[인터뷰] Byung-ho Oh, professor at Severance Hospital, “Introduced a melanoma rapid treatment program”
input 2024.11.20 17:34
input 2024.11.20 17:34
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Oh Byeong-ho, professor of dermatology at Severance Hospital. [사진=세브란스 병원]“Early melanoma lesions are often overlooked because they have no special symptoms other than the presence of pigment like a mole. However, melanoma can be fatal because it can quickly metastasize through the blood or lymphatic system and grow in internal organs.”
Oh Byeong-ho, professor of dermatology at Severance Hospital, said, “Basal cell carcinoma, which accounts for the most common skin cancer, rarely metastasizes and can be easily cured through surgery, but melanoma can metastasize and the pattern of metastasis is difficult to predict, so early diagnosis and surgery must be performed quickly.” emphasized.
Skin cancer can be divided into basal cell carcinoma, squamous cell carcinoma, and malignant melanoma. The most common skin cancer is basal cell carcinoma. The incidence of basal cell carcinoma increased approximately eight-fold from 488 cases in 1999 to 3,908 cases in 2019. Fortunately, basal cell carcinoma and squamous cell carcinoma rarely metastasize to other areas, so they can be easily cured surgically.
However, melanoma spreads quickly to other organs and requires caution.
Professor Oh explained, “Melanoma can metastasize to internal organs,” and “even if it is an early lesion, cancer cells can migrate at the cell level and a mass may appear late in other areas (lymph nodes, internal organs).”
In particular, the thicker the melanoma, the higher the probability of metastasis. Generally, if the thickness is more than 0.8 to 1.0 mm, a sentinel lymph node biopsy is performed to determine whether to administer chemotherapy or radiation treatment. Even after surgical treatment, periodic follow-up is necessary, and additional anticancer drug treatment is required depending on the stage.
For this reason, Professor Oh explains that early diagnosis and prompt treatment are important for melanoma.
He said, “For melanoma, effective anti-cancer treatment methods have not yet been proposed for all patients. “This is why melanoma is the type of cancer that requires early diagnosis and surgical resection the most quickly.” “He said.
Unforeseen situations often occur, such as the melanoma on the foot being operated on without any problems, but then suddenly metastasizing in the brain. It is known that the metastasis and survival probability of melanoma varies depending on the thickness of the melanoma when first discovered.
As melanoma treatment requires rapid examination and treatment, Severance Hospital recently launched a melanoma rapid treatment program. Every Tuesday morning, only melanoma patients are treated to reduce waiting time for patients.
Professor Oh said, “Because the probability of melanoma metastasizing varies depending on the thickness, it is most important to measure the thickness quickly and accurately. To this end, surgical treatment to remove the entire lesion must be carried out as quickly as possible. “At Severance Hospital, this process begins within one week after the patient visits the hospital,” he said.
The standard surgical method for melanoma is wide resection according to thickness. Wide resection is a surgical method in which an additional 1 cm of circumference is removed along the border of the melanoma if the thickness is less than 2 mm, and if the thickness is more than 2 mm, 2 cm of surrounding normal skin is removed. The problem is that the recurrence rate after wide resection is high even though a wide area has been resected.
Severance Hospital is performing Moz Microscopic Surgery, which involves excising normal-looking skin around melanoma, observing it under a microscope, confirming that there is no residual cancer, and then restoring it. This is because Mohs microscopic surgery can lower the recurrence rate compared to wide resection.
As a result of analyzing 210 malignant melanoma patients operated on at Severance Hospital from 2005 to 2015, the recurrence rate of patients who underwent wide resection was 10.7%, while the recurrence rate of patients who underwent Mohs microscopic surgery was 3.7%. . Additionally, Mohs surgery has the advantage of minimizing skin defects by preserving normal skin as much as possible.
Severance Hospital also has a melanoma multidisciplinary system to begin treatment quickly.
First, for an accurate diagnosis, the pathology department performs special staining and measures the thickness. It may be difficult to differentiate if it is an early stage lesion or a partial resection of melanoma is performed. Recently, melanoma is differentiated through PRAME (Preferentially expressed Antigen in MElanoma) staining, which uses an antigen preferentially expressed in melanoma cells.
Depending on the diagnosis results, if the thickness exceeds 0.8 mm, a sentinel lymph node biopsy is performed to check whether cancer cells exist in the lymph nodes. Sentinel lymph node biopsy and lymph node dissection are performed professionally in the relevant department for each region.
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– What are the early warning signs of melanoma that individuals should look out for?
1. Can you explain the significance of early detection and prompt treatment for melanoma skin cancer?
2. What are the differences between basal cell carcinoma, squamous cell carcinoma, and malignant melanoma, and how are they diagnosed and treated?
3. What are the benefits of Mohs microscopic surgery for melanoma patients compared to wide resection?
4. How does the melanoma multidisciplinary system at Severance Hospital work to ensure accurate diagnosis and effective treatment?
5. What are some common misconceptions or challenges faced by patients with melanoma, and how can they be addressed?
