Melanoma

What you do, what you eat, and how you handle stress impact your overall state of well-being.

Melanoma is a deadly form of skin cancer that accounts for only 2 to 4% of all skin cancer cases, yet 79% of all skin cancer related deaths.

In 2011, there were an estimated 960,231 people living with melanoma of the skin in the United States.[1]

Despite its deadly nature, when melanoma is diagnosed early it is considered very survivable.  According to the data from SEER 18 (2004-2010), 91.3% of early diagnosed melanoma cases survive without recurrence at the 5 year mark.[2]

The incidence for melanoma is currently increasing at a rate of 3% per year, the fastest of any cancer.[3]

Although the incidence of melanoma is highest among older adults, it can occur in any age group. For example, it is the most common cancer among women age 20-30.

HEALTHY DIET
Consume a vegetable rich, Mediterranean-style diet, emphasizing whole foods, cruciferous vegetables (broccoli, cauliflower, kale, brussel sprouts, etc.) and foods high in beta-carotene, such as pumpkin, tomato, melon, kale, broccoli, mango, grapefruit, papaya, guava, carrots, spinach, peppers and squash.

Causes/Contributing Factors

A number of risk factors are known to be associated with melanoma, primarily based on genetics (such as skin tone, eye color and hair color), level of sunburn and tanning, and genetic risk factors.

Among the most well-established risk factors include:

  1. A history of melanoma in the family, particularly a first degree relative.  10% of people with melanoma have a family history of the cancer[4]
  2. Having fair skinned complexions – this includes freckles, skin that burns easily, green or blue eyes, or red or blonde hair
  3. Having a history of sunburns (especially blistering sunburns in childhood) and long term exposure to tanning

Other known risk factors include:

  1. Exposure to radiation, solvents, vinyl chloride and PCBs
  2. Smoking
  3. Having a family history of unusual moles (atypical nevus syndrome).[5]
ENVIRONMENT MATTERS
Do not over tan or sunburn.[6] Even tanning without risk of sunburn contributes to the risk of developing melanoma.

Relevant Diagnostic Testing

Physical Exam Melanomas can occur in sun exposed skin, as well as areas not normally exposed to the sun, such as the abdomen, soles of the feet and genital areas. Despite a fair complexion and white genetic profile there is one type of melanoma that is found more frequently in African Americans and Asians, which occurs on the palms of the hands, soles of the feet and nailbeds, called Acral lentiginous melanoma.

Biopsy A procedure to remove the abnormal tissue and a small amount of normal tissue around it. A pathologist will examine the biopsied tissue microscopically. Patients may want to have the sample of tissue checked by a second pathologist. If the abnormal mole or lesion is malignant, the sample of tissue may also be tested for certain gene changes.

Cancer staging and classification Staging is the process of finding out how much cancer there is in a person’s body and where it’s located. Melanoma stages are assigned based on the size or thickness of the tumor, whether or not it has spread to the lymph nodes or other organs, and certain other characteristics, such as growth rate. Physical exams, imaging procedures, laboratory tests, pathology reports, and surgical reports provide information to determine the stage of a cancer. Very thin melanomas (<.75 mm in thickness), are associated with very high cure rates from surgery alone, so early diagnosis is very valuable.

Genetic Evaluation Genetic evaluation may be recommended, as a number of genetic mutations have been associated with prognosis (outlook) and help to predict how beneficial different treatments may be.[7]

WATCH YOUR WEIGHT
Avoid obesity. High fat diets and obesity combined increase risk for melanoma.[8][9]

Dietary Action Plan

Emphasize:

  1. Foods high in beta-carotene, which can then convert to retinol, such as pumpkin, tomato, melon, kale, broccoli, mango, grapefruit, papaya, guava, carrots, spinach, peppers and squash.
  2. Cruciferous vegetables, such as broccoli, cauliflower, cabbage, etc.
  3. Whole foods (foods that are as close to their natural form as possible)
  4. Low sugar/low glycemic diet (Glycemic index (GI) and glycemic load (GL) are measures of the effect on blood glucose level after a food containing carbohydrates is consumed)
  5. Omega-3 fatty acids, found in cold water fish such as sardines, wild-caught salmon, cod, mackerel, tuna
  6. High fiber, from whole grains, beans, vegetables and fruits
  7. Healthy fats, from avocados, nuts, seeds, olive oil, coconut oil, cold water fish
  8. For animal protein, choose lean poultry and fish over red meat, and aim to view meat as a condiment rather than a staple. Try to choose grass fed and organic meats and eggs whenever possible. Eat no fish larger than a salmon to minimize environmental contaminants, including mercury.

Avoid:

  1. Processed and grilled meats. Also, try to limit intake of red meat
  2. Fast foods, fried foods, baked goods and packaged, processed foods
  3. Sugar, sweeteners  and artificial sweeteners
  4. Vegetable oils, shortening, margarine and anything with hydrogenated or partially hydrogenated oils
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Melanoma Supplement Program

Multiple nutritional supplements have been associated with reduced cancer incidence and/or cancer progression. The list below contains those with the greatest evidence-base and benefit, though it is not necessary that they all be included.

Supplement Info

 

Includes:

  • Astragalus
  • Green Tea
  • Coptis
  • Berberine
  • Resveratrol
  • Maitake Mushroom
  • Retinol
  • Chaga
  • Vitamin D3
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[1] http://seer.cancer.gov/statfacts/html/melan.html

[2] Acral Lentiginous Melanoma – Misdiagnosis, referral delay and 5 years specific survival according to site.Boriani F, O’Leary F, Tohill M, Orlando A.Eur Rev Med Pharmacol Sci. 2014 Jul;18(14):1990-6.

[3] Howlader N, Noone AM, Krapcho M, et al. SEER Cancer Statistics Review, 1975-2009 (Vintage 2009 Populations). Bethesda, MD: National Cancer Institute; 〈http://seercancergov/csr/1975_2009_pops09/〉.

[4] Olsen CM, Carroll HJ, Whiteman DC. Familial melanoma: a meta-analysis and estimates of attributable fraction. Cancer Epidemiol Biomarkers Prev. 2010 Jan;19(1):65-73. doi: 10.1158/1055-9965.EPI-09-0928.

[5] Usher-Smith JA, Emery J, Kassianos AP, Walter FM. Risk Prediction Models for Melanoma: A Systematic Review. Cancer Epidemiol Biomarkers Prev. 2014 Jun 3.

[6] Vogel RI, Ahmed RL, Nelson HH, Berwick M, Weinstock MA, Lazovich D. Exposure to indoor tanning without burning and melanoma risk by sunburn history. J Natl Cancer Inst. 2014 Jul 16;106(7).

[7] Kosiniak-Kamysz A, Marczakiewicz-Lustig A, Marcińska M, Skowron M, Wojas-Pelc  A, Pośpiech E, Branicki W. Increased risk of developing cutaneous malignant melanoma is associated with variation in pigmentation genes and VDR, and may involve epistatic effects. Melanoma Res. 2014 Aug;24(4):388-96.

[8] Jung JI, Cho HJ, Jung YJ, Kwon SH, Her S, Choi SS, Shin SH, Lee KW, Park JH. High-fat diet-induced obesity increases lymphangiogenesis and lymph node metastasis in the B16F10 melanoma allograft model: Roles of adipocytes and M2-macrophages. Int J Cancer. 2014 May 20.

[9] Skowron F, Bérard F, Balme B, Maucort-Boulch D. Role of obesity on the thickness of primary cutaneous melanoma. J Eur Acad Dermatol Venereol. 2014 Apr 21.

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