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Zalaudek I.,Medical University of Graz | Whiteman D.,Queensland Institute of Medical Research | Rosendahl C.,University of Queensland | Menzies S.W.,Sydney Melanoma Diagnostic Center | And 3 more authors.
Expert Review of Anticancer Therapy

In this article, we will summarize some of the highlights of the third annual conference on skin cancer, with special emphasis on the the recent advances regarding melanoma and non-melanoma skin cancer epidemiology, diagnosis and treatment. Topics were particularly addressed to a newly developing medical branch in Australia, namely that of Primary Care Skin Cancer Practitioners, and focused on strategies to improve primary and secondary prevention and early detection of melanoma and non-melanoma skin cancer using dermoscopy. Controversies related to skin cancer screening programs and recent progresses for treating advanced melanoma were additionally discussed. Yet, besides its scientific goals, the conference aimed also to encourage research originating in primary care and relevant to primary care. © 2011 Expert Reviews Ltd. Source

Menzies S.W.,Sydney Melanoma Diagnostic Center | Menzies S.W.,University of Sydney
Dermatologic Clinics

Dermoscopy has been shown in meta-analyses to improve the diagnostic accuracy of melanoma unequivocally compared with naked eye examination and to reduce excision rates of benign melanocytic lesions in clinical trials. Sequential digital dermoscopy imaging (SDDI) allows the detection of dermoscopic featureless melanoma. When used in high-risk individuals or on individual suspicious melanocytic lesions, it has a gross impact for detecting melanoma in clinical practice, with a range of 34% to 61% of melanomas detected exclusively using SDDI in these patients. Furthermore, SDDI has been shown to reduce the excision of benign lesions when used in combination with dermoscopy. © 2013 Elsevier Inc. Source

Guitera P.,Melanoma Institute Australia | Guitera P.,University of Sydney | Menzies S.W.,University of Sydney | Menzies S.W.,Sydney Melanoma Diagnostic Center
Expert Review of Anticancer Therapy

In the past few decades, rapid improvements in noninvasive optical technologies have revolutionized the diagnosis of early-stage melanoma. Current knowledge and limitations of these tools will be reviewed in this article. Dermoscopy has been recognized as the 'â€̃gold standard' in the screening phase. Digital dermoscopy monitoring and total-body photography are used to identify so-called 'â€̃featureless' melanoma only on the criteria of change over time. Automated instruments, as well as optical and nonmorphological methods, are still under development, and offer many opportunities to improve the speed and accuracy of the diagnosis of melanoma and/or to reduce the need for expertise. Despite a penetration depth limited to the upper dermis, the quasi-histological imaging achieved by in vivo reflectance confocal microscopy has been demonstrated to significantly aid diagnostic accuracy for selected melanocytic lesions. Future perspectives on diagnostic instrumentation will also be explored. © 2011 Expert Reviews Ltd. Source

McLoone J.,University of New South Wales | Menzies S.,Sydney Melanoma Diagnostic Center | Menzies S.,University of Sydney | Meiser B.,Psychosocial Research Group | And 3 more authors.

Objective To systematically review psycho-educational interventions developed for melanoma survivors. Methods Electronic databases Medline, PsycINFO, Embase, and CINAHL were systematically searched using key words and subject headings for articles describing educational or psychological interventions designed specifically for people affected by melanoma. Results Twenty-seven articles, generated by 16 unique interventions, were included for detailed review. Overall, educational interventions showed increased patient satisfaction with clinical care and information provision, as well as increased frequency of skin self-examination, although accuracy and thoroughness of skin examination were seldom reported. Participation in psychological interventions was associated with decreases in anxiety, health-related distress, and melanoma recurrence rates, as well as positive changes in coping with illness. Programs, when implemented as part of routine clinical care, were found to be cost-effective. Conclusions Interventions in this field vary widely, limiting the identification of 'active ingredients' for psychological or behavioral change. Future intervention studies should ensure sufficient information is provided to support program replication and comprehensive assessment of program outcomes. Copyright © 2012 John Wiley & Sons, Ltd. Copyright © 2012 John Wiley & Sons, Ltd. Source

McLoone J.K.,University of New South Wales | Watts K.J.,Psychosocial Research Group | Watts K.J.,University of New South Wales | Menzies S.W.,Sydney Melanoma Diagnostic Center | And 5 more authors.

Background Providing ongoing clinical care that adequately addresses patients' medical, psychosocial and information needs is challenging, particularly for patient groups at increased risk of developing life-threatening disease such as malignant melanoma. This study examined a model of clinical care developed by the High Risk Clinic (HRC) of the Sydney Melanoma Diagnostic Centre in relation to patient satisfaction. Methods Semi-structured telephone interviews were conducted and analyzed using the framework of Miles and Huberman, and themes were organized using the qualitative software package, QSR NVivo8. Results Twenty HRC patients participated in the study (nine men, 11 women; mean age 57.6 years, age range 34-74 years; response rate 91%). Satisfaction with clinical care at the HRC was high. Factors contributing to patient satisfaction included: rapid and regular access to physicians who were perceived by participants as experts, the development of confidence and trust in one's treating doctor, and a sense of being cared about and understood by one's healthcare team. Although one-third of the participants reported some inconveniences in attending the clinic, these were viewed as minor difficulties and not significant barriers to care. Formal psychological support was not sought or expected by participants, although many expressed long-standing melanoma-related fears and concerns. Conclusions Accessible, expert medical attention, delivered in a patient-centered manner was integral to melanoma survivors' satisfaction with clinical management. Appropriate referrals to psychological support may further increase satisfaction with clinical care. Copyright © 2013 John Wiley & Sons, Ltd. Copyright © 2013 John Wiley & Sons, Ltd. Source

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