Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
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ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
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Advances in Clinical and Experimental Medicine

2006, vol. 15, nr 6, November-December, p. 1099–1105

Publication type: review article

Language: English

Is Cutaneous Malignant Melanoma Preventable?

Czy można zapobiegać czerniakowi złośliwemu?

Piotr Drozdowski1,, Rafał Matkowski1,2,, Bartłomiej Szynglarewicz2,, Jan Kornafel1,

1 Department of Oncology, Silesian Piasts University of Medicine in Wrocław, Poland

2 Second Department of Oncological Surgery, Lower Silesian Oncology Center, Wrocław, Poland

Abstract

It is forecasted that cutaneous malignant melanoma (CMM) will become one of the most dangerous tumors of the 21st century. Results of treatment of CMM in Poland are very poor compared with highly developed countries. Clinical outcome is strongly influenced by the stage of the disease. The aim of this study was to discuss current data concerning CMM primary and secondary prophylaxis. This is a systematic review of published reports on the primary and secondary prophylaxis of cutaneous malignant melanoma. The search for available literature was performed in the PubMed National Library of Medicine database. The most effective method of reducing morbidity and mortality of CMM is prophylaxis. Primary prophylaxis consists of minimizing UV radiation exposure, achieved by reducing exposure to the sun, wearing proper clothing and sunglasses, following sun−protective behaviors, using sunscreen, and avoiding sunlamps and tanning beds. However, it is unclear whether using sunscreen reduces the incidence of melanoma. Secondary prophylaxis against melanoma consists of regular self and clinical examination of the skin in order to diagnose tumors at an early stage and to identify individuals at increased risk of developing melanoma. Health education, including the dissemination of knowledge on protection from harmful solar exposure and awareness of the early symptoms and signs of skin malignancies, may help improve prognosis. Many countries are trying to introduce skin cancer prevention programs. The efficacy of primary and secondary prophylaxis has been proven by decreases in the mortality rates in the USA and Australia, where prophylaxis and educational programs are well developed.

Streszczenie

Szacuje się, że czerniak skóry będzie jednym z groźniejszych nowotworów XXI wieku. Wyniki jego leczenia w Polsce są bardzo złe w porównaniu z krajami wysoko rozwiniętymi. Skuteczność terapii jest ściśle związana ze stadium choroby w chwili rozpoznania i rozpoczęcia leczenia. Celem pracy było omówienie aktualnych danych dotyczących pierwotnej i wtórnej profilaktyki czerniaka skóry na podstawie bazy danych PubMed National Library of Medicine. Najskuteczniejszą metodą zmniejszenia zachorowalności oraz śmiertelności z powodu czerniaka skóry jest profilaktyka. Profilaktyka pierwotna obejmuje ograniczenie narażenia na promieniowanie UV przez: zmniejszenie ekspozycji na światło słoneczne, noszenie odpowiedniej odzieży oraz okularów ochronnych, unikanie sztucznych źródeł promieniowania ultrafioletowego (np. solarium), stosowanie kremów z filtrem ultrafioletu (dotychczas nie potwierdzono jednoznacznie, czy używanie kremów z filtrem zmniejsza ryzyko wystąpienia czerniaka). Wtórna profilaktyka obejmuje: regularne badanie kliniczne, samobadanie skóry mające na celu wykrycie nowotworu we wczesnym stadium, a także wyodrębnienie grupy pacjentów podwyższonego ryzyka zachorowania. Edukacja zdrowotna pacjentów dotycząca sposobów ochrony przed szkodliwym działaniem promieniowania UV oraz rozpoznawania wczesnych objawów nowotworów złośliwych skóry może przyczynić się do poprawy rokowania. W wielu państwach wprowadza się programy profilaktyki nowotworów skóry. W krajach, które mają dobrze rozwinięte programy profilaktyki nowotworów skóry oraz prowadzą edukację zdrowotną pacjentów (Australia i Stany Zjednoczone Ameryki Północnej) śmiertelność zmniejszyła się dzięki skutecznej pierwotnej i wtórnej profilaktyce.

Key words

malignant melanoma, primary prevention, secondary prevention

Słowa kluczowe

czerniak skóry, profilaktyka pierwotna, profilaktyka wtórna

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