Study stresses cancer exams

By By Jonathon Ng

By Jonathon Ng

U researchers discovered that genetic screening for melanoma is useful to patients whether or not they follow screening recommendations.

Sancy Leachman, associate professor of dermatology and coprincipal investigator of the study, said that upon taking the tests, participants followed through with good intentions and made positive lifestyle changes.

“They actually did change some of their behavior which is very powerful because it is one of the most difficult things for people to do,” Leachman said.

Melanoma is one of the fastest growing types of cancer, said Lisa Aspinwall, associate professor of psychology and one of the study’s investigators.

“If you catch it early, your prognosis is really good. If you don’t catch it early, your five-year survival rate is only 15 percent,” Aspinwall said.

U researchers began the study in 2003 and used people who had the highest risk for melanoma. The participants came from families prone to skin cancer in which at least three first-degree relatives have confirmed diagnosis of melanoma.

Researchers were concerned that telling patients their test results were negative would cause them to not follow screening recommendations. These patients may believe they are at a lower risk for melanoma than they really are, Aspinwall said, which is why this area of research is controversial.

The study looked at people who had a history of melanomas and tested positive for the disease, people without a history of melanomas but still tested positive and people who tested negative.

“Our interest was especially in the people who were getting positive test results for this gene mutation who hadn’t yet had their own melanoma diagnosis,” Aspinwall said.

“What we found is that people who hadn’t yet had a melanoma and who got the positive test results dramatically increased their rates of screening.”

Aspinwall said the participants were a “very special group of people” because they donated tissue samples about 12 years ago as part of the gene hunt that led to the discovery of the gene mutation responsible for some familial melanomas.

She said it is also important to know how patients who receive a negative diagnosis will react so that they can know how to best offer support.

“We are interested in understanding the psychological and behavioral factors that influence how people respond to genetic test results, with the idea that the same counseling and messages may not work the same for everyone,” she said.

Wendy Kohlmann, one of the genetic counselors who helped provide counseling to participants in the study and interpret data, said that the genetics of melanoma are very complicated and very controversial.

“At this time, genetic testing for hereditary melanoma has not been widely used,” she said. “Alteration in?(a certain) gene causes an increased risk for melanoma, but families with alterations in this gene often have other factors which also contribute to their risk.”

The study showed that going through the process of testing and counseling does affect how patients treat their diagnosis, she said.

Leachman said she’s more interested in patients understanding the disease and using that to help them deal with it.

“If we catch (melanoma) early, we can intervene and get it out,” she said.

This study could potentially help children get tested if they know their family is melanoma prone, which is important since you get the majority of sun exposure in your childhood years, Leachman said.

People at risk for melanoma also have an increased risk for pancreatic cancer.

“We are now developing, at Huntsman Cancer Institute, technologies to be able to screen for pancreatic cancer,” Leachman said.

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