From the founder and Co-Director of the renowned Columbia University Melanoma Center, the first comprehensive guide to help you prevent and survive a diagnosis of melanoma.

The fastest rising form of cancer worldwide, melanoma can strike at any age. Although rates of cure are higher than they used to be, experts often disagree about the best course of treatment and patients face a bewildering array of possibilities - often with precious little time to choose. Drawing on his years as one of the nation's foremost researchers and specialists in the field of melanoma treatment, Dr. Howard L. Kaufman shares his easy- to-follow, whole-life plan for detecting melanoma early, making informed decisions after a diagnosis, and taking an active role in treatment.

A forty-six-year-old man whose barber noticed a small black mole on his scalp during a regular haircut. An otherwise healthy eight-year-old girl, who came home from school one afternoon complaining of blurred vision. A thirty-two-year-old woman who had been suffering from garden-variety hemorrhoids for several months.

These three patients represent how cunning and varied a melanoma diagnosis can be. The locations it can emerge on the body and its lack of symptoms make it a challenging disease indeed to find and treat, as I know only too well. I've treated hundreds of patients for melanoma in the last fourteen years. In the years to come, I expect to see thousands more because the number of new melanoma patients worldwide is rising at a rate faster than that of any other cancer. Striking every age, gender, and socioeconomic group, melanoma is quickly becoming one of the most familiar cancers among the general population. Already melanoma has become the most common cancer among women aged twenty-five to twenty-nine. Among women aged thirty to thirty-four, it is second only to lung cancer (the leading cancer in both men and women).

That's why I decided to write this book. With such a dramatic rise in the incidence of melanoma, I felt it was more important than ever before to provide the many patients and families beyond the scope of my practice with a basic understanding of malignant melanoma, what it is, how it is diagnosed and treated, and where to go for appropriate care. As both a practicing physician and a clinical investigator, I'm in the unique position of being directly involved with cutting-edge treatment for this deadly disease. With early detection melanoma has a high rate of cure, but there is a great deal of controversy surrounding the treatment of the disease in its later stages. Despite a significant amount of research, the survival rate for patients with metastatic melanoma continues to be only 10-15 percent. And there is no consensus among experts as to the best course of action. Patients and their families faced with a melanoma diagnosis are understandably confused and afraid.

Given that melanoma often strikes previously healthy individuals in the prime of their lives, many find themselves ill prepared and poorly equipped for the medical and psychological journey on which they are forced to embark. Confronted with a melanoma diagnosis, a patient may be overwhelmed with questions:

• What is malignant melanoma?
• How is this disease different from other types of skin cancer?
• Why did I get this?
• What kind of doctor should I consult for this condition?
• How should I be treated?
• Can my disease be prevented or cured?

I hope to answer these questions and more in the following pages.

The proper care of malignant melanoma requires the cooperation of many different types of doctors with expertise in a wide variety of areas, including dermatology, surgery, oncology, radiation oncology, diagnostic radiology, and pathology. There are effective treatments for malignant melanoma when it is found at an early stage. It is essential to learn about malignant melanoma, because the more you know about it, the greater the chances of early detection. Then you can develop a logical treatment plan with experts in the management of this disease.

At the Melanoma Center of Columbia University Medical Center, we have established a multidisciplinary team approach to the diagnosis and treatment of malignant melanoma. This has been instrumental in providing the latest diagnostic techniques, surgical procedures, new treatments, and proper follow-up care for patients with malignant melanoma. Recent discoveries in molecular biology, genetics, and immunology are revolutionizing our approach to the malignant melanoma patient. By bringing together basic scientists, clinical practitioners, nursing specialists, and public-health experts, we are providing the most comprehensive care for our patients. Changes in biomedical research and clinical sciences are happening at a rapid pace, and it will be increasingly important for patients and physicians to obtain the most up-to-date information when making medical decisions.

I have based this book on the collective wisdom and work of the Columbia University Medical Center team. While I don't insist that our approach is applicable for all patients, my hope is that the information provided and the insight into our procedures and decision-making processes will help patients and their families understand what is happening and why. I offer you the same state-of-the-art research findings and treatment options from which my patients benefit at Columbia. No matter where you live, if melanoma strikes, you can use this book to understand the disease and begin the process of healing.

The book is divided into four main parts: prevention, diagnosis, treatment, and research. Part One explains melanoma and how it differs from other types of skin cancer. It also discusses the causes of melanoma and explains how melanoma may be prevented. In Part Two, I lead you step-by-step through the specific ways we diagnose and categorize, or stage, melanoma. Part Three is all about treating melanoma, from basic biopsy to experimental laser surgery, adjuvant therapy, and chemotherapy. No doubt many of you will want to turn directly to that section. I conclude with Part Four, which covers the most current research, including cytokine, vaccine, and genetic therapies as well as a thorough discussion of clinical trials.

My goal with this book is to help you organize key issues, understand the options, and make informed decisions about diagnostic and treatment procedures. Even when the disease is advanced, there are often dramatic responses, and occasionally even cures. By better understanding melanoma, you will learn how to live with the disease, and perhaps prevent it from occurring in your loved ones.

I hope that with the help of the information in this book, you and your loved ones never face a diagnosis of melanoma. But, if you do, here is all the information you need to cope with the diagnosis and increase the chances of survival.

Copyright © 2005 Howard L. Kaufman, M.D., FACS

Tags: Cancer

About the Author

Dr. Howard L. Kaufman is founder and Co-Director of the Columbia University Melanoma Center, attending physician at The New York Presbyterian-Columbia University Medical Center, chief of surgical oncology, and associate professor of surgery at Columbia University College of Physicians and Surgeons. He has conducted numerous clinical research trials on vaccines for cancer, lectures widely on cancer treatment and has published more than 100 articles in the field of tumor immunology and immunotherapy. He lives in New York City.