Professor Georgina Long
A national targeted screening program for melanoma is one of 25 recommendations which could help achieve the stretch goal of zero deaths from melanoma by 2030, according to Australian experts.
The State of the Nation report into melanoma is co-authored by Professor Georgina Long, Chair of Melanoma Medical Oncology and Translational Research at Melanoma Institute Australia and Royal North Shore Hospital, and includes contributions from oncology clinicians, surgeons, dermatologists, researchers and advocates.
It notes that while much has been achieved in Australia in melanoma, there is still potential to reduce disease and deaths substantially. The report says early detection of melanoma is associated with high survival rates, and new developments in precision medicine now offer the potential for substantial improvements in long term survival and symptom relief for patients with advanced melanomas.
“Five-year survival rates for patients with advanced metastatic disease have nearly doubled in the last 10 years, and Australia boasts world leading survival outcomes. Data show that addressing variation in treatment across Australia today could reduce mortality by more than a third,” it notes.
“With urgent and continued action, zero deaths is considered possible within our lifetime; but this requires urgent and sustained action.”
For early detection, minimum standards for diagnosis of melanoma are necessary, along with consistent use of whole-body examinations and dermoscopy, supported by investment in GP and dermoscopy training program are also recommended.
The authors said support for clinicians to adhere to guidelines, a Patient Navigation Service, a clinical care standard and written treatment and care plans would help reduce the variation observed in melanoma diagnosis and treatment.
Other interventions might include improving patient access to clinical trials and addressing high out of pocket costs for melanoma treatment.
“We know that the consistent application of clinical care standards will reduce mortality by 32%,” co-author Professor Richard Scolyer from the Melanoma Institute Australia said.
The 200+ page report also recommended a modernised prevention and awareness strategy along with investment in shade in high-risk public spaces, and a stronger approach to sun-safety in schools, sport and workplaces which could reduce the incidence of melanoma by 45%.
The independent report, commissioned by Melanoma Institute Australia and Melanoma Patients Australia, was informed by consultations across clinical experts, researchers, policy makers, patients and carers.
Victoria Beedle, CEO of Melanoma Patients Australia, said at the launch that by 2030, the number of melanoma survivors in Australia would increase by 83%.
The report called for more supportive care from diagnosis for people with melanoma and improved care through an enhanced network of melanoma nurses.
It also acknowledged that while targeted and immunotherapies had led to marked improvements in long term survival, they came with significant side effects.
Pain, fatigue, anxiety and depression, skin rashes and irritation, and lymphoedema were commonly reported by patients with Stage III and IV melanoma.
The report said there was inconsistent screening for supportive care and lack of a structured model for melanoma survivorship.
State of the Nation: A Report into Melanoma – A National Health Priority was officially launched last week by the Federal Minister for Health Mr Greg Hunt.
The report was partly funded by Bristol Myers Squibb, MSD and Novartis