Therapy Analysis - Psoriasis and Skin Cancer
Skin Cancer
Skin cancer is arguably the most serious dermatological condition; the incidence of melanoma is estimated to have increased 4-fold over the past 25 years. Over 90% of cases are avoidable, as they are due to high lifetime levels of exposure or excessive exposure when aged 15 or younger. The British Photodermatology Group believes there is no such thing as a safe or healthy tan, as it is an indicator of damage and a protective response by the skin. Heated debates over the years have highlighted the association between sunbed use and risk of skin cancer, with evidence drawn from studies such as a UK study which estimated that 100 deaths per year are due to sunbed-associated melanoma. Furthermore, a review of a number of studies found a small but significant association between early exposure and melanoma risk.
The British Photodermatology Group believes there is no such thing as a safe or healthy tan..The most common form of skin cancer, basal cell carcinoma does not readily metastasise and so is rarely life-threatening. Cutaneous squamous cell carcinoma is the second most common form of skin cancer and also has a low mortality risk. Interestingly, rates vary according to skin colour and latitude. For example, incidence in white populations at high altitudes is negligible, while in tropical Australia it can reach 1 in 100. Due to associations with sun exposure, skin cancer frequently develops in obvious and difficult-to-disguise sites, especially limbs, the face, ears and scalp. Again, this can impact on social interactions, especially in cases of severe disfigurement. For melanoma, the third most common type, the disfigurement issues are compounded by the fact it comprises more than 75% of all skin cancer deaths.
Basal and cutaneous squamous cell carcinoma is generally tackled surgically or with cryotherapy, radiotherapy or by administrating chemotherapeutics such as imiqimod, which is an immune stimulant that has been used off-label with mixed success in squamous cell carcinoma patients who are intolerant to surgery. It was recently approved in the US for superficial basal cell carcinoma. Also registered in the US, 5-fluorouracil (5-FU) for the treatment of small and superficial basal cell carcinomas is an option; however, it too has had mixed success. Generally, chemotherapy for treating skin cancer patients with multiple lesions and for poor surgical candidates is topically adminstered, with the drawback that this may result in a longer duration of treatment.
Melanoma can be confronted by several chemotherapeutics, either alone, in combinations, or with immunotherapeutics. Dacarbazine is the most commonly used anticancer drug, and a combination of this with carmustine, cisplatin, and tamoxifen is becoming increasingly widespread. Alternatives include vindesine, vincristine, vinblastine, bleomycin, and temazolamide. To date, the therapeutic response to these has been limited, but a great deal of research into alternatives is ongoing. Our data reveals 65 drugs currently in active development for melanoma, of which only 5 are at or approaching market launch. However, there are no compounds currently reported to be in development for squamous cell carcinoma, and only one drug in Phase II trials for basal cell carcinoma.
