- News & Updates
- News & Updates
News & Updates
– March 2020: Further evaluation needed for smartphone-aided skin cancer diagnosis
– January 2020: NICE recruiting for melanoma guideline committee
– January 2020: Sentinel Node Biopsy Guideline – publication
– November 2019: Update of the Uveal Melanoma Guideline – invitation for expressions of interest
– September 2019: First melanoma test identifies those at low risk of cancer spreading
– June 2019: Melanoma Focus announces three key senior appointments
– April 2019: Newcastle biomarker study, funded by Melanoma Focus, to be published in leading scientific journal
– April 2019: Melanoma Focus to fund Newcastle University research into rare birthmarks
– February 2019: NHS England announces policy on stopping immunotherapy after 2 or more years of treatment
– December 2018: UK Melanoma Adjuvant Pathway Survey (UK MAPS) findings
– October 2018: NHS England changes stopping and retreatment rules for immunotherapy patients
– October 2018: Leading immunologist recommends melanoma immunotherapy patients should still receive flu jab
– September 2018: First safe and effective adjuvant therapy for melanoma is now available on the NHS
– July 2018: ‘How Much Is Enough’ awareness campaign launches
– May 2018: AUG Mucosal Melanoma Guidelines completed
– April 2018: Acral/Mucosal Melanoma Trial seeks participants
– March 2018: Development group being formed for next phase of mucosal melanoma guidelines
– August 2017: Melanoma working group rejects NHS drug retreatment rules
– June 2017: AVAST-M Clinical Trial final results announced
– May 2017: Patient Decision Aid launched
– March 2017: Melanoma treatments: new drug combo restrictions lifted
– January 2017: Melanoma World Society Newsletters
– June 2016: NICE approves combination immunotherapy treatment for melanoma
– June 2015: Patient Impact Programme award to Newcastle University for melanoma ulceration study
– June 2015: Survey finds the public are confused by sunscreen labelling
– January 2015: Review of smartphone melanoma apps recommends caution
– January 2015: Melanoma Focus guidelines for uveal melanoma accredited by NICE
– January 2015: Encouraging results announced for new immunotherapy drug pembrolizumab
– November 2013: Follow-up of high risk cutaneous melanoma cases: key paper released
– October 2013: Sunbeds: an ASA Ruling
- April 2020: Head & Neck Mucosal Melanoma Guideline published
A group of clinicians, nurses and patient & carer representatives began work in mid-2018 to produce a national clinical guideline for head & neck mucosal melanoma. The Guideline Development Group (GDG) was led by Professor Kevin Harrington from The Institute of Cancer Research, with project management and methodological support provided by Nancy Turnbull, the Project Manager, and funding by Melanoma Focus. Work on this project is now complete. For further details follow this link and for the guideline documents go to the resources page.
GDG patient representative member Gillian Paterson commented:
‘As a patient who was diagnosed with sino-nasal mucosal melanoma 3 years ago, the new guideline information leaflet for patients and carers would have been so helpful to me and my family, had it been available to us when I was first diagnosed. In particular, it would have provided us with accurate information about this rare condition and would have given me the confidence to ask informed questions about the options for treatment and how my condition should be monitored in the future.’
Professor Kevin Harrington said:
‘Head & Neck Mucosal Melanoma (HNMM) is a rare condition that can be devastating and life-changing for patients, as well as for their families and friends. However information about the disease is scarce and mostly based on experience of melanoma in general, or of the common types of cancer that involve the head and neck. There have been very few randomised controlled trials that involve patients with HNMM when compared with melanoma affecting the skin. Therefore, there is only a small evidence-base with which to work. In the face of these challenges, the GDG was forced to draw on evidence that came almost exclusively from observational studies. In reviewing and evaluating these sources, NICE-accredited methodology in the form of a series of PICO questions was used to impose the necessary scientific rigour on the process.
‘The product of these exhaustive deliberations – the HNMM Guideline – will endure for many years and will be updated regularly under Melanoma Focus auspices. It will help clinicians in the UK and beyond to understand how to diagnose and treat this often deadly disease. These conclusions are also intended for use by patients, with a lay version written in non-scientific language produced to accompany the main document.
‘Especially in a situation where there was a dearth of hard scientific evidence, the skill of the GDG members was paramount – both in interpreting the limited data and in drawing on their own clinical experience of treating people suffering from this disease. The members of the group gave freely of their time in a complex task that took them away from their already busy working lives. They did this generously and on an entirely pro bono basis, aided by valuable input from patient and carer representatives.
‘I wish to record my thanks to all those involved – clinicians, nurses, patients, as well as to the many organisations and individuals who contributed their wisdom and knowledge in reviewing our findings during the consultation process. I also wish to extend my thanks to the team at Melanoma Focus for having the vision to commission these guidelines and for its support in facilitating meetings and during the process of drafting the guideline documents.’
- March 2020: Further evaluation needed for smartphone-aided skin cancer diagnosis
Skin cancer is one of the most common cancers in the world, and the incidence is increasing. Could skin cancer detection be transformed by innovative technologies such as digital medicine and artificial intelligence? Dr Fiona Walter (Principal Researcher in Primary Care Cancer Research at the University of Cambridge’s Primary Care Unit) suggests a cautious approach is needed before these innovative technologies can be used safely in the community and in primary care, based on a group of recent studies and reviews.
Smartphone apps providing the user with an instant assessment of skin cancer risk are widely available. The latest systematic review, published in the British Medical Journal, showed variable and unreliable test accuracy for all six apps reviewed.
An alternative use for smartphone apps could be to prompt patients to have a timely consultation with their GP. In JAMA Network Open, Dr Walter and colleagues report an NIHR-funded randomised controlled trial of a commercially available smartphone app set in primary care in the East of England. In this trial of 238 participants, the study team found that there were no significant differences in skin consultation rates or measures of skin self-monitoring in the intervention group.
Dr Walter’s Comment in The Lancet Digital Health also explores smartphone-aided detection of skin cancer and concludes that only once validated should these algorithms be incorporated into smartphone apps for patients or clinical decision support for primary care practitioners. Read her blog in full.
- January 2020: NICE recruiting for melanoma guideline committee
The National Institute for Health and Care Excellence is recruiting committee members for the NICE Guideline Committee on Skin Tumours, including Melanoma: assessment and management. It is seeking people in the following roles:
- consultant dermatologist
- consultant histopathologist
- consultant medical oncologist
- plastic surgeons
- maxillofacial or head/neck or general surgeon
- consultant radiologist
- 2 clinical nurse specialists
- lay members
plus the following co-opted members to attend a select/smaller number of committee meetings:
- paediatric & adolescent oncology consultant or paediatric & adolescent CNS
- consultant in palliative care
- January 2020: Sentinel Node Biopsy Guideline – publication
The sentinel node biopsy (SNB) surgical procedure has been used in the staging of melanoma patients for the many years. However, in the light of fundamental changes in the management of melanoma and the findings of recent clinical trials, it had become clear that there needed to be scrutiny of the role of SNB in patient prognosis and treatment, as well as the benefits or otherwise of completion lymph node dissection (CLND) following a positive biopsy of sentinel lymph nodes.
A group of clinicians, nurses and patient representatives met at the Melanoma Focus office in Cambridge in 2018 to debate the issues and reach a consensus on SNB and related issues. Their report was released later in the year, summarised by 11 recommendations in the form of a Consensus Statement.
On CLND, the group said this ‘should not be recommended routinely for patients who have a positive sentinel node biopsy. Patients deemed at high risk should be considered for adjuvant therapy. A lymph node dissection should be considered for those patients who subsequently present with node ONLY recurrence having failed first line systemic treatment’.
Follow this link to see further details and download the guideline document.
- November 2019: Update of the Uveal Melanoma Guideline – Invitation for Expressions of Interest
Melanoma Focus has begun preparatory work to set up a Guideline Development Group (GDG) to update our Uveal Melanoma Guideline, first published in 2015 (to see this version, click here).
The GDG will be led by Dr Paul Nathan, with project management and methodological support & funding by Melanoma Focus. The update will revise the topic areas where there has been new information that may change the current recommendations. An initial assessment of the literature suggests the areas requiring updating relate to tumour genetics and systemic treatments.
We are looking for the following:
• Medical oncologists with an interest in melanoma
• Pathologists with an interest in melanoma
• Translational scientists with an interest in tumours of the eye
• Patient advocates/representatives
We anticipate that the GDG will be made up of some members from the previous group as well as new members. We expect the process to take about six months, involving one or two one-day meetings but with most of the work being done via email and video conferencing. No fees will be paid but travel expenses may be claimed from the charity. Patient advocates/representatives must be UK residents who have experience of treatment within the NHS.
We now invite expressions of interest in being involved in this update. It should be noted that GDG members will be expected to give this work the highest priority and attend all the group’s meetings; only those who are able to make this commitment should apply.
If you are interested in being considered as a member of the GDG please email Nancy Turnbull, Project Manager, in the first instance. We will send you an application form to record your professional details and the reasons for your interest. The deadline for applications is 15 December.
Please contact Paul Nathan if you have any queries.
- September 2019: First melanoma test identifies those at low risk of cancer spreading
A test which reliably predicts that a melanoma is unlikely to spread or return has been developed by scientists at Newcastle University. The pioneering test is expected to be available within two years, offering reassurance for patients with melanoma, the most deadly form of skin cancer.
The prognostic test for the earliest stages of melanoma, called AMBLor, is able to better identify a patient’s true risk of disease progression. It provides all those diagnosed with stage 1 melanoma with more accurate information about the risk of the disease spreading. This is up to 70% of new patients. The team tested 400 archived biopsies from patients who had a stage 1 melanoma diagnosis and showed that the test could predict long-term prognosis of the disease, which in the future could help clinicians develop personalised treatment plans for patients.
Melanoma is increasing worldwide and 17,000 patients are diagnosed every year with the condition in the UK alone.
The research, identifying biomarkers which form the basis of the AMBLor test, is published today in the British Journal of Dermatology. It demonstrates that two protein markers, AMBRA1 and loricrin, are normally present in the epidermis – the upper layer of the skin. The Newcastle scientists identified that the loss of these markers in patients with early-stage melanoma is associated with high-risk tumours while the markers are retained in the epidermis overlying genuinely low-risk tumours. They have used this discovery to develop the AMBLor testing kit.
By applying the AMBLor test to the standard biopsy of the primary tumour on its removal, patients can be identified who have the low-risk, less aggressive cancers. At present, the primary tumours are removed by surgery and pathologists study the biopsy under the microscope to determine the stage the skin cancer is at and the risk of it spreading (metastasis). If defined as low risk, the patient is followed up in clinic for as long as 5 years – and it is these patients that the test is able to identify. Approximately 10% of patients with stage 1 melanomas will go on to develop metastasis, resulting in poor prognosis and a 5-year survival rate of 15% – 20%.
Chief scientist Professor Penny Lovat, Professor of Cellular Dermatology and Oncology at Newcastle University and Chief Scientific Officer at AMLo Biosciences, the University spin-out company behind the testing kit says: ‘Building on our previous studies, this new research demonstrates that the loss or reduction of these proteins indicate that the tumour is more likely to spread, allowing us to develop our test, called AMBLor. This can be applied to the standard biopsy and identifies those who have these low-risk, less aggressive cancers.
‘As a patient, the AMBLor test tells you if you’re in the low risk category – and can offer you reassurance. It could also save the NHS up to £38 million a year by reducing the number of follow-up appointments for those identified as low-risk.’
Dr Rob Ellis is an Honorary Clinical Senior Lecturer at Newcastle University, and also a Consultant Dermatologist and Chief Medical Officer at AMLo Biosciences. He explains: ‘My colleagues and I are seeing more and more patients referred to our NHS clinics as the number of cases of melanoma increases – and we know that 17,000 patients are diagnosed in the UK every year.
‘What we have developed is a test which will offer personalised, prognostic information – so we will be able to predict more accurately if your skin cancer is unlikely to spread. This is a really exciting finding for clinicians and in the future it will help us tailor the treatment and follow up appointments in an appropriate fashion.’
And patients like Rachel Lucas from Guisborough in the Tees Valley have welcomed the test: ‘I had been diagnosed with stage 1 melanoma and I was told there was still a risk it could develop. I just thought, I could be the unlucky one and I just didn’t know how serious it could become.
‘If someone had been able to offer me this test and said that you’re really genuinely low risk, it would have taken a lot of the worry away and made me feel reassured. It also means if I was high risk then we could do something about it.’
The research was funded by Melanoma Focus, The British Skin Foundation, Cancer Research UK, The Newcastle Healthcare Charities, and The North Eastern Skin Research Fund.
Professor Paul Lorigan, chairman of Melanoma Focus, commented: ‘We congratulate Professor Lovat, Dr Ellis and their team at Newcastle on this important discovery. Knowing which patients with early stage melanoma are not at risk of their cancer returning will be a key element in how clinicians plan their follow-up. It offers the prospect of treating patients more accurately, reducing their stress and saving the NHS a great deal of money. Melanoma Focus is delighted to have helped fund this research.’
The team have created AMLo Biosciences and are seeking approvals for the test to make it available to patients within a couple of years.
Reference: Epidermal AMBRA1 and Loricrin; a paradigm shift in the prognostication and stratification of AJCC stage 1 melanomas. Robert A. Ellis et al. British Journal of Dermatology. doi.org/10.1111/bjd.18086
- June 2019: Melanoma Focus announces three key senior appointments
Chris Bryant MP has kindly agreed to be our Patron. As an influential politician and melanoma patient who was diagnosed earlier this year following a trip to the barber, Chris has a keen interest in diagnosis and patient care and urges anyone who detects something unusual on their skin to visit the doctor. Chris is actively pursuing the sun safety agenda and has asked whether there is more the UK government could do to ensure every child covers up in the sun and more people use sunscreen.
Imogen Cheese joins our Board as a Trustee of Melanoma Focus. She has a keen interest in patient affairs based on her experience as a patient and as the organiser of the Melanoma Patient Conference. This year’s will be the fourth in this series of popular events, providing patients with information about support, access to treatments and care for people with melanoma.
Susanna Daniels, our new Project Manager, has recent experience as a medical adviser in the melanoma oncology division of a major pharmaceutical company, following her previous career as a lead oncology pharmacist in the NHS. She brings a wealth of technical knowledge to the charity and will be working on specific projects such as a new Trial Finder for healthcare professionals and patients.
- April 2019: Newcastle biomarker study, funded by Melanoma Focus, to be published in leading scientific journal
This research project, which received an award of £100,000 from this charity in 2015, was designed to look for changes in two proteins – AMBRA1 and Loricrin (‘AMLo’) – in the surface layer of the skin over melanomas. The aim was to discover how these changes might predict which patients are at a higher risk of metastatic melanoma, who will therefore need to be followed up more closely by clinicians after surgery. This mechanism is known as a ‘prognostic biomarker’.
The study, involving two combined cohorts of people with Stage 1 melanomas from the North-East of England, 380 patients in total, is now complete. The resulting paper has been accepted for publication in the British Journal of Dermatology (see details below).
Principal Investigator Professor Penny Lovat, of the Institute of Cellular Medicine at Newcastle University, commented:
‘As a simple immunohistochemical-based assay, the use of AMLo will fit seamlessly into current melanoma diagnostic procedures, informing us about the appropriate use of Sentinel Lymph Node Biopsy (SLNB). This has the capacity to influence the management of early stage melanomas in the context of reducing patient follow up, patient worry and associated healthcare costs’.
For more on this project click here
For more on SLNB, see the Melanoma Focus Sentinel Node Biopsy Guideline
Ellis RA, Tang D, Nasr B, Greenwood A, Mc Connell A, Anagnostou M, Elias M, Verykiou M, Bajwa D, Ewen T, Reynolds NJ, Barrett P, Carling E, Watson G, Armstrong J, Allen AJ, Horswell S, Labus M and Lovat PE
Epidermal AMBRA1 and Loricrin; a paradigm shift in the prognostication and stratification of AJCC stage I melanoma
British Journal of Dermatology 2019 in press
- April 2019: Melanoma Focus to fund Newcastle University research into rare birthmarks
The Institute of Genetic Medicine at Newcastle University has announced that it will undertake research into birthmarks and the implications for developing melanoma. Melanoma Focus has awarded a grant to support this study. Consultant Dermatologist & Clinical Research Associate Dr Siobhan Muthiah, the lead researcher, explained what the study would entail:
‘Melanoma can be a deadly skin cancer and is the most common form of cancer in young adults. We have identified a group of rare patients who had a special type of birthmark in childhood and then went on to develop one or more melanomas, as an adult, exclusively within their birthmark. This suggests that having this type of birthmark predisposes patients to developing melanoma. Understanding what is different at the genetic level in these birthmarks is the aim of this work. Research to date has shown that if patients develop tumours within a birthmark, it amplifies the genetic change in the birthmark.
‘This research will allow for genetic analysis to be performed on these patients’ birthmarks and their melanomas. This work may allow us to find novel genetic changes that play an important role in melanoma development and enhance our broader knowledge of melanoma biology’.
Leveraging cutaneous genetic mosaicism manifesting as rare birthmarks to aid the discovery of novel genes in melanoma pathogenesis
Principal Investigator: Dr Neil Rajan
- February 2019: NHS England announces policy on stopping immunotherapy after 2 or more years of treatment
The long-awaited confirmation of NHS England’s decision to sanction the stopping of immunotherapy treatment and the funding of re-treatment where necessary has been promulgated. The first paragraph of a letter to prescribers reads:
‘NHS England has reviewed the evidence for the elective discontinuation of immunotherapy in patients who have completed 2 years of therapy. NHS England has therefore revised its commissioning position such that clinicians and patients will now have the option of discontinuing immunotherapy after 2 or more years of treatment. If such an option is chosen and if there is subsequent disease progression off treatment, NHS will commission the re-start of immunotherapy monotherapy as long as this re-start is the first treatment at that disease relapse.’
This follows the news in October 2018 that the previous policy – under which funding would not be available in such circumstances – was to be revised. The letter includes an online link to blueteq registration forms that must be completed by clinicians wishing to offer their patients the option of stopping treatment.
Follow this link to download a pdf version of NHS England’s letter, which includes an FAQ section covering a number of issues.
- December 2018: UK Melanoma Adjuvant Pathway Survey (UK MAPS) findings
The results of this UK-wide survey of healthcare professionals involved in the management of patients with primary melanoma were presented at the Melanoma Focus Study Day and the Society for Melanoma Research in October. Titled Systemic adjuvant melanoma treatment: Implications for UK melanoma services, this survey captured information about current and anticipated care pathways. Follow this link to view a poster summarising the methodology and conclusions.
- October 2018: NHS England changes stopping and retreatment rules for immunotherapy patients
NHS England has agreed to revise its ruling covering the stopping and re-starting of treatment for patients with melanoma who are receiving the anti PD-1 inhibitors pembrolizumab and nivolumab. This means clinicians will be able to halt treatment after two years, provided they and their patients consider this to be the correct course of action, with the assurance that funding for the drugs will continue to be available if the disease progresses and the treatment needs to be resumed.
Under the previous ruling – that once stopped, no further funding was available should treatment need to be re-started – clinicians and patients tended to adopt the understandably cautious approach of continuing treatment beyond the two-year point.
The decision is in response to an initiative by Melanoma Focus to persuade the NHS to alter its stance on this issue. There is evidence from recent clinical trials showing that for many patients the drugs have a beneficial effect within the first two years, with no additional gain in continuing the treatment for longer once a response has been confirmed. Indeed, given the severe side-effects some patients experience, ceasing treatment can often lead to significant quality of life improvements. A further advantage is the financial savings if these costly drugs can be suspended once their effect on a patient has become established.
NHS England has set a number of conditions, for example the requirement to submit a special request for retreatment, together with the collection of some additional basic data about patients. The NHS is expected to finalise the necessary procedures and documentation shortly.
Professor Paul Lorigan, chairman of Melanoma Focus, comments: ‘NHS England has responded to the evidence presented in a very positive way, recognising the advantages for patients. Clinicians and patients are completely supportive and the collection of extra data will allow a better understanding of the benefits of retreatment.
‘This is a win-win situation. Patients won’t need to be treated for longer than is necessary, while they can be confident that the drugs will still be available if needed; and there will be substantial savings for the NHS by reducing unnecessary drug treatments as well as the costs of dealing with the side-effects’.
Click here for a .pdf document giving further information for clinicians and nurses.
- October 2018: Leading immunologist recommends melanoma immunotherapy patients should still receive flu jab
With the change of seasons the subject of flu vaccinations arises, specifically in relation to melanoma patients who are receiving immunotherapy treatment. Some clinicians have asked whether they should sanction this injection for such patients since, in theory, an immune adjunct might increase immune-related toxicities.
Medical oncologist Professor Christian Ottensmeier, an expert on immunology from the University of Southampton, was asked for his opinion. ‘My personal view is that there is more harm in NOT vaccinating against flu than there is in vaccinating against it,’ Professor Ottensmeier said. ‘So for inactivated vaccines such as the flu, I tell my patients to continue to have this form of protection. I expect that the worst that could happen is mildly increased flu-like symptoms if the immunotherapy makes the immune system more effective overall.
‘The adjuvant in the vaccine, which is given to make the vaccine more effective, will make antibody responses better. I think it is unlikely to have much effect on the kind of cells we aim to release with immunotherapy against the cancer (CD8 T cells). It is already reported that anti CTLA4 (for example, ipilimumab) does not alter antibody responses after non-live vaccines. There are few data for anti PD-1 – for example, nivolumab or pembrolizumab.
‘In the last flu season we noticed no extra toxicity. I think it is unlikely that either the benefit from vaccination or immunotherapy, or immune-related side effects, would be changed meaningfully after a flu vaccine.
‘The advice for live vaccines (such as the live flu vaccine, or other live vaccines such as yellow fever) is to defer or avoid vaccination in parallel with combination. I think this is because of the vaccine itself and a reflection of caution, rather than specific concerns about the combination. Consistent with this, patients who develop flu-like illnesses do not seem to be more ill if they catch these while on immunotherapy.
‘I would like to make it clear that this is based on my personal opinion and experience rather than on formal evidence from clinical studies or trials. Nonetheless, it appears to be in line with the views other clinicians in the UK and other EU countries.’
- September 2018: First safe and effective adjuvant therapy for melanoma is now available on the NHS
The international pharmaceutical company Novartis has made the following announcement:
‘The first BRAF-targeted treatment for post-surgery stage III melanoma patients, the most aggressive type of skin-cancer, is to be made available for NHS patients in England and Wales following appraisal by NICE (National Institute for Health and Care Excellence). Tafinlar® (dabrafenib) in combination with Mekinist® (trametinib) has been recommended as a cost-effective treatment option for the adjuvant treatment of adult patients with stage III melanoma with a BRAF V600 mutation, following surgery’.
Paul Lorigan, Professor of Medical Oncology at The Christie, Manchester and Chairman of Melanoma Focus, commented:
‘Across the UK we continue to see an increase in cases of melanoma. Whilst the majority of patients are cured by surgery, this is not always the case. The dabrafenib/trametinib combination is the first treatment to be made available on the NHS that shows a significant reduction in the risk of dying from the recurrence of melanoma after surgery. It will transform outcomes for many patients in England and Wales.
‘We have made huge advances in the treatment of advanced melanoma in the past ten years, but this is the first approval of a safe and effective adjuvant therapy. Such treatments are a standard of care in other cancers – including breast, lung and colorectal – but we’ve never had an effective adjuvant therapy for melanoma. Melanoma oncologists and patients have worked tirelessly for the past 20 years to find an effective adjuvant treatment. In the UK alone, we ran two big randomised studies, AVAST-M and Aim High, with more than 2,000 patients agreeing to participate. Internationally, more than 12,000 patients were enrolled in randomised interferon studies, 1,300 in the DERMA trial and many more in chemotherapy, vaccine studies and others. None of these trials showed a convincing survival benefit.
‘The situation is transformed by this milestone announcement. And it’s very likely that adjuvant immunotherapy will also be approved, further increasing the options for patients.’
Speaking on the BBC’s Victoria Derbyshire programme, Dr Pippa Corrie, Consultant and Associate Lecturer in Medical Oncology at Addenbrooke’s Hospital, Cambridge and a Trustee of Melanoma Focus, explained the need for adjuvant therapy:
‘In about half of all melanomas there is a fault in a gene called BRAF and that abnormal gene drives the cancer process. The new drugs, dabrafenib and trametinib, are given orally and they work to block the signals from the mutant BRAF gene and therefore stop the cancers growing.
‘We have been using these drugs to treat metastatic melanoma – disease that we can’t remove – but it is much better to use them up-front, because at that stage you are preventing the cancer coming back. It’s a one-year course of treatment and hopefully it will make a big difference and be more cost-effective, using it to prevent the melanoma returning rather than trying to control the disease long term.
- July 2018: ‘How Much Is Enough’ Awareness Campaign Launch
NEW Skin Cancer Campaign #howmuchisenough
Altruist Sunscreen and Melanoma Focus unite to raise awareness of the dangers of sun damage and tanning.
What price a tan? As the summer holidays kick in, the UK’s unhealthy obsession with getting a tan continues to claim more skin cancer cases every year – and with the heatwave showing no sign of easing up, we are deeply concerned about the lasting impact that overdoing it in the sun will have on our health.
The campaign hits back with a new series of ‘scars and all’ content shorts to tell the human stories behind three common skin cancer cases. They reveal both the physical scars left by the disease and the psychological impact that can live on long after treatment has been completed.
Altruist and Melanoma Focus commissioned the films as a warning to the nation to take care in the sun, whether at home or abroad.
The campaign aims to encourage people to think before they tan, asking ‘How much is enough?’ as it delivers key facts including:
- One blistering sunburn in childhood or adolescence doubles the risk of melanoma
- Regular use of sunbeds before the age of 30 can increase the risk of melanoma by 75%
- Melanoma skin cancer is the 5th most common cancer amongst men in the UK
- One blistering sunburn in childhood or adolescence doubles the risk of melanoma
Please view and share the videos to help us raise awareness and visit our websites for more information on taking care in the sun. Join the conversation at #howmuchisenough on YouTube and our social media channels
- May 2018: AUG Mucosal Melanoma Guidelines completed
Phase I of the mucosal melanoma guidelines, covering ano-uro-genital disease, has now been completed. The Guideline Development Group has released its findings, consisting of a full guideline document, care pathways for each of the disease subsets, an executive summary, a slide set and supporting documents. A summary for patients will be published shortly.
Click here for more information about the project, the GDG and links to the documents.
- April 2018: Acral/Mucosal Melanoma Trial seeks participants
Melanoma Focus is pleased to support a study named PIANO, which is now open at eight UK cancer centres. PIANO will assess a treatment for patients with advanced acral and mucosal melanoma. Acral melanoma affects the palms of the hands or the soles of the feet, while mucosal melanoma occurs in the mucous membrane in the sino-nasal/head & neck or ano-uro-genital regions.
This is a small trial that aims to recruit up to 24 eligible patients with the KIT mutation. As with all trials for rare forms of melanoma, finding sufficient suitable participants is a challenge. Anyone who is interested in learning more about this study should contact Richard Hutson, Clinical Trials Project Manager, at the Manchester Academic Science Centre: 0161 918 2496 or firstname.lastname@example.org.
- March 2018: Development group being formed for next phase of mucosal melanoma guidelines
Melanoma Focus is now inviting applications to join the Guideline Development Group (GDG) for the second phase of its Mucosal Melanoma Guidelines initiative. This work, which will be led by Professor Kevin Harrington of the Institute of Cancer Research on behalf of the charity, will address sino-nasal/head & neck mucosal melanoma.
This follows the success of the first phase, led by Professor Martin Gore, which is currently being completed and is expected to be published shortly.
For more information about this initiative, including details of the disease and how to apply to be considered for membership of the phase II GDG, please click here.
- August 2017: Melanoma working group rejects NHS drug retreatment rules
In a letter to NHS England by Dr Pippa Corrie, the NHSE Melanoma Working Group gives its reasons for not approving new NHS rules on funding melanoma drugs when therapy is re-started after a break in treatment.
The rules have ‘caused great concern and unhappiness across the oncology community’, Dr Corrie comments. Later in the letter she points out: ‘An unintended consequence of these new rules… may well be that patients are denied access to efficacious treatments, with consequent reduction in their survival’.
To see the letter in full – and also a link for registering as a stakeholder in consultation on this issue – click here.
- June 2017: AVAST-M Clinical Trial final results announced
The AVAST-M Trial was one of the largest melanoma trials ever undertaken, involving 1,343 patients at 48 UK hospitals between between 2007 and 2012. Final results were released at the 2017 American Society of Clinical Oncology conference.
Click here to see the patient newsletter summarising the findings, together with comments by the Trial Chief Investigator, Dr Pippa Corrie.
- May 2017: Patient Decision Aid launched
After eight months’ work, Melanoma Focus has launched its Patient Decision Aid (PDA), which is designed to inform people about melanoma and guide patients through the decisions they will need to take during their treatment. By helping people to understand their options, this new online tool will improve the effectiveness of conversations between melanoma specialists and their patients. A smartphone app version is planned in due course.
More than 30 clinicians, nurses and patient representatives contributed to the project, which was chaired by the charity’s CEO, Simon Rodwell, with Melanoma Focus Trustee Dr Mark Harries as lead clinician. ‘We are extremely grateful to the steering group for all their hard work’, Simon commented. ‘The PDA marks a significant improvement in the information available to melanoma patients about their choices and treatments and will help them, their families and their carers’.
- March 2017: Melanoma treatments: new drug combo restrictions lifted
- March 2017: Melanoma treatments: new drug combo restrictions lifted
NHS England has now removed restrictions on access for patients to certain therapies used in combination following a consultation process involving specialist melanoma oncologists led by Melanoma Focus Trustee Dr Pippa Corrie. The combinations are dabrafenib + trametinib, which is suitable for patients with a BRAF mutation, and the immunotherapy drugs ipilimumab + nivolumab. Click here for a full description of what has changed.
- January 2017: Melanoma World Society Newsletters
We now provide links and contents lists for this new series of excellent newsletters that review recently-published papers on all aspects of melanoma medicine. Click here to visit our Library page.
- June 2016: NICE approves combination immunotherapy treatment for melanoma
The National Institute for Health and Care Excellence (NICE) has approved a combination therapy for melanoma patients in England and Wales. This means they will be the first in Europe who can be prescribed this treatment. The decision was made in record time and is expected to apply in due course throughout the United Kingdom.
Dr Paul Nathan, a consultant medical oncologist and Melanoma Focus Trustee, commented: ‘Immunotherapy is genuinely exciting, it is starting to have a profound effect on many cancers and I’m in no doubt there will be patients that have long-term durable control of their disease. It really is a game-changer.’
The drugs, nivolumab and ipilimumab, will be combined in a new therapy for people with metastatic melanoma (or disease that has spread to organs of the body beyond the skin).
Professor Peter Johnson, Cancer Research UK’s chief clinician, said: ‘These results give new hope to melanoma patients. But it’s important to remember that more powerful treatment comes with an increased chance of severe side effects. Our research now needs to identify which patients are most likely to benefit from this combination and who is most likely to experience the side effects, so doctors can make sure we get the balance right.’
NICE’s Professor Carole Longson said: ‘After one of the fastest drug appraisals NICE has carried out, these promising new immunotherapy treatments for advanced melanoma look set to significantly extend the life of people with the condition. The evidence we examined was very promising and I know further trials are ongoing which have also released encouraging data.’
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- June 2015: Patient Impact Programme award to Newcastle University for melanoma ulceration study
- June 2015: Patient Impact Programme award to Newcastle University for melanoma ulceration study
Melanoma Focus has awarded funds to a scientific group based at Newcastle University to investigate the phenomenon of the ulceration of skin above a melanoma and the associated greater risk of the disease spreading to other parts of the body. The project, Validation of Ambra-1 and Loricrin as prognostic biomarkers for the early detection of high risk melanomas, will be conducted over 18 months under the direction of Dr Rob Ellis and Professor Penny Lovat and will concentrate on the role of two proteins found in the layer of skin overlying melanomas. The findings will help to predict which patients are at a higher risk of metastatic melanoma and therefore require closer follow-up, as well as investigating more effective therapies to reduce the rate of metastasis and overall mortality.
- June 2015: Survey finds the public are confused by sunscreen labelling
A survey by The Royal Pharmaceutical Society (RPS) has found that the public is confused about the labelling of sun creams, calling for a standardised rating method by all manufacturers.
Professor Jayne Lawrence, Chief Scientist of the RPS, said: ‘This survey indicates that there is a huge amount of confusion around sunscreen labelling that is a barrier to effective sun protection. Clearly many consumers do not realise the SPF rating applies only to the amount of protection offered against UVB rays, not UVA rays – both of which can damage the skin and cause skin cancer.
‘People should not have to pick their way through complicated dual ratings information to understand how sunscreen works and the amount of protection it potentially provides. We think it’s time for sunscreen manufacturers to provide one easy to understand rating, based on a simple description of the total amount of sun protection offered: low, medium, high and very high protection.
‘People now have largely got the message that they must protect their skin from the sun using sunscreen, along with other precautions such as covering up and keeping out of the sun during the hottest part of the day. What the RPS is calling for now is one uniform measure for all sun protection products, so pharmacists can provide easy to understand advice on the effectiveness of products and how they should be used’.
Of the 2,000 UK adults who were surveyed only one in five was aware that the SPF rating relates to protection against UVB rays, rather than against UVA radiation. There is the possibility that overexposure to UVA or UVB radiation may lead to melanoma.
- January 2015: Review of smartphone melanoma apps recommends caution
- January 2015: Review of smartphone melanoma apps recommends caution
A recent study of smartphone applications (‘apps’) designed to be used by non-specialists in the detection or prevention of melanoma has urged users to be cautious. The review, published in the July 2015 edition of The British Journal of Dermatology, was the work of a team led by Dr Fiona Walter from the University of Cambridge’s Department of Public Health and Primary Care. It is the most comprehensive research finding of its type.
Dr Walter said: ‘Although smartphone apps are recognized as having potentially wide use in detecting melanoma, experts have expressed caution concerning their usefulness, accuracy and safety. We identified almost 40 apps available to detect or prevent melanoma by non-specialist users – patients and GPs.
‘Most apps gave advice or education about melanoma, ultraviolet radiation exposure preventive advice and skin self-examination strategies. Only half of them enabled patients to capture and store images of their skin lesions, either for review by a dermatologist or for self-monitoring to identify change – an important predictor of melanoma. A small minority (4) provided a risk assessment about a skin lesion.
‘In summary, there was little evidence of any evaluation of their usefulness or accuracy, so clinicians and patients alike should be cautious about using these apps to detect melanoma’.
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- January 2015: Melanoma Focus guidelines for uveal melanoma accredited by NICE
Melanoma Focus has announced that its recently-completed national guidelines for uveal (ocular) melanoma have been awarded formal accreditation by The National Institute for Health and Care Excellence (NICE).
Melanoma Focus has funded the project. The guidelines were developed over the past three years by the group of experts, aided by patient representatives. The result is a comprehensive set of recommendations, based on the best available scientific evidence. It is expected to enhance patient care and improve counselling and informed decision-making, while helping clinicians gain a better understanding of outcomes.
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- January 2015: Encouraging results announced for new immunotherapy drug pembrolizumab
A highly anticipated new immunotherapy from Merck & Co Inc proved effective in patients with advanced melanoma as well as some with lung cancer or head and neck cancer, according to early-stage studies presented on Monday… a Phase I study in 411 patients with melanoma that had spread to other parts of the body found that 69 percent were alive after a year of treatment. At 18 months, researchers estimated that overall survival was 62 percent, with some patients on the drug for more than two years. The findings were presented at the American Society of Clinical Oncology meeting in Chicago. (Reuters)
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- November 2013: Follow-up of high risk cutaneous melanoma cases: key paper released
Following the recent remarkable progress in improving the treatments available for those suffering from advanced melanoma, almost 50 of the UK’s leading melanoma clinicians have reached a consensus view on the how to follow up patients believed to be at a high risk of the disease recurring.
The report’s lead author, Dr James Larkin of The Royal Marsden, said: ‘Our findings represent a significant departure from the previous guidelines, which were published in 2010. They are intended as a framework for clinical teams treating patients with melanoma. But this is a dynamic field of medicine and we expect there to be some debate over these recommendations.’
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- October 2013: Sunbeds: an ASA Ruling
Incensed by the extraordinary claims in a sunbed salon’s advertising about the potential health benefits of tanning, John Rouse (an adviser to Melanoma Focus) entered battle. He anticipated having to use expert witnesses to counter the salon’s assertions but in the event the Advertising Standards Authority ruled they contravened the regulation that only products licensed for medicinal purposes may claim such benefits.
Follow this link to read John’s account in full.
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