Western countries, about 90% of cases are diagnosed early, cure rates are high

Tips for living with dermatitis

Posted: 30 Jan 2012 01:43 PM PST

“It’s very difficult to say no scratch,” he explains, referring to his daughter Sarah, eight years. Have atopic dermatitis and when buds appear, the itching will not stop ‘breathing’. “It’s a constant feeling,” said the mother.“When a mosquito bites you on the instep of the foot, for example, no one supports it. To my daughter, this summer, got bitten a lot of mosquitoes and not scratched.”

It is this sensation of itching, stinging, itching, and that really affect the quality of life of patients, who are mainly children. At first, scratching relieves them, but is best avoided, since they can cause infections and worsen the disease itself, according to experts. The affected “should know the disease, to understand what happens to them, understand that no definitive cure, that the best will have to live with the outbreaks (characterized by much itching and skin lesions in the flexures, face and neck) to puberty (at 80%) and in the worst case, all life (20%). It is important that they learn to manage this condition, “argues Raúl Lucas, La Paz Hospital dermatologist of Madrid.

Many hospitals are beginning to develop workshops for both small and parents. At first, “are very overwhelmed with the illness of their children. They think that has to do with food allergy have much fear of drugs, corticosteroids, the recommended treatment become less …”. In this sort of class explains “quietly” everything related to atopic dermatitis and are offered the opportunity to resolve your concerns. Meanwhile, children are not bored.

The magician and the witch Derma Titis

Seduced by the plot of the story of the puppet (‘The Atopy Clock’), get to know more about their disease and through characters like the magician and the witch Derma Titis, themselves end up screaming that the dermatitis “is not spread.” They discover they can do the same life as other children and share the games with them.

Comes the highlight of one of the puppets, the doctor, who is responsible for clarifying some of the myths: “Not only can ducharos but you must also make every day.” With the help of two nurses ‘real’ (not puppets) throws some tips: “ The bath should be cortito , water should be warm and to dry our, we should not rub the towel against the body, but we have to use it to tap soft “.

In the end, all children learn to lie down by the body cream and some tricks to avoid scratching. Mara Mero, a nurse, shares some secrets with them, “You can dip a towel in cold water and put it where you itch. They serve other cold objects, like a smooth stone from the beach or a water bottle. You can use one of these wooden rollers of your parents even give gentle tapping with the palm of the hand. It also works have pleasant situations and think … If you itch behind your ear, think of it, breathing deeply and exhale thinking while you are driving out the itch. “

At the end of the workshop, they make themselves gloves to take home to meet your fingers and avoid scratching, for example, while sleeping. In any case, dermatologists recommend, “children should always wear short nails.”

Self-esteem suffers

So important is to avoid scratching, sudden changes in temperature and irritants, such as applying adequate treatment. They must keep your skin well hydrated. As has Sara, “I put my daughter cream (no irritants, dyes, perfumes or preservatives-) three to four times a day and when you shoot, topical corticosteroids (cream).” Although the causes of atopic dermatitis is unknown, “we know that there is a genetic predisposition that determines an alteration of the outer layer of skin. This means that it is very dry (water loss) and the allergens or irritants can penetrate and cause inflammation in the skin, “says Dr. Lucas.

The consequences of this alteration are not only physical, emotional also.According to a European survey conducted by Opinion Health, 68% of parents of children with dermatitis moderate to severe atopic stated that the disease has a negative effect on self-esteem of their children.23.3% indicated they experienced frustration and 32% felt that they feel different from others, and self-conscious or sad. In the words of the dermatologist: “They experience itching, discomfort, sleep problems, loss of hours (up to five school days per year), concentrated evil … Severe forms are almost incompatible with normal life. It is important well treated and well control the itching. “

This key will also attempt to prevent allergic diseases like asthma, rhinitis or food rejection, which are much more common in these patients. Experts predict that about 50% of children develop atopic condermatitis any other allergic conditions. Since atopic dermatitis, which affects 15% of the population , primarily pediatric-, is a chronic skin disease most often, the Ministry of Health, the Spanish Academy of Dermatology and Venereology (AEDV), the Spanish Association of Primary Care Pediatrics (AEPap) and the Association of Relatives and patients with atopic dermatitis (ADEA) recently presented an animated video (‘Alex, do not scratch’) so they can properly understand their disease. “The cell Glupi leads him to see the inside of your skin and accompanies him on a daily basis, providing recommendations.” This is another of the initiatives being put in place to teach and educate those affected by the importance to correctly follow the treatment and better quality of life

KATOBENGKE FOR HEALTH

Tuesday, January 31, 2012