Helping Melanoma Survivors Engage in Skin Self-Exam and Sun Protection Behaviors through a Web-based Tool
New Brunswick, N.J. – Even though melanoma patients are at an increased risk of disease recurrence and the development of a second, unrelated melanoma, research from Rutgers Cancer Institute of New Jersey shows that many patients do not perform a regular, thorough self-exam of their skin or sufficiently engage in sun protection behaviors as recommended by their doctor. In order to address these concerns, Cancer Institute of New Jersey behavioral scientist Elliot J. Coups, PhD, will explore developing a behavioral intervention for this group. A recently-awarded $2.5 million grant from the National Cancer Institute will support the work, which will focus on the creation and testing of a web-based tool.
According to the American Cancer Society, nearly 77,000 cases of melanoma—the deadliest of skin cancers—were reported last year in the United States with 9,400 deaths from the disease. Studies show that rates of disease recurrence for patients with localized or regional melanoma range from three to 24 percent and up to 51 percent for those with advanced disease that has spread. Between four and 11 percent of melanoma patients will be diagnosed with one or more new melanomas that are unrelated to their initial melanoma. Research shows that half of all recurrences and new melanomas are found by patients themselves, but only 12 percent of patients report doing thorough surveillance of their skin in which they examine all body parts on a regular basis. The aim of this work is to develop a behavioral intervention that will help patients to conduct a regular, thorough exam of their skin, and also promote engagement in sun protection behaviors.
A preliminary study conducted by Dr. Coups and colleagues in 2012-2013 showed that one of the reasons why melanoma patients don’t perform regular skin assessments is because they don’t know what to look for. “Because melanoma can be detected on the skin, a visual, web-based approach to educating melanoma survivors about disease surveillance strategies is ideal,” notes Coups, who is also an associate professor of medicine at Rutgers Robert Wood Johnson Medical School. “And with 85 percent of American adults using the Internet, a web-based tool can make for an effective intervention.”
The proposed web intervention will be designed to have the look and feel of an “app” that might be used on a tablet or smartphone. It will be tailored toward the individual needs of the patient based on such demographics as gender, race, ethnicity, and age. It will feature general information on melanoma and follow-up care, as well as reminders for regular skin examinations, and a section describing sun-safe behaviors, such as covering up, wearing sunscreen and hats and limiting time outdoors. Interactive elements such as quizzes and questionnaires will be included, as well as the ability to create an online body mole map. Users also will learn how to identify suspicious moles through pictures and photographs of their own moles. Patients will be advised to visit their doctor for a full check-up if they identify a suspicious mark on their skin while doing a self-exam.
Following a usability assessment of the web-based tool, 420 melanoma survivors who are three-to-24 months post-surgical treatment will be sought to take part in the 12-month intervention to see how effective it is. The information gained from this project will help further refine the intervention for a larger-scale evaluation trial.
“Even though melanoma survivors may receive detailed instruction from their healthcare team about how and when to perform a self-exam of the skin, additional education is often needed,” notes Coups. “By providing these survivors a resource that is interactive, convenient and tailored to their individual needs, we can help them feel more confident about checking their skin on a regular basis.”
The grant (R01CA171666) will support the work through 2019.
About Rutgers Cancer Institute of New Jersey
Rutgers Cancer Institute of New Jersey (www.cinj.org) is the state’s first and only National Cancer Institute-designated Comprehensive Cancer Center. As part of Rutgers, The State University of New Jersey, the Cancer Institute of New Jersey is dedicated to improving the detection, treatment and care of patients with cancer, and to serving as an education resource for cancer prevention. Physician-scientists at the Cancer Institute engage in translational research, transforming their laboratory discoveries into clinical practice, quite literally bringing research to life. To make a tax-deductible gift to support the Cancer Institute of New Jersey, call 732-235-8614 or visit www.cinj.org/giving. Follow us on Facebook at www.facebook.com/TheCINJ.
The Cancer Institute of New Jersey Network is comprised of hospitals throughout the state and provides the highest quality cancer care and rapid dissemination of important discoveries into the community. Flagship Hospital: Robert Wood Johnson University Hospital. System Partner: Meridian Health (Jersey Shore University Medical Center, Ocean Medical Center, Riverview Medical Center, Southern Ocean Medical Center, and Bayshore Community Hospital). Major Clinical Research Affiliate Hospitals: Carol G. Simon Cancer Center at Morristown Medical Center, Carol G. Simon Cancer Center at Overlook Medical Center, and Cooper University Hospital. Affiliate Hospitals: JFK Medical Center, Robert Wood Johnson University Hospital Hamilton (CINJ Hamilton), Shore Medical Center, Somerset Medical Center, The University Hospital and University Medical Center of Princeton at Plainsboro.