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More than Skin Deep

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Medical oncologist Dr. John Haluschak and clinical trials nurse Katherine Peyton help cancer patients decide if one of the Center’s more than 100 ongoing clinical trials is a fit.
Most people recognize melanoma as the most deadly form of skin cancer. But not everyone knows that it can occur on skin without much sun exposure—even turning up on the soles of our feet.

Now finely focused medicines – developed from genetic research – and innovative clinical trials available at the Samaritan Cancer Center are putting Dayton area patients on the front line in the fight against melanoma.

A Growing Threat

“The incidence of melanoma is probably rising faster than any other cancer,” says John Haluschak, MD, medical oncologist at Samaritan Cancer Center. “Some people think the rise is from the lack of ozone, or more sun exposure, but no one really knows.”

Many of us think of changes in skin moles as warning signs of possible cancer. “But melanoma can involve the mucus membranes, such as the throat, mouth, and the area near the anus. Sometimes, the retina of the eye is involved, which is why we encourage people to wear sunglasses,” Dr. Haluschak says.

Nor, when melanoma recurs, will it appear only on the skin. The cancer can “spread to lymph nodes and circulate with the blood, and can occur in the bone, brain, liver and lung,” Dr. Haluschak says. “It can be anywhere.

“Melanoma is a very, very difficult cancer to take care of once it recurs.” That’s where BRAF inhibitors come in.

Taking New Aim at Melanoma Cells

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Samaritan Cancer Center’s Dr. Howard Gross leads a DCOP discussion assessing new clinical trials.

One of the newest treatments for recurring melanoma, a BRAF inhibitor is a drug that works on cancer cells while leaving the body’s other cells largely intact. The Samaritan Cancer Center offers patients access to this advanced therapy in a limited clinical trial.

“The new drugs target specifically how the melanoma cells survive and grow,” Dr. Haluschak says. Taken as a pill, BRAF inhibitors are a systemic treatment, circulating through the entire body as chemotherapy does. But the body reacts much differently. “BRAF inhibitors have very few side effects because they’re not toxic to growing cells,” Dr. Haluschak explains, “so they don’t cause hair loss and nausea,” common byproducts of chemotherapy.

The Samaritan Cancer Center was the first in the country to implement a melanoma clinical trial and continues to bring national, state-of-the-art cancer research to the Center’s patients as a leader in the Dayton Clinical Oncology Program (DCOP). This regional non-profit cancer research consortium of 15 member hospitals and Wright State University is funded by the National Cancer Institute (NCI).

“Patients in Dayton are very fortunate to have access to DCOP,” says Dr. Haluschak. “It’s one of the few Community Clinical Oncology Programs in Ohio.” And the Cancer Center is its most active member. Each year for the past 20, the Cancer Center has treated more patients on NCI clinical trials than any other program in western Ohio. Dr. Haluschak’s colleague Howard Gross,
MD, also a Samaritan Cancer Center medical oncologist, leads the DCOP as its Principal Investigator.

The Latest Treatments Are Close to Home

“Many clinical trial patients are motivated by the desire to receive the latest treatment, which would not be available to them otherwise,” says Katherine Peyton, RN, OCN, clinical trials nurse at Samaritan Cancer Center.

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Advanced digital imaging technology is just one of the many diagnostic tools medical oncologist Dr. John Haluschak uses to detect deadly melanoma.

“They understand that most new cancer drugs on the market were once in clinical trials.”

Cancer patients can learn about any of the 100 or more clinical trials at Samaritan Cancer Center through their oncologists, radiation oncologists or surgeons. “Patients can also look on the National Cancer Institute website for trials,” Katherine suggests and notes that if Dayton doesn’t have an open trial fitting their needs, she can tap the national connections of the Center’s medical oncologists to help refer patients to studies in other cities.

“Some patients don’t realize that they can stay in town, with their own physicians, and get the same state-of the-art treatment in a clinical trial,” Katherine says. “They can have the same leading-edge drugs and don’t have to travel a distance away.”

The ABCDs of Melanoma

For such a difficult disease, a simple ABCD can help everyone check for melanoma symptoms. The American Melanoma Foundation Off Site Icon suggests this guide for checking moles:

  • A for Asymmetry: One half is different from the other half.
  • B for Border Irregularity: The edges are notched, uneven, or blurred.
  • C for Color: The color is uneven. Shades of brown, tan and black are present.
  • D for Diameter: Diameter is greater than 6 millimeters, just under 1/4 inch.

Also, look for:

  • A sudden or continuous change in the appearance of a mole
  • The appearance of a new bump or nodule
  • Color that spreads into surrounding skin
  • Redness or swelling beyond the mole
  • Pain, tenderness, itching
  • Bleeding, oozing
  • Scaly appearance

“Examine your skin once a month,” recommends John Haluschak, MD, “and have a primary care physician or dermatologist check it once a year. Risk factors such as these call for more vigilant screening, Dr. Haluschak adds:

  • A prior history of melanoma
  • A family history of melanoma
  • A history of atypical moles
  • Light skin, red hair

Learn about advanced cancer care close to home.

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