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Training Lay Partners May Help Identify Second Primary Melanomas

By Lisa Schulmeister, MN, RN, ACNS-BC, FAAN
More than 1 million people in the United States have been diagnosed with a melanoma and are at risk for developing a second primary melanoma. The risk is increased for up to 20 years post initial diagnosis and is 10 times greater than the risk of a first melanoma occurring among people in the general population. Among patients with genetic mutations, 12.7% develop a second primary melanoma within 2 years of the initial diagnosis, and 19.1% develop a second primary melanoma within 5 years. Prompt recognition of melanoma improves survival.

Researchers from Northwestern University Feinberg School of Medicine and Penn State University taught a structured skin self-examination (SSE) to patients with melanoma and their partners and subsequently measured frequency of SSE performance and detection of a new or recurrent melanoma by the dyad or physician. 

Dyads of 430 patients and their partners were randomly assigned to receive the skills training intervention (165 received the training in person, and another 165 received printed instructions) or usual care (100 were in the control group). Patients in the intervention arms had significantly increased SSEs with their partners at 4, 12, and 24 months compared with the control group.

Over a 2-year follow-up period, 66 of the patients developed melanoma. While 43 of those melanomas were detected by the patient–partner pairs in the skin self-examination training group, none were detected among the patient–partner pairs in the control group that received usual care. The researchers concluded that patients with melanoma and their partners can reliably perform SSE after completing a structured skills training program, which included initial instruction and reinforcement every 4 months from a dermatologist.
Reference Robinson JK, Wayne JD, Martini MC, et al. Early detection of new melanomas by patients with melanoma and their partners using a structured skin self-examination skills training intervention: a randomized clinical trial [published online ahead of print June 29, 2016]. JAMA Dermatol.
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